The VBAC Link

After having an HSG (hysterosalpingogram) due to infertility, Wyn was diagnosed with having a left-sided unicornuate uterus. A unicornuate uterus is a rare condition in which the uterus is smaller than normal and only has one fallopian tube. Common complications from a unicornuate uterus include infertility, IUGR (intrauterine growth restriction), and preterm labor. 

Wyn had two unsuccessful IVF treatments followed by two miraculous natural pregnancies! Her first pregnancy ended in an unexpected Cesarean due to a fever and tachycardia in her baby. Her placenta was difficult to remove during the surgery and she was told she had placenta accreta. The OB who performed her surgery also said she had “very interesting reproductive anatomy”.

Wyn deeply longed for the opportunity to try for a VBAC and experience physiological birth. Her original midwife supported her decision to VBAC and Wyn made sure to prepare physically and emotionally. At 41 weeks and 1 day, she went into spontaneous labor, declined cervical checks and other interventions she wasn’t comfortable with, consented to the things she felt good about, and pushed her baby out soon after arriving at the hospital. 

Wyn also shares her experience with taking Needed products during her pregnancy and postpartum period this time around. Her strongest advice for other women preparing for VBAC is to find a supportive team and really listen to what your intuition is telling you to do. 

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, everybody. Welcome to the show. We have our friend, Wyn, from Alaska with us today. She’s going to be sharing her VBAC story and Wyn has a pretty unique– and maybe Wyn, you can tell me more. Maybe it’s not as unique as it feels but a pretty unique situation where you had a diagnosis of a unicornuate uterus. Tell us a little bit more about that. I feel like we hear some uterine abnormalities. I’m quoting it where it’s bicornuate and all of these different things and people say, “Oh, you can’t have a vaginal delivery with this type of uterus or this shape of uterus,” but tell us more about what it means for you and what it meant for you back then. 

Wyn: Yeah, so they found it through an HSG test where they shoot dye up through your uterus and through your fallopian tubes. Basically, just one-half of my uterus formed. I guess when the uterus is forming, it’s two tubes that connect and open up so just the one half formed so I have a left-sided with a left fallopian tube. I have both ovaries so you can still conceive but there are less chances because you have just one side. 

Then once you get pregnant, there are higher chances of miscarriages because the blood flow is less. Intrauterine growth restriction and preterm labor are common and then a lot of time, the breech position is common as well. 

Meagan: With this one, you did experience IVF as well, right? 

Wyn: Yep. 

Meagan: Yeah, we’ll have to hear more about that too because there are a lot of people who are getting pregnant via IVF which is amazing but there are some things that come with IVF as well. So we want to talk a little bit more about that before we get too deep into things. I do want to do a Review of the Week, then we’ll let Wyn start sharing away. 

This review is from I think it’s Amir, I think. It says, “This podcast was my constant source of reassurance and inspiring stories throughout my last two pregnancies. I achieved my VBAC in 2021 and was so empowered with so much knowledge and mental strength going into this birth because of The VBAC Link. I had my second section in 2022 which was not what I wished for but I do plan on having more children and know that VBA2C (vaginal birth after two Cesareans) is a possibility for me because of this podcast. I continue to listen to your inspiring stories each time I hop in the car and I’m so grateful for all that you share. I hope to share my own redeeming story with you in time too.” 

Well, Amir, thank you so much for your review. I also wanted to mention that for Amir, not only does VBAC after two Cesareans apply, but there are even risks that are lower because she has had a vaginal birth. So if you have had a vaginal birth and then you want to go on to VBAC, your chances are even higher for a VBAC and lower for things like uterine rupture. I wanted to throw that tip out there. 

But if you have not left us a review yet, please do so. We love them so much. You can leave it on Google or wherever you listen to your podcasts or you can even email them. 

Okay, Wyn. Let’s get going into this story. 

Wyn: Okay, thank you. Thank you for having me. I feel like it’s come full circle. I listened to The VBAC Link Podcast a lot throughout my pregnancy and even before that and I still do today. So I hope that maybe a little detail from my story resonates with somebody and helps them as well. 

Meagan: 100%. 

Wyn: Yeah. A little back story, before I got pregnant, we did try for a while and my cycles were regular. I was healthy. I didn’t see anything wrong but we went in and got the test done with bloodwork and they suggested the HSG test. I saw my original OB then I had a second opinion with another one. Both said it was still possible but that IVF was probably going to be more likely. 

And of course, this is all happening in February and March of 2020. 

Meagan: Right as the world is in chaos. 

Wyn: Yeah, so I started researching IVF options. We live in Alaska so there isn’t a reproductive endocrinologist here and I found a clinic. Our closest option was Seattle or Portland. I found a clinic in Portland that was willing to work with us. 

In August 2020, I went down for my first transfer or egg retrieval and transfer. That was a chemical pregnancy or early miscarriage. But also, that was the closest I had ever been to being pregnant. It was a little bit hopeful at the same time. 

We regrouped and went down in October and had another transfer that didn’t take at all. We decided to take the rest of the year off and revisit it after the beginning of the year. 

That brings me to my first pregnancy which was a little miracle and I got pregnant the cycle after my failed transfer naturally without IVF. 

Meagan: Yay!

Wyn: That was very exciting. I was a little bit in shock like, How can this happen? Because it had been a couple of years of trying. I went back to the second OB who I had a second opinion from. We didn’t really vibe very well. I went in early at 6 weeks because I was nervous and she was like, “Why are you here so early?” 

So I didn’t end up rebooking with her but I rebooked with a midwife who some of my friends had seen during their pregnancies and explained my situation and she got me in that week. We did an ultrasound and saw a little heartbeat. It was going well. She had me come in the next week too to just make sure things were progressing and everything was good. 

Meagan: Yay. So it was IVF treatment, IVF treatment, and spontaneous?

Wyn: Yep. 

Meagan: Yay, that’s awesome. 

Wyn: It was pretty exciting and just gave me some renewed faith in my body too that maybe it could do it. 

Meagan: Yeah. 

Wyn: So pregnancy went smoothly. I felt great. I loved being pregnant and I was measuring small consistently from about 30 weeks on about 2-4 weeks behind. I wasn’t really worried about it because I figured I had a small uterus but they suggested a growth scan. I went ahead and did that and baby was all fine. She was small and we didn’t know it was a she. We didn’t find out but then my husband and I did some birth prep. 

We watched The Business of Being Born and that solidified my desire for a non-medicated birth. I was okay being in the hospital because there were unknowns with the uterus and I just wanted to experience it all. I wanted to experience everything without medication. I have a low tolerance to medication so I didn’t want anything to derail the birth. 

I made it to 40 weeks. I made it to my due date because it’s common that you go into preterm labor with a unicornuate uterus but I made it to my due date so that was exciting. I was feeling anxious to meet my baby but I was feeling good. 

I was just listening to whatever the midwife told me or suggested because I was a little bit nervous so she offered a membrane sweep and I thought, Okay, I’ll go ahead and do that. It’s not medicated. But still, it was an intervention that I learned later. 

Then we did a non-stress test at 40.5 weeks and she started suggesting induction. I went into my 41-week appointment and I still didn’t want to do any medication but she offered the Foley bulb which he offered to put in there at the office and I would just come back the next day if it didn’t come out or if it started things then it started labor. 

Meagan: Then great, yeah. 

Wyn: Yeah. She went to put it in and my water broke. 

Meagan: Oh, change of plans. 

Wyn: Yep. Yeah. It was just a trickle. It wasn’t huge. She sent us home and told us to rest and to come back in the next morning. Come in if labor progressed or come in the next morning to start more induction since my water was broken. 

I went home and relaxed. I woke up about 2:00 in the morning to my water fully breaking everywhere and contractions started pretty instantly. I had adrenaline and I didn’t ease into it. They were 5-6 minutes apart, full-on contractions. Within a couple of hours, they were closer like 3-4 minutes so we went ahead and went to the hospital. There was a lot of rushing around and a lot of nurses coming in and out. 

I was in my own little world. I was stuck on the bed because they wanted to have the fetal monitor on. I was holding on for the non-medicated. I declined the IV because I thought that would be that much easier. 

Meagan: Easier access, mhmm. 

Wyn: But I had spiked a temperature from my water breaking. I couldn’t keep any Tylenol down so we went ahead and did the IV which took over an hour to get in because I have bad veins and lots of people tried and they eventually got an ultrasound to find a vein. 

Meagan: I was going to say for anyone who may have harder veins or situations like that, you can ask for the head anesthesiologist if there are multiple and for an actual ultrasound and it can really help them and get that in a lot faster. 

Wyn: I wish they had started that sooner. I was just being poked. 

Meagan: Lots of pokes, mhmm. 

Wyn: Yeah, and trying to labor through at the same time. 

They got that in. It didn’t really calm down. The baby’s heart rate was elevated to 170-180. It wasn’t really slowing down at all. Our midwife seemed a bit concerned and started suggesting a C-section. Yeah, just laying there, I was ready to give up. I didn’t want to, but she checked me and I was only 5 centimeters so I wasn’t even close to getting there.

They prepped me for surgery. I went in and baby girl was born in the morning at 8:50. Of course, they took her straight away to the warmer then I didn’t get to hold her until the recovery room. I was still shaking from medication. 

Basically, the birth was completely the opposite of what we had hoped for. 

Meagan: What you had planned, yeah. 

Wyn: Then later, the OB who did the surgery came in and told me that I have very interesting reproductive anatomy. He confirmed it was a left-sided unicornuate uterus. There was a small horn on the right side and my uterus, I guess, was really stretched out and almost see-through. 

Meagan: A uterine window. 

Wyn: Then the placenta was really attached and they had to work to get that out. They labeled that as placenta accreta. I was advised not to labor again if we ever had another baby and just to plan a C-section. 

I felt like I went through all of the stages of grief after and in postpartum for my birth. First, I was in denial because I just blocked it out. I was happy to have my baby. Then you add the sleep deprivation and postpartum hormones and I was a bit angry at myself for not advocating but also just all of the suggestions. Baby wouldn’t have changed anything. It was just a lot of what if’s. 

Meagan: Which is hard. It’s hard to what if this and what if that. Sometimes those what-ifs come up and we don’t get answers. 

Wyn: Yeah, but it just fueled my fire to try for a VBAC. 

Meagan: Mhmm. 

Wyn: So that was my first birth and C-section then our second pregnancy which again, we felt like our little girl was a miracle so we just didn’t know if we would be able to conceive again naturally or if we would have to go through IVF. We waited a little bit and another little miracle came in September 2023.

Meagan: Yay. 

Wyn: Yeah, that was pretty exciting. Of course, I had been researching VBAC from 6 months postpartum with my daughter. I felt like my best option for a physiological birth or as close to it would be at home. I didn’t want to fight the whole time in the hospital so I contacted two home birth midwives and they were both very nice and informative. They felt like I could VBAC but neither were comfortable supporting me at home with my previous birth– 

Meagan: And your uterus, yeah. 

Wyn: They both suggested I go back to my original midwife. I was a little upset at first that they wouldn’t support it but I also understood. I made an appointment with my original midwife. I went in with my guard up and ready to fight for the VBAC. She surprised me and was actually supportive of it. She said that we would just watch and see how things would go. She said there wasn’t any reason why we couldn’t try. I was a bit surprised but wondered if she remembered all of the details or had looked at my records. I just went with it at first but eventually, we talked about everything that happened during the birth. She got second opinions from people in her office and it was okay. 

Meagan: Awesome. 

Wyn: Yeah. I also reached out and hired a doula, Dawn, who was a wealth of information and super supportive. We met regularly. She gave me exercise assignments and movements for labor and positioning. She was just there to help me debrief after each appointment with my midwife. If anything was brought up, she gave me information or links so I could feel confident going forward. That was really cool. 

I saw a chiropractor and did massage. I drank Nora tea from about 34 weeks on. I just tried to cover all my bases to get the best outcome. 

This pregnancy, I actually grew quicker and was measuring ahead, not behind. A growth scan was suggested again, but I respectfully declined because I felt like everything was okay. I was just trying to lean into my intuition and I didn’t want to get a big baby diagnosis that could possibly–

Meagan: Big baby, small uterus. Yeah. I don’t blame you. 

Wyn: Yeah. Eventually, I ended up evening out at 37 weeks and was measuring right on. I just was a little bit quicker I guess. 

So I made it to my due date again at 40 weeks and I was offered a membrane sweep. I was offered a cervical check. I declined everything. I was doing good. I knew I went over with my daughter so I was prepared to go over again. 

40.5 weeks, induction was brought up. I said I wouldn’t talk about it until 42 weeks. 

Meagan: Good for you. 

Wyn: We scheduled a non-stress test again at 41 but I didn’t make it to that because I was starting to have cramping in the evenings. I wouldn’t consider them contractions but they were noticeable. Things were happening. I was trying to walk every day and just stay mentally at ease to keep my body feeling safe. 

So at 41 weeks exactly, I was having cramping in the evening. That was a bit stronger. I was putting my daughter down. My husband and I watched a show. I didn’t say anything to him or anything because I didn’t want to jinx it. We went to bed at 11:00. I fell asleep and slept really hard for an hour and a half. I woke up to contractions starting again full-on. I thought my water broke but I don’t think it was. I think it was just bloody show originally. 

Meagan: Yeah.

Wyn: I got up. I sat in the bathroom for a little bit and I was just super excited that it was starting on its own. I held out. 

I tried to time contractions a little bit at first. I knew it was happening so I just moved around the house quietly. I went and laid with my daughter for a half hour while she was sleeping because that was going to be our last time as the three of us. Yeah. I kept moving around for another half hour or so. By then, I needed the extra support. I woke my husband up. We texted our doula, Dawn, and she told me to hop in the shower for a little bit and she would get ready and head over soon.

She made it about 3:30 AM and I think I was in pretty full-blown labor. I was mostly sitting on the toilet laboring in there but I came out to the living room when she came and I was on all fours. I made a music playlist. I had the TENS unit. I had all of these coping skills prepared and I didn’t use anything. 

Meagan: You were in the zone. You were in the zone. Hey, but at least you were prepared with it. 

Wyn: Yeah, so about 4:45-5:00 in the morning, she suggested if we felt ready that maybe we would head into the hospital. My body was kind of bearing down a little bit wanting to push. We called my mom to come over and stay with our daughter. We called our midwife. She actually lives in our neighborhood. We called to give her a heads-up to get ready to meet us at the hospital. We got there at about 5:45. They did intake and called a nurse to bring us up to the room, and that nurse was our only real hurdle in the birth. She was not really supportive of natural birth or physiological birth. She made a couple of comments. She was trying to force me to get checked to admit me. 

I was obviously in labor because I was kind of pushing. I declined all of that. Eventually, she ended up not coming back in. She switched out with another nurse or maybe they told her to switch out, I’m not sure but that was nice that she removed herself from the situation. 

Meagan: I was going to say, good for her for realizing that her views didn’t align with your views and that she probably wasn’t needed at that birth. I don’t love when people are that way with clients of mine or whatever, but for her to step away, that says something so that’s really good. I’m glad she did for both of you.

Wyn: Yeah, before she left, she was trying to get an IV too. She couldn’t get an IV. I don’t know. 

Meagan: She was frustrated and you’re like, “Yeah, you could go.” 

Wyn: So yeah. Again, I was noticing all this going on but I was in my own little world. We got there. Our midwife, Christina, showed up. She asked if she could check me. I didn’t want to have cervical checks but because I was getting pushy, she didn’t want me to not be fully dilated and start pushing. I let her check and she said, “You’re complete and baby is right there. Lean into it. If you want to push, start pushing.” I couldn’t believe it. I prepared for labor. I had a moment that I had to wrap my mind around it because I couldn’t believe we were already there to start pushing.

I had requested my records so I was able to see all my time stamps. At about 6:30 was when she checked me. I pushed for about a half hour and the baby was born at 7:09 in the morning. It was exactly 41 weeks and 1 day, the same as my daughter. 

Meagan: Wow, and a much faster and much better experience. Your body just went into labor and was allowed to go into labor. You helped keep it safe to do what it wanted to do. 

Wyn: Yeah. Yeah. I was really excited to just be able. My body just did it all on its own which was pretty awesome. It was a pretty awesome feeling. 

Meagan: Very, very awesome. Do you have any tips for people who may feel strongly about not getting cervical exams or not getting IVs or doing those things but may have a pressuring nurse or someone who is like, “You have to do this. You have to do this. Our policy is this.” Do you have any advice on standing up for yourself and standing your ground?

Wyn: Yeah, be respectful but also just be really strong. I had my husband and my doula backing me up. We prepared for things like that. I had a birth plan that had my wishes on it so just yeah, standing strong and keep in with what you want. But also be ready to switch gears. Like I said, I didn’t want a cervical check but when my midwife got there and suggested it, I felt like, okay. I can go ahead with that. 

Meagan: You felt like it was okay at that point. That’s such a great thing to bring up. You can have your wishes and desires. You can be standing your ground and then your intuition may switch or your opinion may switch or the situation may switch. You can adapt with how it’s going or change your mind at any point both ways. You can be like, “I do want this and I actually decided I don’t want this anymore. I changed my mind.” 

We ask in our form, “What’s your best tip for someone preparing for a VBAC?” You said, “Find a great support team. Research all of the facts to make informed decisions and really lean into your motherly intuition.” I feel like through your story, that’s what you did. You learned the facts. You said even before you became pregnant, right? Your baby was 6 months old and you were starting to listen to the podcast and learn more about VBAC and what the evidence says and the facts then you got your support team. 

You just built it up. You knew exactly what you needed to do so you felt confident in saying, “No. I don’t want that IV” or “No, I don’t want that cervical exam for you to admit me. I’m going to have this baby with or without that cervical exam.” I think the more you are informed, the more likely you feel confident in standing your ground. 

Wyn: For sure. 

Meagan: Yeah, for sure. Well, oh my goodness. Huge congrats. Let’s just do a little shoutout to your midwife and your doula. Let’s see, it’s Christina? Where is she at again?

Wyn: Interior Women’s Health in Fairbanks, Alaska. 

Meagan: Awesome. So great of her to support you with a more unique situation too. She was like, “Let me do some research. Let me get some opinions. Okay, yes. We’re good.” I’m so glad you felt that support. Then your doula, Dawn, yes. Where is she again? Oh, Unspeakable Joy. 

Wyn: Yes. Yeah. 

Meagan: That is so awesome. I’m so glad that you had them. We love doulas here as I’m sure you have heard along the podcast. We absolutely love our doulas. We have a VBAC directory as well so you can find a doula at thevbaclink.com/findadoula. Then last but not least, in the form, you said that you took Needed. 

Wyn: Yes, I did. 

Meagan: Yes. Can you share your experience with taking Needed through pregnancy? Did you start before pregnancy? 

Wyn: Yeah. Right as I got pregnant with my second one, I took the prenatal. I took the probiotics and I still take them today postpartum. Then also, the electrolytes or the mineral packets and the nighttime powder that my husband and I take. We put it in our tea every night. 

Meagan: It’s amazing. It really is so amazing, huh? It’s kind of weird because I don’t have to finish it. I’m just sitting there sipping on it and I can just feel everything relax. I have a busy brain. I call it busy brain and my busy brain is a lot more calm when I take my sleep aid. 

Wyn: Yeah. I slept amazingly through pregnancy. Normally with my first, I had a lot of insomnia. It was very nice. 

Meagan: Yeah. Then the probiotics, I want to talk about probiotics in general. We never know how birth is going to go. We could have a Cesarean. We may have a fever and have to be given antibiotics or Tylenol or whatever it may be. If we can have a system that is preloaded essentially with probiotics, it really is going to help us and our gut flora in the end so no matter how that birth outcome it, that probiotic is so good for us because we never know what we are going to get or what we are going to receive in that labor. I’m excited. 

Wyn: Yeah, what is that stuff that they test you for? 

Meagan: Group B strep?

Wyn: Yeah, yeah. Sorry. I didn’t want that because I didn’t want to have an IV. 

Meagan: So, so important. I love it. They usually test for that around 36 weeks so really making sure that you are on the pre and probiotic. What I really love is that it is pre and pro so it really is helping to strengthen our gut flora so much. With GBS, with group B strep, they like to give antibiotics in labor. It’s sometimes a lot. They like to give rounds every 4 hours so you really could be impacting your gut flora. I love that you took that. You didn’t even have group B strep. Well, thank you so, so much for sharing your story. Is there any other advice or anything else you would like to share with our listeners today?

Wyn: Yeah, just again, find your support team and lean into your own intuition. You know what is right for your body and your babies. 

Meagan: It’s so true. I mean, from day one of this podcast, we’ve talked about that intuition. It is powerful. It is powerful and it can really lead us in the right path. We just have to sometimes stop and listen. Sometimes that’s removing yourself from a situation. Go into the bathroom and say, “I have to go to the bathroom.” Go to the bathroom, close your eyes, take a breath, and hear what your intuition is saying. It is so powerful. I couldn’t agree more. Thank you so much.

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 records a short and sweet episode for you today talking all about OP reports. What are they and why do you need them for your VBAC prep? How do you request them? 

If you have a hard time interpreting your OP reports, try reaching out to your provider for clarification. You can also send us an email at [email protected] where you can schedule a one-on-one consultation with Meagan for extra help and encouragement!

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, everyone. It is Meagan today. We are going to be talking about OP reports. What is an OP report? Why do we want to get an OP report? How do we get an OP report and how long are OP reports available before they go away?

We do have a Review of the Week so we are going to get into that and then I’m going to go over OP reports. This review is from Brittanyhenley9478. She says, “Such an amazing resource.” Her review says, “I am pregnant with my second baby and will try for a VBAC in 4 months. Since finding this podcast, I have learned so much and gained a lot of confidence in my decisions. I’m so thankful for the podcast, their Instagram, and the website. I can’t wait to come back and share my successful VBAC story with them later this year.” 

Brittany, if you are still listening to us and you are still with us, let us know how your birth went. I hope that it was amazing and thank you so much for your review. You guys, I say it every single week multiple times a week now, we love your reviews. I seriously love them so much. It makes me smile. It makes my heart so warm so if you have not yet left a review, would you mind doing that for me? I would love it and appreciate it so much. You can go to wherever you listen to your podcasts and leave us either a rating or a review. I know Apple Podcasts and Spotify actually I believe, allows you to do a written review or you can Google “The VBAC Link”. Remember VBAC is V-B-A-C, and then you can leave us a review there. That also helps people find the podcast, find the website, the blog, and even our Instagram account. 

As a reminder you guys, if you are just listening to the podcast, hello. Welcome. I am so glad that you are here but I also don’t want you to miss out on all of the other amazing resources that we have. We have our Instagram account and Facebook account. We have a private Facebook group. You can look that up at The VBAC Link Community on Facebook. You do have to answer some questions so answer those questions and then we can let you in. It is such a beautiful space with people who are really in the same place as you– wanting to know their options, wanting to know the evidence, and wanting to feel that community love during this journey. 

We have a YouTube account and we do have our blog and our website and we also have a course. You can find all of that at thevbaclink.com. You can enter in your email there. We can put you into our subscription where we send weekly emails on updated blogs, updated studies, tips, resources, and all of the amazing things that we feel is really important for you to know during your VBAC journey. Again, you can find that at thevbaclink.com and of course, you can check it all out for free and again, enter your email in and we will make sure to get you those weekly emails. 

Okay, I’m going to go really quickly today but I really feel this is such an important thing to know. It’s not something that I one, knew was even a choice that I could have or two, was something that I should do so I could really learn more and understand more of what my provider was saying about my births and the reasons why the births happened with my body and my post-recovery and all of these things. It’s so good to know what they are saying about your procedure and your Cesarean, your birth. 

So okay. Steps to get OP reports. There are multiple ways and I know since I started requesting my reports back in 2015, it has changed a lot. A lot of people have an online portal with your provider where you can get your labs and a lot of these things. A lot of the times, their OP reports are included in there or there is a little drop-down option where you can request your OP reports. So if you have that, I highly suggest trying that or you can call your provider and ask for your medical records and your OP report. 

Sometimes they don’t really have them and they don’t want to give them to you so they may make you go to the medical records department in the hospital. Now, that is what I had to do. I called my hospital that I gave birth at. It was the same hospital for both of my babies so if you have to go to multiple hospitals, definitely make phonecalls so you’re not running around. 

Give them a call and say, “Hi. I really want to request my OP reports. I’ve had a Cesarean. What do I need to do to get those?” For me, I had to go in and request them with a form. It took about 5 minutes. It was really quite quick and easy and it took about 15 minutes to print them out. They did give me a hard copy which I loved having so I could highlight and write down and everything. 

But these forms are so important for you to have so you can understand and then for me, I did it before I was pregnant and I used it so I could have this form with me as I was going to find my supportive provider so they could have a better, deeper understanding of what was said about me and my body and my reasoning for a Cesarean. 

I want to give you a little bit of a warning. Sometimes you’ll find different reasons from what you were told and that can be very frustrating so just a heads up there. 

Another thing that is important to remember is that every state is different. They don’t just have these medical records saved on file forever. Here in Utah, I was told that it was 7 years. I know that it varies all around. I know Arizona is 6 years. New York, I think, is 6 years. Florida is 8 years. California and Utah, like I said, I think is 7 years. So definitely get your records as soon as you can. Now, I know most people are having babies anywhere from 1-5 years apart but I do think the sooner the better you can get these records is just better. 

So again, check out the portal. Call your provider. Go to medical records. Do whatever you can to obtain these OP reports and if you have a hard time understanding them, they have all of these weird things in there, don’t hesitate to reach out to your provider and say, “What does this mean? What did you mean by this?” I have also done one-on-one consults with many people to go over and process their medical records and help them come up with a path for what their next step could be for their future births and VBAC. I’m no medical professional by any means but I have been doing this for years and love doing it so if you would like to learn more about a one-on-one consult, you can email us at [email protected]. I would absolutely love to chat with you. 

Okay, everybody. Like I said, it was going to be short and sweet, but I really, really think it is important. If you are preparing for your VBAC, put this on the list of things to do. If you have just had a Cesarean, put that on the thing too to request. You don’t even have to look at it right now. It’s something you can have and put away but I do believe so much that it is important to have these and understand what our providers are saying and writing down about us. 

Okay, everybody. We’ll talk to you later. 

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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Rebekah’s first Cesarean was a birth center transfer after her baby boy unexpectedly flipped breech during labor. Though she was confident in her decision to consent to a Cesarean, she was devastated and left with a lot to process. 

Right away, Rebekah’s midwives instilled confidence that she was a great VBAC candidate and introduced her to The VBAC Link. Rebekah thoroughly researched and prepped for her VBAC knowing it was the path she wanted to take. She decided to stay with the same birth center as she felt so loved and supported by them. 

Her second pregnancy was filled with physical, mental, and spiritual preparation for her VBAC. Rebekah developed a deep connection with her baby girl and shares precious stories during both her pregnancy and labor when she knew just what her baby was trying to communicate. 

Rebekah’s VBAC was healing in so many ways. It was particularly special to birth in the same suite that she labored in with her first and have such a different outcome. All of Rebekah’s intentional work paid off to help her have a very sacred birth and postpartum experience!

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, everybody. Welcome to The VBAC Link. We have our friend, Rebekah, here today and she is local to me here in Utah so it’s always so fun to hear a Utah story especially because I usually know the provider and the location and things like that or I’ve served with them so it’s fun to hear the stories that I have served with the people who are serving these amazing VBAC mamas. 

We have our friend, Rebekah, like I said and she is a mama of two. She is a stay-at-home mom and is in Spanish Fork. She is passionate about birth and hopes to one day pursue birth work. She hired one of our VBAC Link certified doulas so just as a reminder, if you guys are looking for a doula, let me just tell you that our doulas are amazing. These doulas truly love birth and love VBAC and are all certified in VBAC so you can check that out at thevbaclink.com/findadoula if you are looking for a doula. 

Rebekah left us a note. It says, “The after-birth high doesn’t always happen. I have heard so many stories of women who experienced it and I was expecting to feel that. I however did not.” She says, “Don’t feel robbed of it.” She was confused why she didn’t feel it but she is going to talk a little bit more in her story. I love that message because I didn’t feel the birth high with some of my kids either and it is weird. I remember sitting there thinking, Wait, aren’t I supposed to be crying right now or aren’t I supposed to be screaming how happy I am right now? It just didn’t come. 

Please know that if you didn’t have that immediate birth high, it’s okay. It’s totally okay. 

We do have a Review of the Week. It is from Yulia and this is actually on our VBAC Course. It says, “This is an amazing VBAC Course that helped me understand how I can educate and support families in the best way.” She is actually one of our VBAC doulas so again, if you guys are looking for more information on VBAC and you really want to learn just all of the history of VBAC and Cesarean and how you can increase your chances of VBAC, check out our course at thevbaclink.com and let us know if you take it. Let us know what you think about it. 

All right, Ms. Rebekah. Your hometown is Utah, same as me. We are here together. You’re in Utah County. You’re probably 45-50 minutes away from me so just shy of an hour. Where did you give birth for your VBAC? 

Rebekah: It was the Utah Birth Suites in Provo. 

Meagan: Okay. Awesome, awesome. Well, I’m so excited to get into your stories today. I know that with your first one, you went through it. It was spontaneous labor turned unplanned Cesarean. Now if you are listening, I’m sure you can raise your hand. How many of us are having the same situations? We are going into labor and we have that unplanned Cesarean. It’s so, so hard. Before we get into your story, are there any suggestions that you would give to the listeners or any tips for moms just like us for moms who went into labor and had an unplanned Cesarean?

Rebekah: The heartbreak and the trauma that comes with that is really hard to navigate so in planning a VBAC, my number one piece of advice is hire a doula. Hire a VBAC-certified doula and do all of the hard work you can to mentally prepare. Try not to blame yourself for the C-section because I know we all do that at some point if it wasn’t planned. 

Meagan: Yeah. I love that you said that. Don’t blame yourself but at the same time, let’s arm ourselves up with information and even first-time moms, there are so many times that we go in and we think we sort of educated ourselves but we didn’t. If we can try and educate ourselves a little bit better, we can hopefully be a little bit more armed for the unexpected and even then when the unexpected happens, it’s not easy to be armed. It’s not easy to be prepared. 

Okay, so let’s talk about that first birth that was an unplanned Cesarean. 

Rebekah: Yeah. I got pregnant in 2020 so COVID insanity and I had known even before I got married that I didn’t want to be in a hospital. I’m number 6 of 7 kids and my mom had all of us unmedicated. I was a home baby. Some of us were born at home. Some were in a hospital. Some were in a birth center. I just really felt that in my bones and in my genes that I can give birth. It’s not scary. My mom did this this many times without medication. My sister did it 5 times so I really felt confident. 

With everything happening in hospitals during COVID, I just was like, I don’t even want to try to mess with that so let’s go the midwife route. I got in contact with a friend of mine who was a doula and she recommended the Utah Birth Suites in Provo. I reached out to them. We toured a couple of different birth centers and that birth center just felt right. We met almost the entire team that first day in the interview. They spent almost an hour just chatting with us. 

I was about maybe 18 weeks, 20ish weeks. I was about halfway through my pregnancy. I had two or three meetings with an OB because I didn’t have a midwife and it just wasn’t my favorite. It was so long between visits and they lasted about 15 minutes. I saw a different person each time. It felt very impersonal and I don’t like repeating myself over and over again to all of these different people. It didn’t feel right. It wasn’t really what I was looking for. 

I found the Birth Suites and they took care of me for the rest of my pregnancy. I had a little bit of hypertension issues toward the end so the last three or four weeks were really juggling this game of, are we looking at induction this weekend? My blood pressure would read really, really high then I would do all of the things to bring it back down. I was watching my nutrition and taking the vitamins and everything to bring it down. It would come down just within a safe enough range to keep giving me care. 

Legally, if it crossed that line into worries of preeclampsia, then legally they had to transfer me into the care of an OB. My midwife was really working hard with me to keep it down. It was doing this up/down thing and by the end of each week, it was like, “Okay, we might have to induce you in a couple of days if you want to stick with us.” I was okay with that. My midwife had talked with me about that so it wasn’t pushed on me. 

I was doing everything to stay within their care. That was my whole goal so if I had to be induced, that’s what I would do. But every weekend came and passed and my blood pressure would come back down. Finally, it was the day before my due date. I went into labor in the middle of the night. It was maybe 2:30 in the morning. I felt my first contraction. I could tell it was labor because it was different than all of my Braxton Hicks. The only sign I had that labor was going to start was that I had cramping the day before. I was like, “Oh, this is kind of uncomfy.” I didn’t think anything of it. 

As a first-time mom, I didn’t know a ton. I did as much research as I possibly could but labor is so random with every mom and baby. There really is no way to tell. I go into labor early in the morning and I woke up my husband. I said, “I think I’m in labor. I think these are contractions. They’re not stopping. They’re getting really intense.” Intense compared to the Braxton Hicks I had been feeling. 

I let him sleep and I went into a different room and classic first-time mom mistake. Instead of resting, I got up and started moving and trying to get things going because I was all excited. I didn’t want things to slow down. I was timing them and texting my midwife. She said, “See if you can lay down. Take a Tylenol if they are super uncomfortable and try to get as much sleep as possible because you’ve got some time.” 

I tried doing that. It wasn’t working for me. I was super uncomfy laying down. I did not like it at all. I felt good when I was up and moving because I think that slowed things down but I didn’t know the difference. I just knew it was less uncomfortable. I was like, “I’m not going to be sleeping. Let’s just go do something.” We went on a drive. We did a little shopping. We walked around. We went back home. We hung out for a little bit. 

Then my husband was like, “Do you think I’m okay to go to work?” I was like, “I think you are. You can go to work. I think we have plenty of time. Things are still pretty spread out right now. We can call our doula and she’ll come hang out with me at home.” So that’s what we did. Our doula came over and my husband went to work and everybody was like, “What are you doing here? Your wife is having a baby. What’s going on?” He was like, “She’s fine. She has our doula.” 

Our doula was with me for a couple of hours and things had picked up enough to where I felt like he needed to be home so we called him back home. Things were moving on not slowly but slower than I wanted. I was just trying to be patient and let things go–

Meagan: Trusting the process. 

Rebekah: Yes, exactly. I’m not a very patient person so this really was a big learning experience for me. 

So my doula is keeping contact with our midwife and eventually, it was like, “Okay, I think you’re good to head to the birth center. It looks like things are pretty steady now.” We got to the birth center. I really wanted a water birth so they drew a tub and I relaxed in the water and tried some different positions. Hands and knees in the water were hard and uncomfortable. They gave me a towel to keep from slipping around but it was really uncomfortable. My knees didn’t like staying in that position and I didn’t want to be laying back. 

So I just wiggled around in the water a little bit. They were like, “Let’s see if we can get you in a different position and try to get things moving a little bit.” So they got me out of the water. We tried the birth stool. I did not like the birth stool but it helped me progress a ton so that was good. I think I lost my mucus plug on the birth stool. I was feeling tons of pain in my lower back, like lots and lots of pain in my lower back. My thighs were shaky and I felt a lot of intense sensations in my thighs whenever I would have a contraction. There was a lot going on with my body that I wasn’t really prepared for or expecting. 

I got back in the water to help relieve my back a little bit and I ended up getting stuck on my back lying back in the tub. It was getting to the point where I was almost passing out between my contractions because I was so, so tired. My body had been working for so long and it just felt like things weren’t quite where they needed to be with how long I had been working. 

Again, my midwife said, “If you pass out, we will have to transfer you.” They gave me the oxygen and some essential oils to smell to keep me awake. They were trying to help me as best as they could. I guess my husband was out in the hall with the midwives and it was student midwives who were taking care of me and there was the head midwife who was overseeing them. They had a little pow-wow about what they thought we should do. The midwife was very big on mother-led labor. She was like, “Well, she’s a first-time mom.” 

I had been in labor for so long that things were concerning at this point so it was just, “Let’s give her a little bit more time and try to keep her awake and see how things are going. She’s doing great. She’s tired and this is normal.” A bit more time passed and one of the student midwives was like, “We need to check her. She should be farther along by now. She says she’s pushing. She feels like she’s pushing but we are not seeing the water separation and as much opening as we would like to see.” 

They got me out of the water and onto the bed and the head midwife performed a cervical check to see what was going on. I had a contraction while she checked me and my water broke. It was just full of meconium. She said, “I can feel his bum. He’s breech.” It was crazy because we thought he had been head down the entire time but when I was in the water, there was a big movement in my belly and I was like, “Oh, that was kind of crazy.” We thought, did he flip? When we realized he was breech, was that movement him flipping while I was in labor?

Then my midwife also made a comment later, “Well, maybe he was bum down longer than we thought he was. Maybe that wasn’t the flip.” It had everybody baffled. My midwife has been practicing for a couple of decades. She’s very experienced and this had everybody stumped. She had never really seen anything like this happen before so at this point, she said, “Well, you have two options. We will send you home and send you a midwife who can deliver breech babies,” because she was licensed and in Utah, licensed midwives aren’t allowed to deliver breech babies which I think is silly. She had the training and experience. She just legally wasn’t allowed to do it. 

She said, “We can send you home and send you a midwife or you can go to the hospital where they will definitely do a C-section.” She gave us a couple of minutes. We weren’t in any emergent situation. The baby wasn’t in distress. His heartbeat had been great the whole time so there was no reason to believe that he was struggling at all. She gave us a couple of minutes to decide. 

Earlier in my pregnancy, I received a blessing from my husband and was told something like, “However our child is supposed to come into this world–”, and I was like, “Well, that’s silly. He’s going to come how we are planning on him to come.” I remembered that in this moment and said, “I think this is what that meant. I think he was always supposed to be a C-section.” It was a very interesting combination of feelings happening at the same time, remembering that and knowing this was how it was supposed to go but also being beyond devastated that this was the path things took. 

So we chose the C-section not because first of all, the thought of having more contractions in the car was like, I’m not going to do that. I just knew it wasn’t safe. I was almost passing out and I knew that a breech baby can sometimes be a bit more work. I was in no position to do that. So my husband drove us to the hospital and I had maybe three contractions in the car. Our midwives called the hospital to tell them what was going on and that we were coming so they were ready for us. It was very quick. 

We got there. They took great care of us and had me in the operating room and the rest was history. We had the C-section. The anesthesiologist was so sweet. He was this old man who spoke really softly and assured me that everything was going great. He stayed with us the whole time through the surgery. I heard him cry and it was great. They wrapped him up. They held his cheek against mine for a minute and then they took him out. My husband followed him and then they stitched me up. 

That was my C-section. We spent 3 days in the hospital. My birthing team came to visit me one by one in the hospital and every single one of them told me that I was a great candidate for a VBAC. They told me about The VBAC Link so that’s when I started on my whole journey listening to you guys and started to really plant those seeds that, “You are capable. You didn’t fail. You are able to do this still.” 

I know that some moms after having a birth experience don’t really want to hear these things and they weren’t in a place to hear those things, but for me, it was really great to immediately have that confidence spoken into me. That was my C-section. 

Meagan: Yes. I love that your team knew you so well to know that that was what you needed to hear in that time. Those were the things that you needed to hear. So knowing right away that you were a good VBAC candidate, was it something that stayed with you and you were like, this is what I want to do?

Rebekah: Yes, absolutely. It wasn’t ever a question if I was going to have a repeat Cesarean. That was never part of my plan. You can’t really plan birth but I had never really had that fear of, Am I going to need another C-section? There’s always a little bit of it there, but it was always, I’m going to have a VBAC. That’s what we’re going to do from that point forward.

Meagan: You knew. You felt that it was right. You found out about us at The VBAC Link. You had your providers already. Did you stay with the same providers or did you switch? 

Rebekah: Yeah. 

Meagan: Okay, stayed. 

Rebekah: Well, technically yes. I stayed with the same Birth Suites and the head midwife who was overseeing the student midwives who cared for me in my first pregnancy was the one who cared for me during my second. I got to know her a little bit better during my second pregnancy and she was ahead of everything at that time. 

Meagan: Okay, awesome. So you are pregnant now for the second time. Tell us about this amazing VBAC journey. 

Rebekah: Yeah. So I got pregnant– when was it? It was probably late summer, early fall when I got pregnant with my second. I immediately reached out to– she’s a licensed midwife now but the student midwife who was in charge of my care the last time. I reached out to her because I loved her so much. I said, “I’m pregnant again and I would really love for you to take care of me.”

She said, “Well, when you are due is right when I go on leave.” I said, “That’s great timing.” I reached out to another girl who was on our team who I loved and the same thing. They were taking their leave at the same time. She was like, “But it’s within a week. You’re due within a week of when I go on leave. If you end up having your baby before I go on leave, are you okay with me being there?” I was like, “Yes. I would love for you to be there if you can to support.” That’s not what ended up happening, but it was fine.

I reached out to Melissa. She’s one of the owners at Utah Birth Suites. She started that whole business. I got to know her with my first so I reached out to her and said, “I’m pregnant again and would love to be in your care.”

It was really great that she already knew my history with my first pregnancy and first birth. I had stayed in contact with them. They do a lot of things in the community and they try to stay in touch with their moms who they take care of. It’s not like it had been 3 years since I had seen her. I had seen them here and there so I felt really comfortable with her. I had a couple concerns with this pregnancy with the hypertension issues and stuff that we had with him being breech. There were just things that I really wanted to stay on top of and keep an eye on. 

My blood pressure was fantastic throughout this entire pregnancy. It was at such a healthy level the entire time. We never had that concern of preeclampsia or hypertension because it just wasn’t a factor. It was really nice. I was doing all of the things this time around with the vitamins and supplements and nutrition and water intake and all of the things that I neglected with my first pregnancy. I was super, super determined to have this VBAC. 

My midwife really pushed protein– lots and lots and lots of protein. We really wanted to strengthen that uterus and try to be as strong as we possibly could so I really took that to heart and tried my best. I got really excited when I came up with a new recipe that had a ton of protein. I would take a picture and send it to her and write up the recipe. I was like, “I’m so excited about this one.” It’s like when a kid draws a picture and is so excited and their parent sticks it on the fridge. That was how I felt. I was like, “Look at me. I’m working so hard this time.” 

I was worried about her flipping breech but that was never an issue either. She stayed head down the whole time. This was a little side note that was interesting. During my anatomy scan to find out the gender, the ultrasound tech was looking over everything and he said, “There’s no way to really tell for sure because your uterus has expanded now,” but he said, “I wonder if you have a bicornuate uterus.” 

He said, “Because your birth was breech, right? He flipped?” We had seen this ultrasound tech for the first so he knew everything that happened there. So I said, “Yeah. He flipped breech.” I had never heard that word before. I didn’t know what that was. He explained it to me and said, “It’s really common for women with a bicornuate uterus to have babies who flip breech.” So I was like, “Okay, that’s interesting.” He said, “After you have this baby and your uterus shrinks back to normal, we should take a look at it.” I have yet to do that but I’m curious too. She never flipped breech so I don’t know. Maybe I just have a goofy-shaped uterus. I don’t know.

Meagan: Maybe or it was just a freak thing. Baby needed to be head up. 

Rebekah: I don’t know. That was interesting and I’m curious to see what the results of that are. But anyway, we got in contact with a doula, a VBAC-certified doula in the area. Her name is Isabelle and she is fantastic. She is absolutely phenomenal. She is also a birth assistant so she is fully immersed in this birth world. She is so knowledgeable and has tons of experience. We clicked really fast and I knew that I wanted her to be our doula. 

She really just was invaluable the whole time. She recommended that I do some fear-release exercises and meditations to work through some of the trauma that I didn’t really realize that I had from my first birth. I thought I had processed and accepted as much as I could but I think healing isn’t a linear process and being pregnant again and having another baby brought up a lot of stuff and a lot of fears. On a personal note that I won’t really get into, I had a different set of fears surrounding this pregnancy for different reasons so there was just a lot to work on emotionally and mentally. I took that very seriously. This was a very sacred and spiritual pregnancy for me. 

Maybe it’s just like that mother-daughter bond. I don’t know. I felt way more connected to my baby this time and I really wanted to do my due diligence in making sure that my mind and my spirit were in a good spot for this pregnancy and this birth. 

One of the fear release exercises she sent me was one provided by The VBAC Link. It was a little worksheet to get your mind going and there are specific questions on there about what are some fears you have and where do you think those fears come from? It was that kind of stuff and toward the bottom, it helps you reframe those a little bit. 

Meagan: Yeah. 

Rebekah: It had me write out what my fears were and then to write an affirmation to counter each fear. I had 20 affirmations all written down just to go along with this list of fears. Then I actually used a couple of those and printed them out as my visual affirmations for when I was in labor. 

So fast forward, we’re about 38 weeks and I was thinking for whatever reason that this baby girl was going to be early. So 38 weeks came around and I was starting to get excited. I’m like, “I think she’s going to be here pretty soon.” I was starting to have some prodromal labor which I didn’t experience with my son so that really reinforced the idea that she would be here soon and that was not the case. 

I had 2.5 weeks, well yeah. I guess it was about 2.5. Normal labor started around 39 weeks. So every night on the clock from 8:00, I would start getting really intense contractions that felt like early labor with my son but I also had much stronger Braxton Hicks this entire pregnancy so I was like, “I can’t really tell the difference.” I told my doula that. I was like, “I’m afraid I’m going to miss you and I’m not going to reach out to you in time or you’re not going to make it to us in time because I won’t know when labor is actually happening.” That was a big worry of mine this time around. It was so different than with my son. 

She said, “It’s okay. You can just text me as much as you need to and as much as you want.” So I did. I texted her a lot the last few weeks and she was like, “Your body is doing great.” She told me that in her experience, she said, “Just from what I’ve seen with my VBAC moms, I actually see prodromal labor happen a lot. I personally think that it’s the body’s way of being more gentle rather than doing all of the labor hard and fast at once. It’s lots of little bits of labor to get your body ready and ease into it so it’s not as intense on your body.” I was like, “You know, that makes sense.” 

I don’t know. I don’t think there are any studies around that that I know of, but that made sense to me. I really tried to just internalize that and not get too discouraged when things would stop as soon as I went to bed which they did every time. At 8:00, they would pick up and be there for a couple hours then it would stop when I fell asleep then I’d be fine until the next night when it would pick up again. 

My husband and I would go on a walk every single night and on these walks, I could have sworn that she was going to fall out. I could feel that she was right there. I could feel that my body was literally opening. I could tell that I was dilated. I never got cervical checks this time around which was oddly empowering. I really trusted my body and knew that things would happen regardless of the number that my body was dilated. 

I had no idea but my midwife was like, “You know, it wouldn’t surprise me if you are sitting at a 4 right now.” So if anyone has experienced prodromal labor, you know how exhausting it is and how discouraging it is mentally, physically, emotionally– all of it. It had been a couple of weeks of this and I had officially gone past 40 weeks. 

I’m officially overdue and my son being born right on time, it was really frustrating that I was going past my date with this one. I didn’t want to be induced. There was really no reason for it other than I was getting tired of being pregnant. 

My midwife was supportive if I wanted an induction. After I hit 40 weeks, I think she would have done it. She said, “Oh, we can do this,” but she also was really encouraging and assured me that my body was doing what it needed to. It was normal to feel discouraged, but let’s just give your body time, especially with a VBAC. Induction can come with its own set of risks. I knew that. It was just such a mental battle trying to remember that. I know the risks sometimes can be small, not that it would worry me personally. For some moms, I know it would but for me, the risks that came with induction weren’t enough for me to say no to it completely. 

But also, you never know so let’s not play that game. Let’s just be as patient as we can. 

A couple of days before I went into labor, I had it. I was over it. I was in the middle of a breakdown in tears just exhausted. I was with my husband and I said, “Why isn’t she here yet? Why doesn’t she want to come?” I was just processing things out loud and I said, “I know my body is ready. I can feel it. My body is open. She is so far down there. I feel like her head is going to pop out any second. What is going on? Why have I not gone into labor?”

Then he just was really comforting to me and letting me process how I needed to and then I said, “I feel like she’s scared.” That was a really interesting feeling. Like I said, I felt more connected to this baby and it was like a lightbulb that was the answer. Your body is ready but your baby is not. We were overdue at this point so I said, “I feel like she’s scared. I’m not quite sure why, but I’m almost positive that’s it.” 

So I took a moment to kind of then go into myself. I went into a different room by myself and again in tears was just sobbing and praying and spent some time talking with the Lord and then I spent some time talking to my baby. I told her, “We’re ready for you. We are so, so ready for you. I know you are scared. I don’t know why but you’re not going to be alone. We’re going to go through this together. You’re going to be safe. Mommy and Daddy are going to take care of you. You’re going to be okay.” It just was a really, really sweet moment. 

Two days later, I went into labor. 

Meagan: Ohh. 

Rebekah: I guess she just needed that reassurance that things were going to be okay. 

Meagan: She needed the okay. Yeah. 

Rebekah: Yeah. I think she felt that something was coming with all of this prodromal labor. She knew that things were picking up and she just needed a little pep talk. 

So this time around, again, around 3:00 AM– I guess that’s when babies like to come. I hear that so, so many times between 2:00 and 3:00 AM is when things start to happen. I don’t know why that is the magical hour, but it is. 

This time, because we know I was afraid I wouldn’t know when labor had started, this time is started with my water breaking. My water didn’t break until after 17 hours of labor with my son. I was asleep and woke up to re-situate myself and I felt this pop inside my body. It kind of hurt a little bit. I was like, what was that? It was a really weird sensation. I thought, Was that my water? I reached down and I feel around. I’m like, Well, I’m not wet. I stood up just to see what was going on and there was this huge, giant gush. I was like, Well, yep. There it is. 

This was probably my favorite part of my entire labor. My husband was asleep and I said, “Honey, honey, my water broke.” He was still half asleep and he said, “Do you want me to fill it up for you?” He thought that I had dropped my water bottle or something. I was like, “No, honey. My water broke.” He jumps up and he’s like, “Oh, oh.” He started freaking out and he was like, “What are you supposed to do?” He was frantically looking around. He was still half asleep. I was like, “Okay, take a breath. Go get me a towel first of all,” because I was gushing all over the floor. “Get me a towel and then text Melissa (my midwife)” or my doula. I didn’t know who it was. I said, “Let them know.” 

He said, “Are you okay? Do we need to go somewhere? What’s going on?” I said, “No, we have time. Water breaking is not a big deal.” I had done lots and lots of research and listened to a million birth stories so at this point, I feel like a pro because I am fully immersed in this birth world. I said, “No, I’m okay. I’m just going to change and lay back down because I’m not having contractions yet. I feel fine, but I do need to rest so I’m going to change myself and lay down.” That’s what I did. I wasn’t going to repeat the mistakes of my first birth of moving too fast. 

Meagan: Getting too excited and yes. 

Rebekah: Yeah, especially with the exhaustion that I was feeling toward the end of my labor with my son, I was like, I don’t want to feel that again. I lay back down. I know myself well enough that I wasn’t going to fall back asleep. There was no way that was going to happen, but I was like, But I need to stay as relaxed as possible. We kept the lights really low. I put my birth playlist on and just really did some breathing to keep myself relaxed and as open as I possibly could. 

That’s how I labored for the next several hours but things got intense really fast. As soon as my water broke, I knew that my contractions were going to be more intense. Even though labor had technically just started, I had a feeling that I wasn’t going to be in labor for very long because it had been 2.5 weeks of prodromal stuff. I was like, I think this is going to be quick. 

I was really unsure of what to do though because I was timing my contractions. I have screenshots and was sending them to my doula. She said, “Oh, those look great but let’s wait an hour and see how that goes.” But I was feeling like things were picking up. I felt like things were getting more intense but people kept telling me to wait. My midwife was like, “Oh, you have time.” My doula was like, “Oh, you have time.” I told my husband, “I don’t know what to do because everyone is telling me that I have time but I don’t think we do.” 

Every time I stood up to go to the bathroom or get in the shower– I tried the water in the shower because my doula said, “Sometimes that can make things a little bit more comfortable. Some women like to labor in the shower for a little bit.” I thought I’d try that. I loved the water but I did not like being upright. I did not like standing because it made contractions so, so intense but they were short. They were half the length than when I was lying down. 

I think they thought I had time because there were still several minutes between contractions and they were still pretty long. They were like, “We want them just a little bit shorter and a little bit closer together,” or longer contractions. I don’t remember. 

I was like, There is something in me that is telling me that this is moving pretty quickly. I don’t like being upright and I feel like I need to rest. It was a lot of weird stuff going on in my head trying to figure out how to handle things. I stayed in bed. It was this instinct in me, “You need to stay lying down.” Any time I stood up, it picked things up and for any birth with other moms, that’s what you want, right? You want things to pick up and you want things to progress and technically standing upright was progressing things, but it didn’t feel right to me for whatever reason. I knew I needed to be resting and lying down. 

I was starting to get tired. I texted my midwife and said, “I’m starting to get worried because I don’t feel like I should be this tired this early, especially with how much I’ve been lying down and resting.” She said, “I think you need a little boost of energy.” She said, “Eat a snack and go outside and take a walk. Get some fresh air. Get some sunlight.” In my head, I was like, I don’t want to do that. I don’t want to be up. Every time I stand up, I can’t explain it. 

Everything in my body and spirit was like, “You need to stay lying down.” I was like, “You know what? She’s been doing this longer than I have. I’m going to trust her. I’m going to do it.” I make my way upstairs and as I’m getting a snack, I have a contraction that just had me seeing stars. I almost passed out. It was so, so intense and I told my husband, “I’m going to throw up. I’m going to pass out.” I leaned against the counter. He rubbed my back and when it was over, I ate my snack really, really quick. It was a sugary snack to give me a blood sugar boost. I ate my snack really fast and then immediately went to the living room and got on my knees and leaned against the couch. Again, I can’t be standing. 

Meagan: Yeah, and gravity is causing it to happen too much. 

Rebekah: Yeah, and I was like, I don’t have the capacity right now to handle these standing. I need to be more grounded. I got on my knees on the couch and my husband was like, “Are you okay?” I was like, “Yes, I just can’t stand up.” I had a few contractions on the couch because everyone was telling us to wait so I was like, “Okay, let’s just do a few more contractions and see how these were going.” 

That’s when I hit transition. It was a little before 9:00 AM or it would be 8:30-8:40. I had a few contractions and they got really, really intense really quickly. It was starting to get a little bit more painful. I was feeling a lot more pressure in my bum and I had to physically relax my pelvic floor and open it because things were starting to feel a little bit pushy. I say that’s when transition was. I actually don’t know. I feel like I breezed through the transition phase because things just happened so fast. I would guess that’s when it was. 

We called our midwife. Our doula hadn’t come to us yet. I called maybe an hour before and said, “Why don’t you make your way to us because things are starting to pick up?” She said, “Okay.” She lives maybe an hour away. So she’s on her way to us and hasn’t made it to us yet. We call our midwife and say, “Things are pretty intense over here.” She listened to a couple of contractions over the phone and she said, “Those sound great. You’re doing awesome.” These contractions, I was getting really, really vocal through them, and having gone through labor unmedicated with my son, I knew that I was pretty close just based on the noises that I was making and the way my body was feeling. I was like, We’re pretty close here. 

She said, “Okay, do you want to meet me? Let’s meet at the birth center at 10:00,” which means we would have had to leave 20 or 30 minutes from that time or from the time we were at. I said, “We can’t do this at home for another 20 minutes.” I had another contraction and my husband and I both go, “No, we’re coming now. We can’t stay here and do this for another 30 minutes. Things are moving too fast.” She said, “Okay, great. I’ll meet you there.” 

We called our doula and we said, “Go straight to the birth center.” The birth center is kind of in the middle of us so she didn’t have to backtrack. We get to the birth center. Our doula met us there. She said, “You had one contraction after you got there and the next one, you were pushing.” My midwife was there maybe less than 10 minutes after we showed up, between 5-10 minutes but I had a couple of pushing contractions with just my husband and my doula at the birth center. 

When I got to the birth center, I assumed the position. I got on my knees and leaned against a chair because that’s how I had been doing it at home. I loved it. Every time I would have a contraction, I would put my hands on the ground so I was on hands and knees and I would lean back a little bit. Everything in my body just told me to get as low to the ground as you possibly can. Any amount of pressure or sensation on my body was amazing. It just kept me feeling grounded because of my son, when I was in the tub leaning back, I kept reaching up like this saying, “Help me. I need help. Help me.” I felt so untethered and nobody knew what to do for me because I was in the tub. They couldn’t do counterpressure on my hips or my back because of the position I was in. 

It was just like, there’s nothing we can do for you. I refused to move so it was like I got stuck in this position where I felt so ungrounded and untethered. But this time around, I was solid. I loved it and I actually had a bruise on my forehead the next day because I was pushing my forehead against the chair every time I had a contraction. But it was awesome. I loved that feeling of feeling so solid and grounded. 

I had pushed for maybe an hour before she was born and I felt that ring of fire. It made me say a bad word. I was like, “Oh my gosh,” because I didn’t feel it with my son. When I leaned back during a contraction, I could see some blood on the chucks pad on the ground that I was moving on and I asked them, “Am I tearing?” There was a pause and my midwife said, “Your body is stretching exactly how it’s supposed to.” So that was tearing. She was not going to tell me, “Yeah, you are.” 

She was really encouraging and she was like, “Your body is stretching the way it is supposed to,” but in my head, I was like, I know I’m tearing. I could feel it. It wasn’t horrible, but I could tell. 

I had this memoir going on in my head the whole time where I literally had to tell myself, You’re not going to break. You’re not going to break, because those sensations on my pelvis while pushing her head out were so intense. 

Meagan: Intense, yeah. 

Rebekah: It just felt like my pelvis was going to crack but I knew that wasn’t the case. My body was made to do this. It was doing what it was supposed to do. It was really a big mental battle. I’ve heard a lot of women talk about how they go into labor land and it was this out-of-body experience, but when I tried to do that and let go I guess is the term, that’s when I started to feel fear set in and I felt really uncomfortable when things got more painful so I really had to keep myself in my body. 

I am not the type that can just close my eyes and say, “Okay, my body is just going to do the work.” I couldn’t do that. I had to really stay fully present. I guess I needed to feel that sense of control so I was talking myself through it the whole time. “You’re doing okay. Keep your voice low.” I was very, very loud. “Keep your screams and your moans in a low tone and keep yourself open. You’re not going to break.” I had to keep telling myself these things. 

My husband was talking to me, “You’re doing so great. You’re amazing. Our daughter’s going to be beautiful. You’re doing such a great job.” My doula was scratching my back and doing counterpressure. Everybody was just amazing. The vibe in the room was just absolutely incredible. 

She started to crown and my midwife said, “Rebekah, why don’t you feel down and you can feel her head? That might be encouraging to you.” I think she could tell I was getting frustrated. Every push I was sure she would come and she didn’t. I would get so mad and I would push harder than I probably should have and maybe that’s why I tore because I was being impatient. 

I feel down. I could feel her head crowning. I started talking to her. I started crying. I’m like, “Sweetie, I’m so excited to meet you. Hi, sweetie. You’re doing great.” A couple of contractions later, her head came out. Then we chilled with her head out. We chilled between contractions. 

One of the girls on our team got an awesome shot just from right behind. She took a picture of her head sticking out so it was just a straight shot of my bum with her head and it was just a beautiful, beautiful picture. 

So I feel down and I feel her head. I’m rubbing her head. I’m talking to her and I’m breathing. I got water between every single contraction. I took a drink of water. I took some electrolytes. Oh, between contractions, I would sit up and lean on my husband. I would lean on his lap and then during a contraction is when I would go down on all fours. It was just this up, down rhythm that I got into. That’s what I did. 

Meagan: That is awesome. 

Rebekah: It was awesome. I really got into a groove. I felt safe and comfortable. After her head came out, the next contraction, her entire body just slipped right out and I got to reach down and grab her and pull her up onto my chest. It was just amazing. 

But I didn’t feel that birth high. I was expecting to feel it. Everyone talks about this incredible rush of endorphins and “I wanted to do it again. I had just done this amazing thing and I got a rush of these feel-good hormones”. I was expecting to feel that and I didn’t. It was a beautiful moment and I was so happy to be there but I kept waiting for that high to hit me and it wasn’t hitting me. I was like, “Oh, that’s weird, but okay.” 

I had hemorrhaged after my placenta came out. It wasn’t enough to really be emergent, but it was kind of concerning. They were doing the fundal massage. They were putting pressure on it. I was holding my baby the whole time leaning on my husband and my husband was like, “Is she okay? What’s going on?” I asked him to say a prayer and to pray for us. 

So the midwives were working on me quietly. My husband says this quick, beautiful prayer just that everything would be okay and that things would go the way they were supposed to. My midwife asked if I would be okay with Pitocin to help stop it and that was fine with me so we did a quick shot of Pitocin and a couple of minutes later, it completely stopped and I was good to go. 

It was just a few minutes of this and even hearing the word “hemorrhage” or “You are losing more blood than we would like,” I still never really panicked or felt afraid because I trusted my team so much and I knew that if things were emergent, things would be going differently. There would be a different energy but no one was concerned. No one was rushing around. No one seemed panicked. It was just like, “You’re losing a little bit of blood, but–”

Meagan: We’re taking care of this. 

Rebekah: “We’re taking care of this.” It was so quick. It was so quick. It was taken care of and I’m so blessed that that was how things go because I know sometimes that’s not the case for other moms, so in my case, it really wasn’t that big of a deal. 

Meagan: Yeah. 

Rebekah: I got to take a postpartum bath. Well, I guess they did the stitches first because I had a second-degree tear that required stitches, and when they were checking my tear and they told me, “You’re going to need some stitches,” I immediately burst into tears because for whatever reason, that sent me back to my C-section because to me, stitches meant, “We’re stitching you up. We’re closing you up.” 

Meagan: Yeah, yeah. 

Rebekah: It was this weird flashback moment that caused me to panic and I started crying. I told them it reminded me of my C-section and I know that sounds silly. It’s just a few stitches from tearing in comparison to stitches from a C-section.

Meagan: It doesn’t sound silly. 

Rebekah: But to me, it wasn’t. Oh, also, I was in the same birth suite that I was laboring in with my son the first time around. I was on that same bed when the midwives told me, “He’s breech. We have to do something else.” So it just was like I was back in that same space where I was being told that I have to do something that I don’t want to do that was scary to me. 

My doula was really sweet and talked me through it. My whole team talked me through it. They were like, “You’re fine. It’s okay. It’s not a big deal.” They were very validating like, “I understand. That’s why you are scared and why this is bringing things up again but you are safe. We’re going to take care of you. You’re not even going to feel it. We’re going to numb you.”

Meagan: Numb it up, yeah. 

Rebekah: Yeah. My doula stayed with me through my stitches and she was like, “Let’s put on some music,” because I was talking about this music that I loved. She was like, “Let’s find this album and let’s listen to it.” So she found this album and she talked with me the whole time through the stitches. Then I got to take my beautiful postpartum bath in the salts and the flowers and stuff. It was just beautiful. My doula got a picture and she was like, “You look so angelic like a mermaid.” I was lying sideways and my hair was all draped. She was like, “There are flowers in the water. It is beautiful.”

Again, it was a healing full-circle moment when they handed me my baby to take this bath together because the tub was another source of stress and anxiety from my first birth. I felt stuck. I felt abandoned. I felt like I didn’t have a ton of help. I had help but it didn’t feel like it. So just a lot of little moments throughout this suite that I was in that helped heal me a lot from my first birth that were all of these trauma points from my labor with him. 

They did the newborn exam. I got to hold her and be in the same room as her the entire time. I held her the whole time they did my stitches. We waited to cut the cord until it was white. My husband got to cut the cord. It all was incredibly, incredibly beautiful and healing. I did have to have two bags of IV fluids because of the blood that I lost which kind of helped rebuild that. My doula fed me soup while I was in the tub snuggling my baby. It just was a night and day difference. 

Meagan: Yeah, such a different experience. 

Rebekah: She’s 7.5 weeks old and we’re doing great. I healed very well, so much faster than with a C-section. Again, night and day. I don’t even feel like I had a baby. Healing this time has been incredible this time especially having a toddler and worrying, Am I going to be able to do these things?

Meagan: Yeah, that was actually one of the reasons among many that I did want a VBAC too. A lot of people were like, “What are your reasons?” One of them was that I want to have a better postpartum experience physically as I’m recovering because I just remember being so– and it can happen with vaginal birth too. Vaginal birth doesn’t just eliminate your chances of not a great experience. You can still have a not-great experience with that with a vaginal birth, but yeah. I was like, “I want to be able to pick up my kids. I want to be able to drive if I needed to. I want to be able to–”. 

Rebekah: Go to the bathroom and shower by yourself. Normal human things. 

Meagan: Right, not have my husband holding me up showering. Yeah. That, for me, was such a big difference too in my recovery. That alone. 

Yeah. I’m so happy for you. I’m so glad that you were able to not only just have a different experience that was healing just in general but then all of these little things that you were able to heal from in addition like you said with the tub and these peaceful experiences and your connection with you and your daughter like, “Hey, I think she’s scared and I need to go talk with her. I need to be with her.” And even during the pushing, you had that connection again. “Hey, honey, we are excited.” 

You were touching her and talking to her. It just goes to show so much how much more connected these babies are than we think they are. They really, really are and your body was ready. Your baby wasn’t ready and sometimes that is the case and we have to understand that usually when spontaneous labor is going on or whatever, it’s a team effort– body and baby together. Sometimes it’s not and we have to help them. 

Rebekah: Yeah, exactly. It was crazy actually pushing a baby out. I don’t want to say that I’m scared of doing it again but I wasn’t expecting it to be as intense as it was. With my son, I was complete. I had dilated to a 10. I was fully effaced. His bum was right there. I think if we hadn’t known sooner that he was breech, I wonder if we would have had an accidental breech delivery at the birth center because I was complete. I was ready to push a baby out. My body was already pushing. 

I had done all of the labor up to the pushing a baby out part. I think I had just built it up in my head, “Oh, you’ve done this before. You’ve done this before. You’ll be okay.” I had done everything but the pushing phase. Feeling her actually coming out of my body was such a bizarre sensation. After her head was out, I actually felt a little wiggle. She wiggled her body in there and I said, “I can feel her moving.” My midwife was like, “Yep. She’s getting ready to come out.” 

It was incredible that I was able to actually feel all of these things even though it was painful and it was hard. That’s the only thing I wanted. I wanted to feel what it was like to actually birth my baby out of my body and do what it was designed to do. It just was incredible and it doesn’t take away from the experience with my son at all. Both labor experiences and both birth experiences taught me so many things in completely different ways. 

When I tell my birth story with my daughter, I really hope that it doesn’t come off that I was trying to rewrite history or trying to erase the way things happened with my son because it’s not the case. The stories don’t exist without the other. It’s just been incredible to see how their personalities are different just based on how labor went with them. I really believe that the way your labor goes and the way your pregnancy is, you can almost tell what your baby’s personality is going to be like based on those things and how they go. 

Definitely with my kids, that has been true. 

Meagan: Yeah. A lot of people especially with breech are like, “Oh, this stubborn baby. This baby wouldn’t flip. This baby threw us a curveball,” then they come out and they’re like, “They’re still throwing curveballs. They’re still stubborn.” I mean, I’ve heard that is definitely something that can happen. The babies set the stage. 

Rebekah: Yeah, absolutely. I kept saying when I was pregnant with her that I felt like she was going to be a feisty baby and be fiery. That is how she is. It was beautiful. 

Meagan: Well, I’m so happy for you. I absolutely love, love, love your birthing team over there. They are just so amazing and I’m so glad that you had a doula and you had the support and that you were able to find healing through this birth experience. 

You know, every single birth is unique. You’re going to heal and grow through every single experience. It’s the most beautiful thing. 

Rebekah: This podcast helped a ton. That was another thing that I did during my prep. I was listening to The VBAC Link Podcast and a couple of other podcasts. I watched lots of birth stories so for VBAC moms, it is another piece of advice I have. Really just soak in all of those VBAC stories and instill that confidence in yourself because I have heard some moms who stay away from podcasts and they like to just have their thoughts and their experiences be their own. That’s great and that’s fine, but for me, I really needed that support and I really needed that constantly spoken into me. 

So hearing birth stories, especially VBAC birth stories for VBAC moms is invaluable. It was incredibly empowering. I’m so thankful for your podcast and the fact that you do this and put this community together for moms who listen to it.

Meagan: Thank you. It’s definitely something that I missed out on in my pregnancies and wanted. I was searching and searching and searching. There would be VBAC stories here and there but I really needed something more. That’s why we started this so we could hopefully help people along the way and have more and have that community and that support and just that drive. I feel like you hear these stories and it really helps you be like, “Oh, okay wait. These hundreds of women before me have done this. These are not even half of the women out there.” The amount of submissions that we get and the amount of stories on social media, there are so many stories out there. 

You are all Women of Strength and you can do this. I think you are right. Listening to these stories, you’re going to find something. You’re going to find connection and nuggets. You might even find healing through other people’s stories. It’s weird to think about that but truly, yeah. 

Rebekah: Even the repeat C-section stories, I loved hearing those and that was what my mental and emotional prep this pregnancy revolved around. I was like, If we’re going to have a VBAC, we’re going to have a VBAC. That’s not what I was worried about. It was that I wanted to make sure that my mind and my spirit and my body were in a place to receive another C-section if it needed that. If I have to have another one, I’m going to make sure that it’s a positive experience this time around. 

So hearing those stories from women who had repeats and even that was healing for them was awesome to hear. 

Meagan: Yeah, and you were talking about that in the beginning with that unexpected. Your unexpected was that you had an unexpected breech, surprise baby and you were exhausted. That was the route that felt right and some people go into spontaneous labor and it turns into a Cesarean for whatever reason or they go into an induction and the body wasn’t responding and baby wasn’t responding. We have these unexpected experiences and it’s hard because when we are preparing for unmedicated vaginal birth or a medicated vaginal birth or vaginal birth in general, we don’t want to think about that Cesarean. We don’t. 

It’s easy to push it aside. That’s one of the reasons why I think sharing CBAC stories and scheduled C-section stories on the podcast is so important because it does happen and it’s important to learn your options there. 

We just share stories here and we want everyone to find what’s best for them and if we limit what we can learn, I think we are doing ourselves a disservice. 

Rebekah: Absolutely, yeah. Yeah. I hope to get into birth work someday. Ever since I got pregnant with my son, I have been completely immersed in all of it. My Instagram feed is 90% birth workers. So I have learned so much and I used to do that. I used to only really pay attention to the holistic, natural, unmedicated side of things but now, I follow several labor and delivery nurses and OBs and take little pieces from here and little pieces from there. As you are preparing for a new baby, you can’t possibly know everything or prepare for everything but knowledge is power and knowledge helps to dissipate fear. As much as you possibly can, learn and arm yourself with it. Like you said, I think that’s why doulas are so important too. They can help you in that process of figuring out what education you can focus on or should be focusing on based on what you want. Yeah, it’s just incredible. Birth is incredible no matter how it happens. It’s hard and it’s gritty and beautiful. 

Meagan: Absolutely. I couldn’t agree more. Well, thank you again so much for being here with us and sharing your stories. 

Rebekah: Thank you 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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Colleen’s first pregnancy ended in a miscarriage at 6 weeks. At 12 weeks along with her second pregnancy, Colleen and her husband found out that their daughter would be born with a genetic condition called Trisomy 18. Colleen shares her experiences with Trisomy 18 and how she found the right support to help her navigate through it all. Due to IUGR and other medical concerns, Colleen had her daughter via Cesarean with an 85-day NICU stay afterward. 

To her surprise, Colleen had a third pregnancy just 6 months after her daughter’s delivery which ended in a heartbreaking second-trimester miscarriage. After discussing her pregnancy and birth histories at an appointment, Colleen’s doctor referred her to be screened for a MTHFR gene mutation for which she came back positive. 

MTHFR (methylenetetrahydrofolate reductase) is a gene that impacts your ability to process and absorb folate. It can be responsible for complications during pregnancy and is detected through a simple blood test. 

Colleen and Meagan talk more about what MTHFR means, and what Colleen was able to do to have a fourth uncomplicated pregnancy and a beautiful, smooth VBAC delivery! 

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Welcome to the show, everybody. We have our friend, Colleen, on with us today sharing her stories and navigating through this amazing journey that we call birth. Birth is such a journey, wouldn’t you agree, Colleen?

Colleen: Absolutely. 

Meagan: One of the most unique things about it is obviously through the stories we all hear. They are all unique and individual to us and even one birth that you’ve given doesn’t mean the next birth is the same. So we’re going to be talking today about navigating through birth and we know that a lot of the times through these journeys whether it be because of a Cesarean or because of how we were treated or because of how our body responded or whatever it may be, sometimes and a lot of the times, we experience trauma. Trauma is viewed differently from everybody and processed differently. We are going to be talking about navigating through trauma. 

Then Colleen is actually going to share some of her fertility journey as well. I think that’s also a really important thing because we have so many mamas out there– we know. We know. We see it. They have to navigate through fertility challenges. We’re going to be talking about that along with a VBAC. 

Let’s get into that here in just a minute. We do have a Review of the Week then like I said, I’m going to introduce Colleen and turn the show over to her so she can share her beautiful stories. 

This review is from lexieemmarie. It says, “So thankful. I just wanted to say thank you for creating this podcast. I had my baby girl via emergency Cesarean at 30 weeks due to several medical complications with my baby. We spent 95 days in the NICU and while in there waiting for my sweet girl to grow, I started to research VBACs to see if it was right for me. Once I found this podcast, it sealed the deal. I absolutely can’t wait to VBAC with my next pregnancy. You all are incredible to listen to because you provide the wealth of knowledge and positivity but are also fun and entertaining to listen to. Amazing job, ladies.” 

Aww, that just made my heart so happy. Oh my goodness. Thank you so much, Lexi, for your review. As always, we love these reviews. They make our hearts and our minds so happy. You guys, this is what we want. We want you to have that wealth of knowledge. We want to have you feel inspired and guided and uplifted and educated along the way through all of these stories. 

As usual, leave a review if you haven’t yet. We would be so grateful. 

Meagan: Okay. We have Ms. Colleen. She lived in Michigan. Did you have your VBAC baby in Michigan? 

Colleen: I did, yes. 

Meagan: You did. 

Colleen: My husband and I live in a suburb of Detroit in Gross Point so that’s where I gave birth in August of 2024. 

Meagan: Awesome. Awesome. Okay. Wait, 2024? Just right now?

Colleen: Yeah, I’m 2 weeks postpartum. 

Meagan: Yes, I love it! So really, really fresh. 

Colleen: Fresh. 

Meagan: I love sharing stories that are so fresh like that. It is right there in your brain. 

Colleen: Exactly. 

Meagan: Oh my gosh. Okay. She has two beautiful children now and one two-week-old baby. Your two-year-old daughter is Gianna? 

Colleen: Gianna, yes. 

Meagan: She was born via Cesarean due to chromosomal abnormality. Do you want to share what that means?

Colleen: Yeah, I would love to. Gianna has a chromosomal condition called Trisomy 18 that we did find out about through the genetic screening early on in pregnancy that she was considered high risk for coming down with Trisomy 18. As the pregnancy progressed, it became pretty evident that it would be the reality. 

For those of you who don’t know, Trisomy 18 on its surface means that the baby will have an extra 18th chromosome in some or all of their cells. How that manifests itself is through some pretty serious medical complexities that require quite a bit of care. I will get into that a little bit more with my story but that is the quick version of Trisomy 18. She is also now 2 years old and a bubby, sometimes sassy, little girl. 

Meagan: Is there another name for it with an E?

Colleen: Edwards Syndrome, yes.

Meagan: I have another friend who has that and I seriously adore him. He is thriving and doing amazing in life. 

Colleen: Yes. She is a warrior. She is so strong. She is so beautiful and has brought nothing but love and joy to everyone who knows her or who don’t know her. There are so many people from near and far who love her. It’s great. 

Meagan: Yes. Awesome and then we’ve got Sonny who was born via VBAC just two weeks ago you guys. She says, “As a mama of a medically complex child, she is passionate about awareness and education for those within her daughter’s condition. She also enjoys running, reading, cooking, and volunteering.” 

Colleen: Yes, that’s a little bit about me. 

Meagan: I love it. Welcome to the show and thank you so much for being here with us. I would love to turn the time over to you to start sharing Gianna’s story. 

Colleen: Amazing. Thank you so much for having me on. The VBAC Link was a staple on so many of my walks when I was getting ready to give birth. I just found it to be so uplifting and empowering and I’m so glad that I found you as a resource. 

A little bit of background before getting to my VBAC– it really does begin in about 2022. It starts out with some of those fertility issues that you had mentioned at the start of the podcast. My husband and I decided to start trying after about two years of marriage and we got pregnant pretty quickly. That ended early in a miscarriage at about 6 weeks. 

But we said, “Okay, let’s try again.” We had processed and accepted that miscarriages do happen so we quickly said, “Let’s give it another go.” But we had those reservations and that in the back of our mind of moving forward cautiously. We did get pregnant quickly again. Throughout the first trimester, we just kept it tight-lipped. We just told immediate family and then decided we wanted to do the genetic testing of course to find out the gender. We didn’t really give too much thought to what else you learn from that bloodwork. 

As my pregnancy progressed throughout the first trimester, I was feeling confident then at about 12 weeks, we received a call from my midwife. She told us that it was a girl and that she came back high-risk with Trisomy 18. We weren’t expecting that. It was scary and a shock and the more we learned and the more we read in those early days was devastating to us. We were just coming off the heels of a miscarriage so then to have this thrown at us was just a real curveball. 

In order to move forward and navigate that, my husband and I were always planning on keeping the pregnancy so it just meant, what does that mean going forward? After talking with more specialists and maternal-fetal medicine at the health system that I was at at the time, it became very apparent that they weren’t really willing to help. 

We needed to find another health system. We are so fortunate because we were living out of state for quite some time then moved home before we started to try. We were living in Chicago and then moved back to Michigan. University of Michigan, so CS Mott Children’s Hospital is for sure the best in the state and one of the best in the country for caring for kids with my daughter’s condition. We switched all of my prenatal care there and they provided us with hope and were willing to monitor me and have a very wonderful NICU. They were willing to provide interventions and things after she was born. 

But as it related to my pregnancy, it completely deterred any sort of plans and any sort of “normalcy” that one might have. It was shrouded in sadness and anxiety and fear and unknown. Each ultrasound and each week was closer and closer to meeting her but also closer and closer to what does this mean for her? What does this mean for our family? I completely abandoned any apps or what size fruit she was going to be at a certain week because she had intrauterine growth restriction. That rulebook and those guidelines went out the window. 

I was really afraid to connect with her when I was pregnant. A lot of the time I would say, “Okay, be in tune with her. Read to her and rock her and listen to music with her,” and I would just end up in the nursery that we decorated in tears because I just had so much fear and sadness around what was to come. 

With that being said, because my plans had been derailed, I really threw myself into learning about her condition and learning about what would come afterward. That gave me hope as a very Type A person. I needed to be doing something to prepare and connected with other families from around the country to give me and my husband hope and learn about what life with children with Trisomy 18 looks like and what they are capable of really was our main driver throughout pregnancy. 

With that said, I did not prepare for birth at all. I didn’t learn about how it could possibly go. I really just, like I said, focused on what care for her would look like. Just as a very small example of what that even looked like was when I came to write my birth plan, I probably wrote a couple of things like, “Oh, open to epidural. Do you have a birthing ball?” I honestly had a line in there that said, “If she is born not breathing, resuscitate her.” That is where my head was throughout pregnancy and it just came to however she was going to arrive, that was second to her being here and us starting to care for her. 

Meagan: Yeah. 

Colleen: That said, my care team, obviously I was being seen by the MFM department at CS Mott. They were very supportive. I never felt like they weren’t looking out for both me and her. I think they wanted me to deliver vaginally and with the understanding that if it came to a Cesarean that would be what it was. My husband and I made it very clear that we wanted to be treated however they would handle a typical pregnancy. 

Meagan: Anybody else, yeah. 

Colleen: Yes. Yes. If it meant a C-section, that’s what it was going to be kind of thing. She was showing that she wasn’t tolerating labor. 

We got to the end of pregnancy and we were discussing what birth would look like. We all agreed that an induction at 37 weeks was going to be the plan for a couple of different reasons. From our perspective, we wanted to just start caring for her knowing that she was going to have complexities. We were in the best place possible to start that process. There is some research that would show that the longer that babies with Trisomy 18 are in utero, you could run into a stillbirth situation. Now again, it’s a little bit more on the anecdotal side because many, many kids with Trisomy 18 are born vaginally at 40-41 weeks and it’s how you want to play it. 

Meagan: You have to weigh it out for what’s best for everybody. Was IUGR becoming a problem at all or was she still small but staying within her own growth chart?

Colleen: Toward the end there, we were seeing some stagnated growth so yeah, they were very much of the mindset, “Let’s just get here here,” kind of thing. She was born at 3 pounds, 12 ounces. She was just a peanut. 

Meagan: Little tiny, yeah. 

Colleen: I was induced at 37 weeks without having much knowledge of what the induction process was going to look like for me and I went in at a centimeter. They started with a cervix softener so that they could then insert the Foley balloon. I was in bed a lot. I utilized the tank of nitrous oxide. I labored that way for a while just to mitigate that pain. I was walking around a little bit but honestly, the Foley balloon for me in the whole induction process was probably the worst part. 

I was in quite a bit of pain after that. 

Meagan: Were you dilated at all before when they tried to insert that or was it a closed, posterior cervix? I’m assuming at 37 weeks, it’s not doing much. 

Colleen: I was a centimeter when I came in and I was maybe a 2 when they inserted it I believe. Yeah. It was very apparent that my body was probably not ready for that process. 

Meagan: Yeah. 

Colleen: Yeah. That also became apparent once the Foley balloon came out but then pretty much I got to 5 centimeters and just parked it there for quite a bit. The pain was pretty intense so I received an epidural after laboring I would say probably 14-16 hours or something like that. The attending OB wanted to take additional steps by breaking my water and my husband and I were talking. We said, “If they break my water and then I don’t progress, then what situation are we in?” We also knew beforehand that my daughter did have a confirmed heart defect. We wanted a more gentle approach to induction especially when it came to Pitocin. We really wanted to take it slow and monitor her to make sure she was tolerating it and things like that. 

We opted for Pitocin before breaking my water and took it slow. I would say probably another 6-8 hours went by. We were taking it very slow. I wasn’t progressing and then we started to see some sporadic, not super consistent but enough to keep make us aware of her, decels that she was having. 

Again, the attending OB really wanted to continue on. She wanted to break my water. She wanted to optimize my chances for a vaginal birth, but again, I think my husband and I were so zeroed in on having her here safely that even the attending OB after observing some of the decels into the night was like, “Okay, I think–”

Meagan: That was enough. 

Colleen: Exactly. She arrived via C-section on October 28, 2022 at 3:18 in the morning which we find incredibly special because 318 is a universal number around Trisomy 18. We just feel that she was meant to be here just as she is. That was enough for us to say, “Okay. We did what we think we needed to do to get her here safely.”

Meagan: And happy birthday to her today. She will be 3?

Colleen: She’s actually turning 2. She’s turning 2. Yep, yes. 

So that was my obviously first birth experience and it was– I can’t even say different than what I expected because again, I really went into that not having much of a reference or much preparation at all. 

I say, “Okay. That was my experience. It was a C-section.” We weren’t thinking at the time. We always knew we wanted future children but with the timeline, we had an 85-day NICU stay with her. There were other things that we were focusing on. 

Meagan: You and the reviewer. You NICU mamas are amazing. 

Colleen: Perfect review for today. After 85 days, we came home in January of 2023. We were getting settled into home life and then fast forward to about 6 months postpartum. We had just been home for a couple of months and much to my husband and I’s surprise, we were pregnant again. 

From the first miscarriage to my daughter, we had that hope and that mentality of, “We have no reason to think that anything is going to go wrong so let’s just operate from the stance that everything is going to be okay.” We took a similar approach this time around. We said, “Okay. We’re going to roll with the punches. Gianna’s going to get a sibling a little bit sooner than we initially had thought. Let’s just play it like everything is going to be okay.” 

We had met with a geneticist and knew our risk for having another child with Trisomy 18. We were just slightly above the general population when it comes to the statistics there. We weren’t super concerned. It was a very, very low risk. We decided to do the genetic testing anyway. I didn’t consider myself to be high risk so I moved my care to a little bit closer to home. The University of Michigan is a little over an hour for us. I had a great experience but wanted to move just a little bit closer to home to a practice that is very utilized on this side of town by many women. 

I did the genetic testing and everything was good. We were having a boy and then the very next day, I woke up to a very large gush of blood. I went to the emergency room. This was on a Saturday. They did an ultrasound and said, “Baby is looking good.” I was again, about 12 weeks at this point. They said, “Sometimes just bleeding in the first trimester happens.” I took that at face value. I came home 

Now mind you, with my daughter’s condition, she has a lot of medical equipment and lower muscle tone so it’s a lot of carrying her around and at that point, she was still pretty small but again, I’m pregnant and I’m hauling her medical equipment plus her some days. I’m a stay-at-home mom so I’m trying to navigate all of that. I’m going about my daily life not really thinking much of it just saying, “Okay, that’s what it is. The first trimester bleeding.” I went back to the OB that week and they also confirmed, “Oh yeah, it could just be bleeding.” 

I said, “Okay.” Then about 2 weeks later I’d say, again on a Saturday, it happened again. The bleeding had tapered off then it happened again. I went back to the emergency room to make sure everything was okay and it was a different emergency department. The nurse practitioner came back in after the ultrasound and said, “You have a really large subchorionic hematoma.”

Meagan: I was going to ask if that’s what it was. 

Colleen: Yes. We had done research obviously between the two ultrasounds and people said, “If you do, it likely will heal on its own.” 

Meagan: It takes time, but if you do activity and things like that. 

Colleen: Yes. I would say probably about 2.5-3 weeks went by with me not knowing I had it. I hemorrhaged again. This time, I really tried taking it easy leveraging my husband, my mom, and my mother-in-law to really help care for my daughter so I would be able to rest and recover. 

When I had gone to the OB that Monday just because I had been in the emergency room over the weekend, they painted it like there was not much you can do. If you can take it easy, great. If not, I actually went in that Monday and I had brought up the subchorionic hematoma and the provider that I met with said, “Oh, yeah. You have it but actually, I want to talk to you about something else.” It was a potential marginal cord insertion or a velamentous cord. 

Meagan: Okay. 

Colleen: She said, “I actually want you to be more aware of this than the subchorionic hematoma.” Again, it was pushed to the side. At that point, in partnership with some other pretty inappropriate and I would say frankly bad bedside manner from the practice, I was looking to move again. They were very insensitive around my daughter’s condition. They made me to be othered because of her. I just didn’t appreciate that. I was like, “This is a different birth.” I didn’t appreciate that treatment. They asked very inappropriate questions about her and her life expectancy and things that were very triggering for a) someone who was fresh out of birth and a very traumatic pregnancy. I just felt that was very inappropriate to ask those things especially when we are also not talking about my daughter. We are talking about this pregnancy at hand that was having some issues. 

I was looking to switching providers. I have my best friend in the area. I loved her. She was pregnant at the time as well. She loved her OB so I was looking to switch. I couldn’t get in for a couple of weeks so I just said, “Okay.” At the next month’s appointment, I would switch practices away from where I currently was. 

In the meantime, I would say about a week and a half later, I was bleeding again. It was on a Monday so I got in that day and I personally had a little bit of peace around it because I just said, “Okay, this has happened before. Baby has always been okay, but let’s get in.” 

So I got in that Monday and I was given an ultrasound and the ultrasound tech put the wand over my belly and then very quickly went out of the room. My heart sank. I just knew what that meant. She came back and I asked, “Was there a heartbeat?” She just shook her head no. I was by myself because my husband was home with my daughter and it was just completely unexpected and devastating. It crushed us because we again had just come off of something so difficult and had so much hope and for that to be the result was quite crushing. 

I had reached out to the OB that I had planned to switch to and I just explained the situation. She said, “I’d like to still see you.” I went in about 2 weeks after my miscarriage and just laid everything out for her. She shook her head after me telling her about my first miscarriage and then my daughter and this most recent miscarriage. She took it all in and she goes, “I think there is something going on. I don’t think these are just flukes so I want to run some tests.”

She ordered some pretty extensive bloodwork mostly in the autoimmune space but she also ran for MTHFR. After many vials of blood and a few weeks of waiting, I came back negative for anything autoimmune but I did in fact come back for MTHFR and she is a provider who believes that it does make a difference. She said at the time that she provided us with this glimmer of hope. She said, “If I know that a patient has that, I start them ideally on a pretty ‘easier’ regiment or something to get them started to see if that makes any difference in their pregnancies. If not, we can build with Lovenox injections and things like that.” Basically she said, “I want you on additional folic acid.” I took methylfolate and a baby aspirin. 

But she posed it to my husband and I. “Do you just want to go the Lovenox route? Once you go on Lovenox, I won’t be able to walk you back on additional pregnancies. If you have a successful pregnancy–”. Again, knowing this wasn’t going to be the answer and that we could potentially have another loss or more issues with pregnancies but we wanted to start on that first step before jumping forward.

She said, “Pick up those supplements when you feel like you are ready.” We needed time. We needed months of healing and of focusing on my daughter’s care to just really level-set for our family. But in December of last year, we felt strongly that we wanted Gianna to have a sibling so we decided to try again. I got pregnant and began those supplements. From that perspective, my pregnancy was very difficult. Now, it also gave me that time both prior to getting pregnant and then throughout my pregnancy to really– I really wanted to level-set my approach and my outlook on pregnancy. 

I had felt like I had been always in this cycle of seeking out information or researching based on issues and I think my and as well as my husband, the trauma aspect always played into it of, okay. Here’s a symptom. It could be something very normal or it could be these very unique, rare things that we got used to feeling comfortable in that space. 

Meagan: Yeah. 

Colleen: I sort of recognized that as something that I needed to work through. I needed to work through some things that were either emotions I pushed aside. I pushed aside the thoughts and feelings around especially that second miscarriage because I said, “Okay, I have a daughter with medical complexities.” I needed to jump back in and I think that distraction helped me push those thoughts away but then I will say they came back. They reared their head and I said, “Okay. It’s time for me to deal with them.” 

So going back to talk therapy has been really helpful for me for working through some of those emotions as well as unprocessed things with my daughter’s pregnancy and birth and care and things like that, the realities around her life and how it’s impacted myself, my family, and things like that. 

I went back to talk therapy and then also got pregnant. I thought that was the perfect time to really sort of level-set my outlook on pregnancy. We forewent the genetic testing around. We just said, “What will be will be.” For now, the fourth time, we are choosing to believe that all will be well. We will have these feelings. My first trimester almost felt like the closer I got to the end of my first trimester, the more anxiety I had because I had that second-trimester miscarriage that I just had the opinion that it could happen at any time and why wouldn’t it just happen to me again?

There were some friends who didn’t know that I was pregnant until my anatomy scan just because I felt like I needed to hold it close to my chest. 

Meagan: Just keeping your space safe. 

Colleen: Exactly. Exactly. And protecting my own emotions. So the first trimester for my son did have some of those thoughts and feelings. The OB who I had switched my care to was very accommodating. She had a little portable ultrasound machine in her office if I felt like I needed that reassurance that she would provide the ultrasound for me. She asked me how often I wanted to come see her. She was just very understanding and accommodating based on my previous circumstances. 

It also allowed me the space, especially as I moved through pregnancy, to really think about birth and think about how that process could be healing as well. In my second trimester, I remember going on a walk because I needed to clear my head and just feeling so overwhelmed by not knowing where to start and then I was being hard on myself because I was like, I should have done this with my daughter. I should know these things already. This is my second birth. I was being very self-critical as if I didn’t have other things to focus on with her. 

That’s when I came across The VBAC Link. I actually came across it because my husband and I had taken some on-demand birthing classes through Mommy Labor Nurse and we very much so said that we needed a refresher and probably to take some more diligent notes this time around. 

It was a resource that she has promoted so I checked it out and I just immediately felt like it was going to be so helpful as it was throughout pregnancy just listening to the podcast episodes, referencing the blog, getting your emails, and just really feeling like I had a resource that was going to support me. I can’t express how grateful I am for that because– and I’m about to get emotional– of how along pregnancy and that journey has felt. I’ve constantly felt like I’ve been up against walls that it’s been exhausting to have to overcome and to break down. 

Meagan: Yeah. It’s a terrible feeling to feel so alone in this really big moment in your life and not feel like you know the direction all the time and then also making decisions and then having the world pretty much question why you are making that decision. It’s so heavy and that’s why I love this community so much because they make you feel connected to people that are not even within reach. They are hundreds and thousands of miles away. 

Colleen: Absolutely. Absolutely. Just to have that support because it very quickly became my goal to VBAC because I flipped the script after finding The VBAC Link. I said, “There is nothing pointing to my body not being able to do this. I’m going to go for it.” I’m a competitive person and sometimes I’m competitive with myself and I said, “This is going to be a competition and I’m going to do this.” I will say getting into the true VBAC part of it, my OB was very supportive. 

She said, “I think you are the perfect candidate to VBAC.” She did want to see what my body did closer to which made me a little bit nervous. She was like, “I’m not for induction but I would do augmentation.” I was like, “Okay. Let’s see.” Again, it was a motivator to me to do all of the things that I could do to edge myself along kind of thing. 

The biggest thing I leveraged was walking. I walked a ton and I just found a routine in the business of life that worked for me that I could rely on each and every day and say, “Okay, these are the three things that I’m going to do throughout the rest of pregnancy to a) give myself peace mentally and physically, but also just to say life is busy, but this is what I’m going to do to move myself forward.” It was a lot of walking. It was a prenatal that I just really adored and I just committed to a pretty nutritious diet to make sure that I was nourishing my body in all the ways that I could. 

Around 36 weeks, I received a cervical check and was starting to dilate and efface. I was about 2 centimeters. 

Meagan: Wow. 

Colleen: Yes, with about 70% effacement at that time. My OB said, “Things are looking good. You are on the right track here.” I just kept doing what I was doing. I did opt for a membrane sweep at 38 weeks and I will say having never labored before, between that 36 and 38-week mark, I was having a ton of prodromal labor which was very frustrating because I never knew what was real. We went to labor and delivery once. I got turned away and sent home. I thought it was the real deal. Yes. Prodromal labor is a tease. 

But after the membrane sweep, it became very apparent that I was actually in labor. That afternoon, my husband and I and my daughter lay on the couch. I was having closer and stronger contractions and we joke that it was absolutely the real deal because all the times leading up with prodromal labor, everything was squared away. My meals were prepped. Everything was squared away with my daughter. My in-laws and my parents were ready to go and jump in. 

The day that I started to be in labor, our basement flooded with our sewage backed up. 

Meagan: Oh no. 

Colleen: I’m actively in labor and my husband comes up and says, “This is absolutely the real deal because this wouldn’t have happened if you weren’t.” I’m in labor and my father-in-law are bleaching the floor and scrubbing. It was a whole thing and I was like, This isn’t funny right now but it will be funny one day. And it’s funny. 

I was able to labor at home for a few hours. I got to the hospital. I had the membrane sweep at noon that day. I got to the hospital around 9:30 PM and was at a 5. I was feeling pretty good about that. I was feeling those contractions of needing to pause. I wasn’t really able to talk through but still at that point now knowing what later labor felt like that it was just the beginning of things. I had a wonderful labor and delivery nurse who was super supportive. I never felt being there like I had to convince anybody. They knew that my plan was a VBAC. The attending OB was cool with it. 

My OB lived just a few minutes away from the hospital and said that she would be there within a moment’s notice when I did deliver so I would have her for the moment of. I got to a 5. They did put me on the monitors and had me hooked up so my movement was pretty limited which kind of limited what I was able to do. I wanted to walk a little bit more. I was only able to sit on the birthing ball in a certain area of the room. That was a little bit tricky. The shower was really nice and I did appreciate laboring in the shower but it was the attending OB who had checked me when I first got there and determined I was a 5. 

A few hours later, the labor and delivery nurse checked me and said, “Oh, I think you are a 7.” My goal was to get to active labor before I decided if I wanted an epidural but ideally, I wanted to go unmedicated. So when they said I was a 7, I was like, “Oh, okay. All right. That’s the motivation I needed to keep pushing on. I can do this.” My contractions were becoming more frequent but they weren’t getting stronger. It almost felt like at a moment’s notice when they had to put the IV in or if the pain was too intense that I would start to space out again which I found to be interesting. 

But when a few hours went by, the pain was intensifying. They wanted to check me again and it was the OB this time who had checked me earlier and she said, “Oh, you’re a 6.” My husband and I said, “Well, they said I was a 7 when they checked me last time.” She said, “Yeah, but I’ve got the frame of reference and you’re more of a 6.” That messed with my head. 

Meagan: I’m sure. 

Colleen: My breathing was no longer effective. The pain was getting to me. The next step they wanted to take was breaking my water. I just didn’t feel like I was in the headspace to continue on without the epidural. 

Meagan: You were mentally derailed. That can happen. 

Colleen: Yeah. When it came to my birth plan this time around, I was a little bit more descriptive because I had done more research. I wanted to go the unmedicated route if I absolutely could. If not, at least active labor. I really didn’t want any augmentations or interventions when it came to breaking my water or Pitocin. I really wanted to be able to do it on my own but I will say and I think this is one of my bigger takeaways from this birth is that even when things don’t go according to plan, you really have to trust your gut. I will say in those moments, my gut was telling me I think what needed to happen to service the overall goal which was my VBAC. 

I said, “Okay. I think in order for my body to relax, I want the epidural.” I get the epidural. My body did just that. I was able to relax. My contractions were getting closer together again. They did break my water and now we were into the morning hours here. I get a call from my OB and she said, “Hey, I’m aware of your situation. I see that your contractions are getting closer together but they are still not at that strength that we are really wanting to see.” She said that, “If you are okay with it, they want to start me on very low doses of Pitocin.” She said, “I think you will need a whiff of it in order to get to where you need to be.” 

My husband and I looked at each other and I think because of our experience with Pitocin previously and not wanting to stall out or anything go wrong, we really struggled with that piece but I think ultimately, we said, “Okay, we’re already here. If this is what my OB thinks this is what I need–” and again, I personally felt okay with moving forward in those directions, “then, let’s give it a try.” She was absolutely right. They started at a 1 and bumped it up 45 minutes later. 

I was feeling some pressure and I wanted to switch positions. I had the nurse come in to help me. She lifted up the blanket to move me and she said, “Oh, his head is right here.” He had been crowing for we don’t know how long.

Meagan: Oh my gosh. 

Colleen: My husband looks down and he goes, “Yeah, his head is poking up.” My OB gets there. It was super relaxed. She just walked in. She had her sunglasses on. She was just like, “Okay, let’s do this.” She was getting set up. He had a bunch of dark hair and she was giving him a faux-hawk while she waits for things to get set up. For the moments that led up to that with anxiety around the interventions, the moment of his birth was very relaxed, very calm– 

Meagan: Lighthearted. 

Colleen: It had this great energy around it. I pushed for about 15 minutes and he was born. 

Meagan: Oh my gosh. That is amazing. What a way to end such a lead-up to get to this moment in your life. 

Colleen: Yes. His birth, the moment of his birth and the half-hour leading up was so joyous and healing like I had always hoped it would be and exactly what I think my heart needed. Just not necessarily VBAC-related, but I think I also struggled with all of the needs of my daughter and having now split time, I think going from one to two for some mamas can conjure up those feelings and that guilt around what your firstborn is not getting especially with all of her extra needs and things. I was really feeling that guilt. 

Now he’s here and he is exactly what my family needed. He is just this puzzle piece that was missing. We didn’t know it. We didn’t know it until he was here and now we feel that way on so many levels. 

Meagan: Isn’t that crazy sometimes? This is one of the coolest things I think about being a doula is that we see these couples and they think that their life is so amazing and it is. Don’t get me wrong. It is amazing. They think that they love each other more than they ever could love each other. I can see the love in their eyes. I can see the support as the labor goes and then this human being enters their family and like you said, it’s just this puzzle piece that fit that you didn’t know you were missing. 

It’s this extra joy and this deeper love that they didn’t even know existed and it’s one of the coolest things to see families transform. Yeah. It’s absolutely amazing. Even from no kids to one kid and from one kid to four kids, it doesn’t matter. Like you said, it’s the puzzle piece that they didn’t know they were missing. 

Colleen: Absolutely. I just can’t wait to watch my daughter learn from him and him learn from her. That relationship– I even had the thought where I was like, “I’m the most important thing to my daughter,” then I’m like, “Okay, but she’s going to have a sibling and that is such a gift in and of itself that I just am happy to be able to provide that,” but to your point, it is. It’s a love unlike any other love. You will always obviously hold your partnership with your partner. It’s so important and so instrumental to providing that love for your children as well but that love that you get from birthing a child is unparalleled. 

Meagan: Oh my gosh. It’s so amazing. It is so amazing. I feel so grateful as a doula and as someone who is done having kids– my youngest is 8 years old now but I get to keep living through all of these couples. It’s just so amazing. Oh, well congratulations. 

Colleen: Yes. It’s so beautiful. Again, it didn’t go on the micro-level according to plan, but on the macro-level and in my big-picture goal of having a VBAC, it was all I could ask for. Rolling with the punches and I will say again, going back to the beginning of the podcast and sharing that I’m a very Type A person, I think had my past not happened, any of these little interventions that were needed throughout this birth could have also derailed me or discouraged me and I just think all of these experiences I had up until this point taught me that rolling with the punches and just understanding that things might not always go according to plan but healthy me, healthy baby– 

Meagan: And a good experience. 

Colleen: Exactly. 

Meagan: Rolling with the punches while trusting your intuition because some of those punches might look like punches but it’s actually what you need. 

Colleen: 100%. Trusting your gut, advocating for yourself, also important to keep in mind. 

Meagan: Super important. Well, before we go, I wanted to quickly give some more depth into some of the things that you had brought up along the way. We talked about your daughter’s condition and then there was something that you said that is a really big tip that I give to my clients when it comes to breaking the waters versus starting Pitocin. 

It’s okay if you don’t agree with me, everybody out there. A lot of people would rather break water over starting Pitocin because it’s the “more natural way to get things going”. But I’m such a person of, let’s try a whiff of Pitocin that we can turn off, but if we are artificially meaning we are breaking the bag of waters by ourselves against mother nature’s choice, we can’t patch that back up and we don’t know what’s going on so we don’t know if baby’s in a weird position. We don’t know if baby is too high. We don’t know what’s going on so sometimes I think just starting that 1-4 mL drip of Pit and then you can always turn it off and it’s gone. 

I was going to say that’s weirdly one of my suggestions that over all of my years of doing this, I would weirdly suggest that sometimes over breaking your water. That really depends on where we are at too. If we are 9 centimeters and baby is +2 station, we’re really engaged, I dont know. It might change. But if we are at the point where you were at, I actually would suggest that. 

I wanted to really quickly talk about VCI and marginal. So velamentous cord insertion. You mentioned that the OB was like, “Yes, subchorionic and we’re here but then we’ve also got this.” With VCI, that is where the cord is inserted abnormally into the placenta. It can cause things like IUGR which we talked about earlier so intrauterine growth restriction. I don’t know if they gave you any stats on this but it’s a 1% chance of that happening with a singleton baby, a 6% chance with twins and then if they do share the same placenta, it can go up. I want to say it’s upward of 15%, so much higher. 

But a lot of the time, even VCI babies carry to term and everything is okay. I do want to throw it out there that a lot of providers do suggest a Cesarean with VCI. I don’t know if you’ve ever heard of that. People can have vaginal births but a lot of providers will suggest Cesareans. If you have VCI or are being told that you have VCI, just know that might be a conversation and you want to discuss that with your provider earlier on. 

She also mentioned a marginal cord insertion which is where that attaches to the side I believe so also an abnormal insertion. I don’t know. Did your provider tell you anything about that? 

Colleen: Not the statistics around it but they also said that I was 6 months postpartum, post-C-section when I did get pregnant again so their recommendation I think regardless was going to be a repeat C-section. 

Meagan: Yeah, so it can happen. Then last but not least, I just want to throw out anything that you have about MTHFR to the listeners who may have gone or are going through experiences like you. MTHFR really depends on a provider. Some people still roll their eyes at it but it’s definitely a thing. Do you have any suggestions toward anybody who may have it or maybe finding out that process?

Colleen: Yeah. 

Meagan: Or going through the process?

Colleen: For sure. Just through my own research, again, my OB was like, “Just additional folic acid.” 

Meagan: I love that you mentioned that by the way. 

Colleen: So I obviously am no expert or dietician or nutritionist but when you do have MTHFR, you can either have homozygous or heterozygous mutations. There are also two different variations. There’s the A variant and the C variant. I think there is research around the severity or the impact of each of the variants on fertility and things like that but sort of the biggest takeaway when it comes to MTHFR is that it can make you more prone to clotting issues as well as malabsorption or the inability to use folic acid effectively. 

That is why a lot of research will indicate that you should be on the purest form of folate which is methylfolate because it’s so easy for your body to absorb when you do have the MTHFR mutation and then when it comes to having additional methylfolate, essentially I found a prenatal that had methylfolate and was just chock-full of a bunch of good stuff. I was also taking additional micrograms of methyl folate on the side just as a pure supplement. 

Personally, I found that to be helpful and again, that is something that I baked into that consistent routine of mine making sure I was on a really optimal prenatal as well as taking the methylfolate every day. In addition to the baby aspirin, that was to mitigate some clotting issues. 

The other thing I will plug is a resource and a follow on Instagram if you don’t already follow is Lily Nichols. 

Meagan: Yes. We love her. She has been on the podcast. We have her books. 

Colleen: Yes, exactly. In addition to when you know you have MTHFR, just really ensuring that you are getting proper nutrition and that is top of the line in pregnancy when you are trying every day of your life basically. 

I definitely broke and cheated with my little guilty pleasures here and there of course. But I really largely throughout pregnancy tried to stick to a really vitamin and nutrient-dense diet. 

Meagan: Yes. I don’t know what prenatal you took and I don’t judge you for any other prenatal of course. We love Needed but you said the optimal amount. That’s what we are finding. So many of these prenatals don’t have the optimal amount and they don’t have the purest forms. We love Needed and truly 100% suggest it. But yeah, exactly what you said. It’s so important. It’s so important.

Colleen: Exactly. That would be my advice to anyone who wonders. I would also advocate and press to be tested if you are having issues. I just think it would be so beneficial just to have that piece of information in your toolbox so that if you do want to ask either on your own or you do want to press your provider to take it seriously, then I would definitely recommend just saying, “Hey, can I get the bloodwork to find out?” Then you can go from there. 

Meagan: Yeah. Yeah. Bloodwork. You can start there and know. 

Colleen: Exactly. 

Meagan: Oh my gosh. Thank you so much for this amazing information along the way, your beautiful stories, and thank you for taking the time to share with us. 

Colleen: Thank you so, so much for having me. It was such a pleasure. 

Meagan: Absolutely. 

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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Katie is a newborn and family photographer based out of Chicago. After going through IVF, Katie was surprised to find out that her first pregnancy was with identical twins. At 33 weeks, she had an unexpected bleed and then another at 35 weeks. Because of placental abruption, she went straight to a Cesarean and her babies were in the NICU for 7 days.

Katie wanted to know what a singleton pregnancy and VBAC birth could be like. She found a supportive midwife group through her local ICAN chapter that had around a 90% VBAC success rate! She also hired a doula. As her due date approached, Katie decided to opt for membrane sweeps to avoid a medical induction starting at 38+6 weeks.

After four membrane sweeps over the course of two weeks, spontaneous labor began. She arrived at the hospital and her sweet baby was born vaginally just 5 hours later!

Though she said she has a low pain tolerance, Katie's VBAC was unmedicated and she also shares her experience with a retained placenta and a second-degree tear. Katie, that is no small feat-- we know you are an absolute warrior and woman of strength!

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Welcome to the show, Katie. Thank you so much for being here with us. You guys, Katie is from Chicago, right? Chicago. 

Katie: Yep. 

Meagan: She is an IVF mama. She’s got three girls. She is a girl mom and two identical twins and then a baby girl. How old is your baby girl now? 

Katie: She’s going to be 3 months tomorrow. 

Meagan: 3 months so still little tiny. Oh my gosh. I love it. So yeah, and then you guys, when she’s not doing the mom thing with all of her girls, she is also a newborn and family photographer which is awesome. Can you share with us your handle so we can come follow you?

Katie: Yeah. On Instagram, I’m at katiemichellestudios. 

Meagan: Okay, katiemichellestudios and we are going to make sure to have that in the show notes so you can go follow her and follow her amazing work. And if you’re in Chicago and you need newborn or family photos, hit her up. Is there a specific– Chicago is big. Is there a specific area that you serve?

Katie: I’m in the northwest suburbs but I do in-home sessions wherever. I use a studio in Oak Park. 

Meagan: Okay, awesome. Then with your stories today, we’ve got a couple of highlights. We have IVF, placental abruption, and sticky placenta. I’m excited to talk about sticky placenta for sure because it’s not something a lot of people talk about that could happen. Then, of course, the twins and all of that. 

We are going to get into that but I do have a Review of the Week. You guys, I know every single week I know you are probably sick of me asking but I love your reviews. Thank you so much for your reviews and remember, we always accept your reviews. 

Okay, this is from cassie80. It says, “Extremely educational and super empowering.” It says, “After a traumatic C-section in 2016, on my research journey about VBAC, I came across this podcast and instantly fell in love.” You guys, that just says something to me. 2016 is when she had her C-section and 2018 is when this podcast started. It’s crazy to think that it’s been going for so long but I’m so grateful for all of you guys sharing your stories like you, Ms. Katie, and helping this continue. 

It says, “I am currently trying for number two and am on a mission to VBAC. Hearing all of these wonderful stories of strength has given me the confidence that I can do it when the time comes. You and all of the women who courageously share their stories are just amazing. You all provide healing and support for all of us mamas.” 

Thank you so much, Cassie, and I’m so glad that you are here with us and have been with us for so long. 

Okay, Katie. Thank you again for being here. 

Katie: Thank you so much. I am so excited to be on this podcast myself because I listened to you guys nonstop my entire pregnancy even before and I always had it in the back of my mind that, Oh, if I get my VBAC, I’m going to come on here and tell my story. I am super excited and thank you for having me. 

Meagan: Oh my gosh, thank you so much. Let’s talk about these twins. Let’s talk about that birth. 

Katie: Yes. They were IVF but they were obviously surprise identical twins. My embryo split into obviously identical twins but they were an interesting pregnancy because usually with IVF, the twins are mono-di which means they share a placenta and have two sacs but my girls are actually di-di so they had two placentas, two sacs, so that meant they were a little bit less of a risky pregnancy and a vaginal birth was a possibility. 

That’s what I was planning on. Everything was pretty smooth up until 33 weeks which is when I had my first bleed. It was just the middle of the night. I got up and I just started gushing. The doctor said that it was a marginal placental abruption. That means it was on the edge of the placenta and it wasn’t a risk to them. Obviously, it was super scary. I thought that I was going to lose them both but everything with them was fine. 

They sent me home after a few days at the hospital. They just told me to take it easy, but they said it might happen again. It did at 35 weeks and 3 days. I had another bleed. At that point, they said, “They are almost to term for twins.” It’s technically 37 or 38 weeks is when they like to induce for twins so they just said not to risk going any further and let’s just get them out right now. 

I was planning on a vaginal birth, but because of that abruption and we didn’t know what state the placenta was in and what would happen if there was an induction process that was started, so with the doctors, we decided I didn’t want to risk induction and then needing a C-section anyway for the other twin so we did the C-section. 

It was a really, really rough recovery and they were in the NICU for a week. One of them needed breathing support and the other one was there for growing and feeding. 

Meagan: How big were they?

Katie: 5 pounds, 3 ounces, and 4 pounds, 13 ounces. 

Meagan: Okay, okay. 

Katie: They were a good size. They were overall healthy but it was for me, super duper rough as a first-time mom to twins especially. The breastfeeding journey was really hard. I dealt with low milk supply and they were so tiny that it was hard for them to latch so I ended up exclusively pumping for 11 months. 

That’s their story. 

Meagan: Wow. That’s a lot of work by the way for someone maybe who hasn’t pumped a lot. Holy cow. Good job. 

Katie: Yeah. So when we decided to have a third which was a tough decision for us, my husband was not on board. We ended up deciding that we wanted to experience what it’s like to have a singleton baby and just having a singleton pregnancy hopefully and a VBAC. 

I definitely knew that I wanted a VBAC and started doing all my research. I found a very VBAC-supportive midwife group in my area. They have a 90-something percent VBAC rate in the hospital which is crazy. 

Meagan: Wow, yeah. That’s amazing. What do you think they do so differently that a lot of other groups don’t do that makes them so successful? Or are you going to share about it?

Katie: I’m not sure. I think the hospital might be part of it, like the hospital policies might be more supportive. They deliver at Evanston Hospital if anyone is interested. Overall, I think the doctors that they work with because it’s a midwife group that they work alongside doctors that when there is a delivery for the midwives, the doctors are also in the hospital. I think the doctors are also very VBAC-supportive so I think that helps when they are working together. 

Meagan: Yes, absolutely. 

Katie: That’s that story. 

Meagan: So you found them. You found the providers. Did you go and ask them questions? How did you feel like you realized that they were supportive? 

Katie: Yeah. I went on– what’s that group that have a Facebook group all around the country for different areas about lowering the C-section rate?

Meagan: Oh, cesareanrates.org? 

Katie: I’m not sure. They are an organization. 

Meagan: Oh, ICAN?

Katie: ICAN, yes. I went on my local Facebook group for ICAN and I asked around. I got their info. I first went for an appointment with one of the doctors at that practice before I was even pregnant because I was planning for the transfer and I liked that doctor, but then I realized that they have midwives and people really raved about the midwives. They said if you are looking for a more holistic experience and they spend more time with you than the doctors do. I just decided to go that route and somehow picking the midwives made me dive into the whole unmedicated birth side of things as well. 

I ended up hiring a doula as well. I never thought I’d be someone interested in unmedicated birth. I consider myself to have very low pain tolerance. 

Meagan: So tell us more about the birth. You have a low pain tolerance but you did go unmedicated?

Katie: Yes. I ended up doing it. 

Meagan: Okay. Did you go into spontaneous labor?

Katie: Yeah, it was interesting. I ended up having four membrane sweeps which is not that spontaneous. 

Meagan: Well, hey. This is the thing. A lot of people ask about membrane sweeps and sometimes people feel, Hey, this is worth it. Let’s do this. Some people don’t. Sometimes it works and sometimes it takes many and sometimes it doesn’t. It’s whatever feels right. So do you remember where you were with the first membrane sweep cervical-wise and how many weeks and things like that? 

Katie: Yeah, so I wanted to start them. Remember, I had never been pregnant past 35 weeks. 

Meagan: Right, yeah. 

Katie: I really thought that I was going to have an early baby again, but that really wasn’t the case. I had her at 40 and 5. So the membrane sweep, I started the first one at 38 and 6 so basically at my 39-week appointment. I had no change after that one. Nothing happened. 

That’s kind of what I assumed would happen so I had another one the next week at 39 and 6 and at that point, I was 2 centimeters, 80% effaced, and -1 station. 

Meagan: Okay, so pretty good cervical statistics there for a membrane sweep. 

Katie: Yeah. So then it was my due date and I was starting to feel more pressure. The mucus plug was coming out and baby was acting super active which I heard can happen close to when a baby is ready to be born but nothing really happened at that point. 

So then I decided to get my third sweep. I think that was 40+2 and at that point, I was 2.5 centimeters but the same for everything else. But things were starting to happen. I was having more stuff come out and I was like, Oh my gosh. How much longer am I going to be pregnant? 

Meagan: I’m sure. This is the thing. When you had either preterm or just early deliveries before and then you go past that, it feels like, No. I cannot be pregnant longer than this. This is eternity. 

Katie: Yes. It was really hard because I had the two-year-old twins also. It was getting to be a real mental and physical struggle. 

Meagan: Yes. Yeah. 

Katie: Also, I was doing pumping to try to induce labor and that wasn’t doing anything. 

Meagan: Yeah. Was it causing contractions at all or was it just causing them and then you’d stop and it would stop?

Katie: Yeah, basically it would just cause the Braxton Hicks contractions and nothing else. 

Meagan: Then it would go away. 

Katie: Yeah. So I had my third sweep and that one really started to do something because I went into prodromal labor which was a doozy. 

Meagan: Yeah. You know, that can be a risk of trying a membrane sweep. It can cause some prodromal labor but again, a lot of the time, prodromal labor still does stuff. It’s tiring and it’s exhausting but it’s still doing something. 

Katie: Yeah, and it definitely did for me. My prodromal labor was a nighttime thing. The sun would go down. I’d put the kids to bed and it would start with irregular contractions. It felt like period cramps then I wouldn’t sleep all night with that. 

I had that for two nights and then I was finally– 

Meagan: Typical prodromal. 

Katie: Then it would go away during the daytime. 

Meagan: It’s so annoying. It’s like, seriously? Fine. If you’re going to do prodromal, at least do it during the day when I’m awake but don’t take away my sleep. 

Katie: I know. At that point, I was getting super disheartened. I decided to schedule my induction because if this was going to happen every night, I would have zero energy for this VBAC. I did schedule my induction for 41 and 3 I believe if I made it to that point but I decided to go back and get my fourth membrane sweep June 3rd so the day before she was born. 

That started something. The midwife was like, “Okay, if I do this, I might see you back here later tonight.” 

Meagan: That’s a promising thing to hear. 

Katie: Yeah, so once she did that sweep, I was actually already 4.5 centimeters dilated. That prodromal labor was doing something. 

Meagan: Um, 100%. 

Katie: Yep. That morning I had that sweep. We went to get lunch. We walked around. I was starting to right away have contractions and these were during the day so I knew something was up. By 4:00 PM that day, I was feeling it. I was starting to need counterpressure and had to stop what I was doing. 

Based on what the doula had said, that was when I should call them. I texted her and I told her, “I’m having these contractions that I’m having to stop and breathe through but they are still 10 minutes apart so I don’t know what’s going on.” She’s like, "Okay. I think you need to stay home a little longer. You’re probably not in active labor yet.” I’m like, "No, I think I’m there. Things are really intense.” Despite what she said, I headed to the hospital.

It’s a good thing I did because by the time I arrived at 10:00 PM, I was already 6.5 centimeters. 

Meagan: Okay, nice. 

Katie: I was very surprised because usually what the doula community says is sometimes when you head to the hospital when you are not in active labor, things can slow down because of the change of scenery and yeah, your body just shuts down. But in my case, it actually was the reverse. I went from super irregular contractions to walking up to the hospital doors and they started coming super regularly like 2-3 minutes apart. 

Yeah. 

Meagan: I do feel like the opposite can also happen where our body gets to that final destination and it’s like, Okay. You can do this now. You have this sense of release. What you were saying, yes I’ve seen that too where the mom has to reacclimate to the space and labor stalls a little bit then it goes on, but this one it sounds like it was the opposite where it maybe brought you relaxation and safety. 

Katie: Yeah. I think maybe part of it was that this hospital experience was so different than my last one. At the last one, it was rushing to the hospital while I’m bleeding. I get there and there’s this rush of nurses. Everyone’s checking me and this time, I waddled up to the hospital. The room was dark. There was one nurse checking me in. I’m just chilling on the bed. I was just relaxed. 

I think a lot of the things that I did with the doulas to prepare, like they did classes about comfort measures and things like that and I was really trying to use those. I got the twinkle lights set up and got the music so that really helped. 

By 1:00 AM, I was already feeling the urge to push and I was feeling so much pressure, especially in my butt. I needed counterpressure for every single contraction up to that point then I was like, “No more counterpressure.” I was screaming for my husband to stop doing it because it was starting to hurt. I knew that something was happening. 

I was on my side trying to get some rest in between and I was starting to give up at that point. I know what they say is when you are starting to give up, you’re starting transition. 

Meagan: You’re right there. 

Katie: For me, I was thinking, I need an epidural right now. 

Meagan: A lot of people do though. A lot of people are like, “I can’t do this anymore. I’m done. That’s that. I need that epidural. I need relief now.” 

Katie: Yep. I hadn’t had a check since I was admitted. It had been about 5 hours since I showed up or 4 hours since I showed up to the hospital so I was like, This can’t be it. I can’t be ready to push because I’ve only been here 4 hours and it’s my first labor. I was in disbelief but I was like, “I need a check right now because if I’m not close to pushing, I’m getting the epidural.” 

The doula was trying to talk me out of it. She was like, "Are you sure? What are you going to do if you’re not there?” I’m like, "I’m going to get the epidural.” I was 9.5 centimeters at that point. 

Meagan: Oh yeah. Right there. 

Katie: Yeah, and I was like, "Oh my gosh. This is actually happening.” My body was starting to push on its own and it was such a weird feeling. It was so different than my friend’s birth that I photographed. She had an epidural and it was an induction. That’s the only other birth that I’ve seen and this was so different because my body was pushing. I can’t control it. 

Yeah. That was about an hour of pushing which felt like an eternity and the contractions were actually fine at that point. I couldn’t feel them. I could just feel loads of pressure and the ring of fire which was intense, super duper intense. Then my water broke about 10 minutes before she was born and yeah, she was born. 

Meagan: You get to 10, your water is probably going out through breaks and baby comes down. 

Katie: Yeah, I had a bulging bag at the end which is really interesting to feel. She was born at 2:34 AM. 

Meagan: Aww, that’s awesome. So pretty dang quick. 

Katie: Yeah. If you don’t count the two nights of prodromal labor. 

Meagan: Prodromal labor, yeah. But your body was doing it slowly and surely. Each sweep did give you that extra nudge. It maybe gave you some prodromal labor along the way, but it seemed like it was helping and doing something. 

Katie: Yeah, if that helped me avoid a medical induction, I’m super glad that I did those. 

Meagan: Yeah, that’s something when it comes to someone facing an induction or facing that hurdle, a membrane sweep might not be a bad idea. 

But too, with that said, if we go in and we are barely 1 centimeter or our cervix is really posterior and we are 30% effaced, we need to know mentally that if we go for a sweep, the chances of it working is a lot lower. It’s just lower because our body is maybe not ready. It also doesn’t mean it’s not going to work. So like I said earlier, you had that ideal cervical stat. You were that 2 centimeters and 80% effaced. Things were looking good and softer, starting to open and they were able to get a really good sweep but even then, it took time. 

Katie: Yeah, definitely. My midwives never pressured induction on me. I was pressuring myself mainly because IVF pregnancies– there are differing opinions but some doctors say that you should be induced at 39 weeks and some say you shouldn’t go past your due date because of the placenta not being as good. 

Meagan: Well, yeah. It’s so hard because– so twins were IVF and was this baby IVF too?

Katie: Yeah. 

Meagan: Okay, that is hard because there are a lot of people who do say that you should induce at 38-39 weeks with IVF and we do know out there that with IVF, the chances of having placenta issues and abnormalities like abruption are increased. Accreta, previa, and things like that. But if everything is going okay, all is looking well, it’s that battle of do we induce? Do we not induce? What do we do?

Obviously, your providers weren’t pushing it so they didn’t see any real medical need but then we have other providers on the complete opposite end where they are pushing it hard. 

Katie: Yeah, in some of my IVF groups on Facebook, basically every single person is induced or has a C-section. It’s pretty rare for a provider to say you can go to 42 weeks like mine did. 

Meagan: Interesting. I actually don’t know the real stats on IVF placental issues after 38 weeks. Had anybody ever talked to you about what your chance of issues really were after a certain point?

Katie: No. The abruption was I think more of a risk factor was that it was twins and my uterus was so stretched but no one really mentioned placental issues or even said, “Let’s look at your placenta after 40 weeks.” They do have the standard ultrasound to look at baby and do the BPP test, but they said that there is nothing really you can see from an ultrasound after your due date. 

Meagan: We know that ultrasounds can be off by size and by all the things. 

Katie: Yeah, and she was measuring bigger. She was 85th percentile which was actually true. She was born 8 pounds, 4 ounces so she wasn’t tiny like my twins were. 

Meagan: Yeah. I Googled really, really quickly. This isn’t even a study. This is just an article on it. I’ll try to get some more studies and things in here but I’m going to include this article. It’s from the Real Birth Company. It looks like they are teachers of birth classes. It’s highlighted. It says, “What do you need to know if you are pregnant through IVF and you’re being advised to have an induction because you are told that there is a higher chance of stillbirth?” It says, “The only study that we found that gives us the information also noted at higher risk of stillbirth for IVF pregnancies, but crucially, they said no increase in their rate of stillbirth after 28 weeks of pregnancy. 

It just says, “This research therefore tells us that induction at terms would not necessarily reduce stillbirth rates for babies who are conceived by IVF.”

Katie: Yeah. From my understanding, it’s hard to do studies on this because a lot of women who need IVF have other health factors which can increase the risk of obviously stillbirth and other issues in pregnancy. 

Meagan: Yeah, it’s showing that sometimes IVF moms have placenta accreta and placental abruption at a higher risk. It shows that IUGR babies have a higher chance for being smaller. It also says that gestational diabetes and preeclampsia have an increased chance. So like you said, there are other things that they may have. 

I’m just going to throw this in there in case anyone listening is an IVF mama and wants to know more. It’s interesting that you’re saying that in that group– are they scheduling C-sections?

Katie: Yeah. Most women get scheduled C-sections, not scheduled C-sections, scheduled inductions but they end in a C-section because they aren’t ready. 

Meagan: Okay, so they aren’t necessarily scheduling them right off the bat just because they are IVF. 

Katie: Right. 

Meagan: But again, like you said, they aren’t ready and inductions are happening and people are ending up in a Cesarean. 

Katie: Yes. 

Meagan: Interesting. Well, this article was written in 2021. I’m also going to put a couple others in here that says actually 2024 so I need to look more into this but it’s something to consider because again, this is a space where we are trying to reduce unnecessary Cesareans. We’re seeing that it’s happening so it might be something that you want to research if you are out there and you are doing IVF, research that and see if it’s something that really is necessary for sure. 

Katie: This is just my personal story, but my placenta looked perfectly fine at 40+5 with this baby. 

Meagan: Yeah, so everything was looking good at that point. We did talk about that in the beginning– sticky placenta or really retained placenta. Did you have that with this? Maybe you can talk to us more about the placenta. You gave birth to babe. It was a VBAC that was a lot faster than anticipated and you went unmedicated when you didn’t think you could. I kind of love that so much that you were like, “I have a low pain tolerance,” but then you did that. It just goes to show how possible it is, right? 

But yeah, talk to us about your placenta. 

Katie: Yeah. That was actually worse than the pain of the entire birth and something I didn’t expect because I had asked about this because it can be an issue with IVF pregnancies. I had asked about this in one of my prenatal appointments and the midwife said, “We don’t know if you’re going to have that or not. IVF is a risk factor for it,” but since I had the opposite of a sticky placenta. I had a placenta that was coming off the wall. With my last pregnancy, she was like, “I’m guessing that you’re not going to have that,” but I did. 

After baby was out, my placenta was not coming out after 10 minutes and around 30 minutes, I think they like to have it out by then. So they gave it 10 minutes for it to come out naturally, but my contractions completely stopped. Nothing was happening at that point. My body wasn’t expelling it. They were trying to pull on it. Eventually, it came out but I was still having bleeding when they were pressing on my stomach than they would like to see. 

They gave me the Pitocin and that didn’t work and then they tried two or three other medications. 

Meagan: Did they give you Cytotec at all? 

Katie: Yeah, I think so and another medication that goes in the back in the booty. 

Meagan: Oh, yes. They usually will insert it rectally. Yes. Yes. Cytotec is not okay when we are pregnant and we are trying to go into labor, but because it makes the uterus contract so hard which is the whole issue with Cytotec and VBAC, it can help reduce bleeding and help the placenta and all of these things. Yeah. 

Katie: Yeah. They gave me the max dose of Pitocin in my IV and none of that worked. They gave me the Pitocin in the leg and that didn’t work, the Cytotec. Then they brought out the ultrasound machine and scanned around and saw that there were some pieces left inside. So she had to stick her hand up and get them. That was horrible. 

Meagan: And you were unmedicated. I’m just going to tell you right now that you have a high pain tolerance. I think you might be incorrect on that. Not saying that really, but holy cow. Unmedicated and a retained placenta retrieval scrape– they are essentially scraping and fishing for your placenta. 

Katie: Yes and she had to go in two or three times. They gave me some kind of IV medication and all it did was make me feel drunk. 

Meagan: Probably fentanyl. 

Katie: It was something with a D maybe. Dimerol.

Meagan: Dilaudid. 

Katie: Maybe Dilaudid. It made me feel loopy and nauseous but did nothing for the pain. I was holding my baby the whole time and I just want to forget that horrible experience. 

Meagan: That is rough. Sometimes placentas “stay sticky” and it really can take up to an hour even for a placenta to come out. Sometimes we don’t know why and like you said, IVF stuff maybe could have helped but the placenta usually is in that 5 to 30-minute period and providers do start to worry if it’s more than that because after we have our baby, our cervix was 10 centimters. It dilated and everything was open and thinned and then it starts coming back and closing again which is the normal process. 

Katie: Oh my gosh. I didn’t even think of that. 

Meagan: Yeah, it’s just that normal process where it starts closing so providers start fearing that if the cervix is closed or too small, the placenta can’t move through and then we’ve got the placenta inside and retained placenta is a very serious thing. You want to get your placenta out. It’s an amazing organ and functions amazingly. It raises these amazing babies through these 9 months. It supports them and feeds them but we need to get it out because retained placenta can make you very sick. They start fearing that and sometimes when they are tugging, it can make it so the blood vessels get ripped off or they weren’t ready so then we have bleeding and retained placenta and all of these things. 

They start fearing it and things like breastfeeding, Pitocin, Cytotec, and all of these things that they are trying to get to help you contract more is an effort to help get that out. But yeah. That is a lot. That’s a lot. You had this beautiful birth and then whoa, quite a lot right there. 

Katie: Yeah, a bit of a turn and in addition to that, I had a second-degree tear that they also had to stitch me up. I don’t remember if that was before or after the whole extraction. 

Meagan: Your provider fishing could have caused more tearing. Yeah. There is also a possibility that if for some reason it doesn’t come out that you will have to be taken to an OR which is a more rare circumstance but I’ve had one client in all the 10 years of doing this and she was a VBAC client too actually. She had a beautiful birth and then had to go in and get it manually removed. So yeah, breastfeeding as soon as you can, changing positions and also emptying your bladder is something that you can do because if your bladder is full then it can hold things up so sometimes it’s detached but not coming out so there are things we can do and then of course, taking medication and going a step further if we really need to. 

Katie: Yeah. Overall though, I don’t regret any of that. It was still such a beautiful birth even though the end and the golden hour took a turn, it still was more than I had imagined. 

Meagan: Yeah. I was actually going to ask you. Even with that which is a lot, would you still suggest doing it or would you have done it differently if you could go back?

Katie: No regrets. The recovery was a million times easier even with the tear and all of that. I was going to the botanical garden 4 days postpartum with my family. 

Meagan: Oh my gosh. You were out walking around. 

Katie: Yeah. 

Meagan: Oh my gosh. That is amazing. That is amazing. 

Katie: With toddlers, you’ve got to get back to real life. 

Meagan: I know. It’s so hard to take that break and recover when we have life that is still moving around us. 

Katie: Definitely. 

Meagan: Remind me, you said you took Needed’s collagen, right? 

Katie: I did. Yeah. 

Meagan: That actually probably helped healing as well. 

Katie: Yeah. I love that stuff because I wanted to get more protein in. I just put it in my shakes along with all of the other things that I did like the chiropractor and the dates. I did all of the things. 

Meagan: Yes. And your doulas, do you want to do a shoutout? 

Katie: Yeah, 3-1-2 doulas and I worked with Heather. 

Meagan: Awesome. 

Katie: Yeah, and they have awesome classes too. If you are a doula customer, they are free and if you’re not, you can still sign up for them and they are super great. 

Meagan: That is so awesome. We love our doulas and to all of those listeners out there, just a reminder. We have a major doula directory from literally all over the US to outside of the US if you are looking for doulas too. You can go to thevbaclink.com/findadoula. We love our doulas so dang much. Obviously, I love doulas so much I became one. Doulas are so amazing. I love that you said you did chiropractic care and dates and all of the things. 

Are there any other suggestions or tips that you would give our listeners as they are going through their VBAC journey? 

Katie: Yeah, just listen to these podcasts a lot and you’ll learn so much. Join The VBAC Link group on Facebook. 

Meagan: Yes. I love that community. Isn’t it just amazing? 

Katie: Yeah, it’s great. There’s also another VBAC Facebook group that I loved as well. 

Meagan: Do you remember the name?

Katie: I don’t remember. 

Meagan: There are a few on there. We love– 

Katie: VBAC Support Group. Yeah, that one’s great. 

Meagan: Awesome. 

Katie: Yeah, just believe in yourself. You can do it. You are a badass. 

Meagan: You are a badass and you can do it. I agree. We’ll end on that note because that is such a true statement. Girl, you are amazing and I’m so grateful for you sharing these beautiful stories today. 

Katie: Thank you so much for having me.

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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Rachel is a professor, an author, and a VBAC mom who is here to share her story from a traumatic C-section birth through a VBAC. This episode really dives deep into how picking the right provider is key to improving your chances for a VBAC. They give practical questions to ask your providers, more than just yes or no, to really get to know their birth philosophy and what qualifications and experiences your provider might have that would make them a better fit for VBAC chances. 

Rachel and Meagan also give a lot of validation and advice on how to start the process of overcoming birth trauma; it’s reality and to not be ashamed of it. You’re not alone.

 

Through the many important messages of this episode, they both mention many times to trust your intuition. If something feels off, listen to that. And if a change in provider is necessary…it is never ever too late to change. 

Invisible Labor: The Untold Story of the Cesarean Section

How to Naturally Induce Labor

How to Turn Prodromal Labor into Active Labor

Membrane Sweeps for VBAC

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello everybody! Welcome to the show! I am so honored to have Rachel Somerstein on with us today. She is a friend of ours from New York. She is a writer and an associate professor of journalism at SUNY New Paltz. She is an author of Invisible Labor: The Untold Story of the Cesarean Section.  And her writing has also appeared in the Boston Globe, The Guardian, The Washington Post, and Women’s Health. She lives in Hudson Valley, NY with her husband and her two children and is here to share her stories with you today. 

Rachel had an unplanned Xesarean section with her first child and the experience was anything but routine. I know that there are many of us who have been through this journey and on this podcast, maybe listening today, that also had an unexpected experience and it may have left us with trauma, or doubt, or fear, or all the feelings, right? And so she is going to be talking to us today about her experiences, but then also we’re going to talk about some guidance on how to find peace and to offer ourselves grace and to set ourselves up for a much better experience next time. 

We do have a review of the week, so I want to get into that and I’m going to turn the time over to Rachel.

This review is by Deserie Jacobsen. The review title is “Thank You.” She actually emailed this in and it says, “This podcast and parents course is amazing. I am not a VBAC mom, but I have been listening since 2020. I binge listen near the end of every pregnancy to remind me of everything I need to remember in birth and process through my previous births. This time around I felt more prepared than ever before, having plans in place just in case. We were able to have a quick birth of my 5th baby. I love the education, passion, and love this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast, thank you.”

Thank you so much Deserie for your review! Seriously you guys, I just love hearing that people are finding the information that they need, they’re finding community, they’re finding that they can do this too. Just like them, and all these reviewers and all the people that have shared their stories and all these reviewers you guys can too. This birth, VBAC, is possible too. Better experience is possible. A healing CBAC; it’s possible. You guys, all it takes is getting the information, the prep, finding the provider, to have a better experience.

Meagan: Alright Ms. Rachel, welcome to the show and thank you again so much for being here with us. I kind of talked about this a little bit before we started recording about how I think your episode is going to be so powerful and deep and raw too. You’ve got these feelings and these words. I love it. I love reading your book and I can’t wait to hear it from your own mouth. Which speaking of book, can we talk about that a little bit? What kind of just inspired you, jumpstarted you into writing a book about this?

Rachel: Well, I’m a writer. And I wrote an essay about my birth about two years after I had my baby, my first birth, my C-section. And I realized I had a lot more to say and also I heard from a lot of moms when that came out and that made me start thinking that I think there was a bigger project. 

Meagan: Absolutely. And an amazing project that you completed.

Rachel: Yes.

Meagan: And remind everybody before we get into your stories where they can find your book. I actually have it here in my hands. It’s Invisible Labor. So where all can they find that? And we’ll make sure that we link it. 

Rachel: Sure, thank you! Yeah, so it’s Invisible Labor: The Untold Story of The Cesarean Section. And you can get it on Amazon, you can get it from Barnes and Noble, you can get it from your local bookstore, you can get it as an audiobook? Or you can also get it as an ebook.

Meagan: For the audiobook, did you record it?

Rachel: I did not. The narrator is Xe Sands and she did a great, great job. It sounds excellent. 

Meagan: Awesome. We’ll be sure to link that. I think it’s definitely a book that everyone should check out. There's a lot of power in that book.

Rachel: Thank you.

Meagan: And it’s not even just your story. I mean there’s a ton. Like if you go through the note section there’s a ton of research in there, and history and studies, and so many really great things. Well okay, let’s hear about the story that started the inspiration and behind this amazing book.

Rachel: Sure! Thank you. So like so many moms, I had an unplanned C-section that I was completely unprepared for, which is another reason I wanted to write this book because I think a lot of people go into pregnancy just assuming they’re going to have a vaginal birth and like me, I didn’t even read the parts of the books about C-sections, I skipped them. Because I was not going to have a C-section. Which is whatever, hindsight is everything, right? 

But I had a totally textbook pregnancy. I switched to a different group of midwives and OB’s about halfway through because I just didn’t have a connection I felt with the providers in the first one. And frankly, I didn’t have a connection with the providers in the second one either, but by that point, I was like well whatever, it’s fine. Which I think is actually, if I could go back and do it again I would have changed that. But you kind of are like, I don’t want to, could I possibly change again? And I think that for people who are VBACing, yes you can and sometimes you actually really need to, even like late on in your pregnancy, people will switch groups or providers even late in the third trimester, so. 

Meagan: Even if you’re changed already, you can do it multiple times.

Rachel: Exactly.

Meagan: It’s not a bad thing to find the right provider for you. It’s not. 

Rachel: It’s not. And It's hard. And you can feel like, Oh my god. Am I really going to send all my records over? It can feel like so much effort and it can really be worth it. I just wanted to say that as someone who switched once and then was like, Okay, I’m done, and wished I’d switched again. 

So anyways, it was late in week 39 I went into prodromal labor but I didn’t know that prodromal labor even existed because nobody told me about it.  And it was my first baby. So I was like is this labor? I think I’m having contractions, these are not Braxton Hicks. And in the end, we talked to the doula I was working with, and in the end they ended up petering out. And at that, I think that that for me marked the beginning of, this is not going to look like the way I had expected it to look. 

And again, hindsight is everything. What I wish I had known at the time– and I think this is really relevant to some VBAC moms is that sometimes prodromal labor means that your baby is not in the best position for having a vaginal birth. And I can’t exactly say oh I would have done this or that differently if I’d known it, but it would have helped me understand what I was going into with the labor and the birth. 

So anyway, I eventually went into labor in the middle of the night. It was exactly my due date and I knew it was different. I could just feel this is labor. And I was really eager to get it going quickly. And again, I wish someone would have said, “Rachel, rest. It’s early. You’re going to need your strength. You’re going to need your energy however your baby is born.” And instead I quite literally was running up and down the stairs of my house to try to push labor along. Which is, I have compassion for myself, I understand why I was doing that. What I really needed to do was get in the bath, or I don’t know, lay over the birth ball. Watch a silly movie, right? The feelings I was having were real pain and I was scared. But you kind of can’t run through this, especially a first labor as we all know, those take a long time, right?

Meagan: Yeah. And if we were having prodromal labor, our body may be kicking into labor, but still might need some time to help that baby rotate and change positions. 

Rachel: Exactly, exactly. And this is the kind of education that is so missing from birth classes. And that is one reason why this kind of podcast is so helpful because that’s how I learned about these different things. I didn’t ever learn about them from a provider being like, “Let’s talk about what will happen in your birth, and let’s talk about why you had prodromal labor.”

So anyway, we went to the doctors office where we met a midwife and my doula for a labor check. And I was hardly dilated, I was at a 2 but I was in extreme pain. And I have to say, I have a very, very high pain tolerance and I now know I was having back labor. 

Meagan: Baby’s position.

Rachel: Exactly. And the contractions were like boom boom boom boom. They were not, I didn’t have any rest in between them. Which again, I think my baby was like I gotta get in the right position, this isn’t working out, I’m freaking out, ah! Plus my mom is running around, ah! Right?

Meagan: Yeah. 

Rachel: So we went to the hospital and I was checked in and the midwife who checked me in was like, “Oh you’re actually not even 2 centimeters, you’re just 1 centimeter dilated.” And they checked me because I was in so much pain I think. And I don’t know that that was necessarily wrong,  but again, no one was sort of explaining, “Here’s what we think is going on.” 

And it’s partly because I believe those providers thought I was exaggerating what I was experiencing physically. They didn’t know me. Well, they didn’t know that I’m usually pretty stoic. They didn’t know that I’m not a squeaky wheel. And I wasn’t like screaming or crying or pounding. I was like quiet and I was like I’m in a lot of pain.

Meagan: An intense quiet.

Rachel: Intense quiet. Exactly. But that doesn’t look like what we think pain looks like to people. And the fact is that people are very individual and how they express pain especially during labor where you’re already kind of like leaving the regular plane of reality.

Meagan: Yes. 

Rachel: So an important takeaway is like, even experienced providers cannot read your mind and make mistakes in assessing what's truly going on with you. And this comes up later in my second birth, but my husband now does a much better job of saying, “You might look at Rachel right now and think she looks like she’s doing great, but this is what’s really going on with her.” And he does that in a way that’s not like he’s speaking for me in a way that’s annoying, but it’s like I actually can’t advocate for myself, I can’t express this. 

So anyways, I asked for an epidural. They said that the anesthesiologist was busy. Which may have been true, but may have been they were trying to put me off because I was hardly dilated. And they told me to get in the birth tub. And I remember hanging over the side of the tub and staring at the clock on the wall and being like, I actually don’t know if I’m going to survive this hour. I was just in so much pain. Incredible pain from back labor that was incessant. 

Eventually he showed up. They hooked me up to all the monitors. At that point, one of the nurses was like, “Oh, you are having monster contractions.” Like the contractions that were being measured were so intense they were going each time to the edge of what was measurable. And now that the computer said it it was like oh…

Meagan: You’re validated now. 

Rachel: Exactly. Right. And the anesthesiologist, it took him three tries to get the epidural working properly which would echo problems to come. But he did, and it took away the pain. And then I was just in the bed and kind of left there. And the nurses and the midwife did not use a peanut ball, they didn’t move me around. And obviously, listen, I’m attached to the monitors. You know you cannot really move that well, the belt slips, and that increases the chances you’ll have a C-section. And there are still things that can be done. It’s not like you’re a loaf of bread, you just lay in a bed. But they didn’t do that stuff and I wasn’t dilating. The nurse and doula eventually basically were like, “Well, we’re going to go out for dinner and we’ll be back in a few hours and we’re going to give you this thing to sleep and if you haven’t dilated by the time we get back you’re going to have a C-section.” 

And at that point I was exhausted. It’s evening now, I’ve been up since the middle of the night. I’m totally like, what is happening with this birth? No preparation; I took birth classes, I read books, no preparation suggested that this series of events could take place. I felt completely abandoned by my providers, including my doula who I was paying out of pocket. And one thing that came up at this time also was I had this colposcopy in college, like scraping of cervical cells. I didn’t hide it from anybody, I was open. And the midwife said well maybe that’s why you’re not dilating is because of this colposcopy.

Meagan: Do you think you got scar tissue?

Rachel: That’s what she said. And I remember at the time being like why are we only talking about this now? Why has nobody brought this up in any of the prenatal visits that I’ve done? And I felt blamed. This thing about your body is defective. 

After a few hours when the midwife and the doula came back and I rested and it was quiet, I had dilated to a 9. And I think what that’s about is that I had been in too much pain to dilate. I was so frozen up and tense and also extremely scared.

At this point people are like, “Oh wow.” And finally my water broke,y water hadn’t broken. So you know, things are kind of continuing and I am starting to actually feel even more fear and my room is getting really crowded with people. And the midwife asks me to start pushing. And I was afraid and I was excited. They turned on the baby warmer, and they were like, “Okay, your baby is going to come out.” And I started to push but I couldn’t feel what I was doing. I had no idea. And the midwife was like, “Do you have an urge to push?” And I was like, “No.” 

The epidural that hadn’t gone well from the beginning had then come down with a very heavy hammer and I felt total numbness. It was not helpful. I needed someone to have turned it off or something, or turned it down so I could feel an urge to push and feel how to push, where to push, what muscles to use. 

And at a certain point I could tell something was going not right and it turned out that my baby was having heart rate decelerations. So just to sketch the scene. At this point it’s 1 o'clock in the morning, I’ve been awake for 24 hours. I’m exhausted. My husband is exhausted. Neither of us has any idea that things could have gone like this. The midwife says I think it’s time to do a C-section. And I don’t disagree with her. I don’t even know what to think at that point. 

I’m also feeling tremendous fear. I was like I’m afraid I’m going to die, I’m afraid my baby’s going to die. And the overall sense in the room…and people were like, “Oh no, you’re going to be fine”. And the sense in the room was that I was hysterical and I was not in my right mind. Which I wasn’t in my right mind; I had been awake for a long time, I’d been trying to have this baby, nobody really told me what was going on and I felt totally unsupported. Actually, my response was completely reasonable given the circumstances and nobody really attended to that and saw that and recognized that as completely valid. 

Plus, I don’t have evidence to stack this up absolutely, but I have since come to find out that there is a medication that some laboring women are given to help them rest and one of the side effects is an impending sense of doom. And I have a friend who had a baby at this same hospital and had the same response after having been given something to rest during her labor. I could go back and look at my records and I may do that but I’m like, well that would explain also why I had the response I did. 

Meagan: Mhmm.

Rachel: Anyway, we go to the OR. I hunch my back for the spinal that the anesthesiologist has to do a couple of times to get it right. I’m still contracting at this point. My body is still like, Come on, let's get this baby out. Let’s get this baby out. And I’m so uncomfortable. And you know that advice to not lay down flat on your back when you’re pregnant, but that’s what you have to do when you’re in the OR. The whole thing felt like I was going to choke under my stomach and very exposed like you are in the operating room. 

Meagan: Yeah, it’s cold and it’s bright and you’re very exposed. And you can’t move your body normally, especially if you’ve had a spinal. 

Rachel: And also in retrospect, again I’m like I cannot believe that the first time I learned what happened in a C-section was in my C-section. I really should have at least learned about this even though it would have still been scary and I still would have been surprised. 

So when the OB goes to operate, he starts his incision and I say, “I felt that.” And he says, “You’ll feel pressure.” And I say, “I felt that.” And he continues operating and I was not numb. I felt the operation. And according to his notes..parts of this I don’t remember…but he wrote it down and my husband has also told me that I was screaming, my legs were kicking. There’s no question that I was in tremendous pain. And I was moaning and it was horrible. And it was horrible for the people in the room too by the way.

Meagan: I’m sure. 

Rachel: Right? Like it’s really important to say that. My OB didn’t listen to me. That is a super common thing that happens in healthcare, especially for women. Especially for pregnant women. He’s not a sociopath. He didn’t want to be evil, but he didn’t listen and the consequences were so steep and so dire. And I think that it was traumatizing to him and I know it was traumatizing to some of the other providers in that room, the nurses to watch this. 

He kept going and when the baby was born, which I don’t remember, apparently they held her up to my face and they put me under general anesthesia and sent my baby and my husband away and stitched me up. Then I woke up in recovery. The doula and the midwife had gotten the baby to latch while I was unconscious and were talking about me without knowing that I was awake about her latch which really, really bothered me because it just underscored how it felt like I was just a body. And even people who were supposed to be there to take care of me and be tender and advocates, I felt they disregarded me. And under other circumstances I really would have wanted to breastfeed my baby like right away. But I wasn’t even there to say yes I want to do this or no I don’t want to do this. 

It was a terrible birth and I would not wish it on anybody. 

Meagan: And I think, kind of talking about what you were just talking about with breastfeeding and stuff, these people in their hearts and in their minds were probably like this is what she would have wanted. We’re trying to help. But in whole other frame of mind over here, I’m not present. I haven’t said those things. And I know you’re trying to help and I know that’s where your heart is, but I’m not okay with this. 

Rachel: Totally.

Meagan: And I think sometimes as doulas, as birth workers, as any one of you listening, remember that words matter. Actions matter. These moms' feelings matter and it’s sometimes in our minds we’re trying to do what’s best, but it might not be. 

Rachel: Totally. Absolutely. Yes and I again, it’s so important to point out. Yes they were coming from a good place. They really were coming from a good place. But it wasn’t the way that I felt it or experienced it. 

Meagan: And it left you with trauma and angst and heartache. 

Rachel: Absolutely. Totally. Yeah. 

Meagan: Well that definitely sounds like a really rough birth. And it’s so crazy because it’s like you went from not progressing to baby in a poor position, to getting an epidural. I love that you talked about that. That can be an amazing tool. A lot of people are very against epidurals, and there are pros and cons with epidurals. We’ve talked about those. Fetal heart decels is one of them. I don’t think, maybe in this situation it sounds like a lot of other things happened; baby’s position being one of the biggest ones. But that can really be a tool that helps you just relax and be more present and have less trauma. 

We talk about this in my doula practice of where there’s a difference between pain and suffering. And pain, progressive positive pain that’s bringing our baby to us that’s one thing. But when we’re suffering and we’re so tense that our body’s not even able to try; that epidural could come into great play. But again, we’re not that loaf of bread in a bed and it is important to move and rotate. And it doesn’t have to be drastic. It doesn’t have to be crazy big movements. Just subtle movements to change the dynamics of the pelvis and to encourage our baby to keep coming down. 

So there were so many things that just went poorly but also went well, and then poorly again and then well and then real poorly there at the end. 

Rachel: And I think like to your point, I went into my birth I should say, I was planning on having an unmedicated vaginal birth. I was like I’m not going to have an epidural. And I think that if my providers had different skills I would have, I may have been able to have that baby vaginally. And I say that based on what happened in my second birth. 

So it’s not just like wishful thinking, right? And I’m really glad I had that epidural. I really needed that. I was suffering. The pain I was experiencing was not productive pain. And an epidural can help you with suffering, alleviate your suffering. But it can’t and doesn’t substitute for emotional support. And I think that’s what was missing for me, throughout that first birth. Even if I had gone on to have ok fine, a cesarean, or even a vaginal birth, I still think I would have been like that wasn’t a good birth because I didn’t feel emotionally supported. And an epidural can’t do that. 

Meagan: Yeah. No an epidural cannot do that. And I, for anyone listening who supports birth, or even who are going for a birth you kind of mentioned it. You’re in this other land and sometimes it’s hard to advocate and open. You might be thinking something and you might so badly want to say it. It’s right here, coming out. And you can’t say it for whatever reason. It’s a weird thing, it doesn’t make sense sometimes but it can happen. But really being heard, validated, understood; which are so many things you weren’t. Right? And when we’re not heard and when we don’t feel safe, and we don’t feel supported, those things leave us with PTSD. In fact there was, in your book, I’m just going to read it. It says, “2022 study by anesthesiology and obstetrics professor Joanna and colleagues found that what’s important about women who feel pain during childbirth is how mothers feel about their pain. And how their providers communicate with them overall…”

You were communicating, and no one was communicating to you. 

“...feeling positively about pain and heard by providers protects a mother from developing PTSD.” And I mean it goes on which is why you need to get the book so you can read more about it. 

Rachel: Yep. 

Meagan: But really, feeling heard. 

Rachel: It’s not just crunchy whoo-hoo feels good, feels right, sounds good. It really matters. And I have to say that I’m participating in and helping to work with providers on designing some studies about providing different pain options for moms during C-sections. 

We literally had a conversation about this yesterday. And one of things we were talking about is it’s not just the pain. It’s not just pain relief. It’s also being listened to. Because there will be people who are like, I might say I’m in pain, but that doesn’t mean I need an epidural or want an epidural. But I’m feeling pain and I want to be heard and I want somebody to…even if you can’t express this. You can’t even express it because you’re the one having labor. 

What you’re needing is someone to see you and look you in the eye and be like you’re going to be okay. And I think as mothers we totally are experienced with that all the time. When your child is hurt or sick, part of your job obviously is to get them the help they need, but it’s also to assure them this nosebleed is going to end. You’re not going to have a bloody nose for the rest of your life. Which, when you’re going through something really hard you can sometimes forget, right? And you’re pointing out from the studies this helps to prevent people in birth, in labor, from developing PTSD. The stakes are really high. They matter so much. 

Meagan: When you were just talking, I don’t know if you saw my eyes kind of well up a little, but I connected a lot with my first birth when I was clinging to a bed, literally clinging. And I was looking at my husband and I’m like, “Do something!” I had a baby in a poor position. I was being jacked full of pitocin. My water had broken, there was a lot of discomfort going on. I had told him I didn’t want an epidural and he’s like what do you want me to do? And I was like I don’t know, I just need something! 

And I was terrified and desperate. And he was just like… It wasn’t fair for me to put him in that position either but at the same time he was like I don’t know, I don’t know what to do, right? And the nurses were just like we’ll just get you an epidural. And I was like no, I don’t want an epidural. And then it just was like epidural, just went down from there. 

And I wish so badly that there was something else. Let’s get you out of the bed. Let’s get you in the shower. Let’s give you some nitrous. There was so much more that I could have had, but wasn’t even offered. And I think too, I needed someone to tell me that nosebleed was going to end. 

Rachel: Yes. 

Meagan: And it was going to end and it was going to come back every five minutes and it was going to end again and I was going to be okay. And I was going to survive that. And just hearing you talk about that, why my eyes got all welly, is that I don’t know if I realized how much that impacted me until just barely. And here I am, my daughter is almost 13.

Rachel: Just like how powerful these things that, I don’t know, this is part of why we have these conversations. They shed different corners of light on our experiences that it’s like oh my gosh, I didn’t even know I knew that. And that’s so why we, even though I’m not postpartum immediately, it’s valuable for me to talk about it too; to hear what you’re saying, you know?

Meagan: Yeah. Ah, so after a not-so-amazing experience, going into that postpartum, you’ve talked a little bit about that in your book. Well, not a little bit, you’ve talked about that a lot. Tell us about that journey and then what led you to deciding on VBAC and ultimately going and having a VBAC. 

Rachel: So I should say, I was really…Talk about not realizing things right away. It took me a long time to figure out how traumatized I had been by that birth. And I was about two years postpartum and I was having a procedure for something else and I just completely, I had a panic attack. I had never had a panic attack before, I didn’t know what it was and couldn’t have explained what was happening. And when the anesthesiologist who did this procedure was like have you ever had any issues with anesthesia, which is exactly the question that should be asked, and I had said what had happened he was so taken aback. He was shocked and didn’t know what to say and walked out of the room.

Not in the way of, I’m abandoning my patient, but just like from his perspective here’s this kind of routine thing. This patient is crying and shaking and talking about this very traumatic incident which I had not talked about. I didn’t go to therapy. I had talked about it with friends and my family, it wasn’t a secret, but I felt a lot of shame. I felt like I must have been this total freak of a person that this had happened to me. 

And after that I remember saying to my husband, I just don’t know if I’m ever going to be able to get over this trauma enough to have another baby. And I didn’t even know if I wanted another baby, like separate from the trauma. In therapy I started to see that I felt very stuck in my life and that included how and whether to grow my family. And that was actually because of the traumatic birth. It just like made this big block. 

I think one thing that’s important to think about for those who have had a traumatic birth is that sometimes that can show up in your life in ways that you don’t expect. 

Meagan: Yes. 

Rachel: And so to be compassionate with yourself about that and also to be open to that. We’re in the era of warnings and trigger warnings and those are important, but sometimes for a traumatized person the things that are triggering or activating are not what you would think. Like for me, I couldn’t watch a scene of a hospital birth even if it was happy without getting very uncomfortable and having to walk away and there wouldn’t be a content warning on that. So it’s just to say be patient with yourself. Accept that…don’t, I guess if you’ve had a traumatizing birth you don’t have to struggle against these things. As horrible as they might feel, as uncomfortable as they might feel it’s normal and it’s ok and it shows up differently for everybody. 

Rachel: Yeah so I had this big question and then I was like ok, it took awhile for me to be like I do want to have another baby. But I wasn’t ready emotionally. And so I waited. And then about, let’s see, October of 2019, I was like I think that I’m ready to try to have another baby. 

And we had met this midwife who lived in our community, who my daughter actually made friends with her niece at our public pool which is so beautiful. I ran into her one night while she was walking her dog. She was like your husband shared a little bit with me, if you ever want to talk. And this, I feel like, I could not be more grateful that this person came into my life. She just is, her skills are phenomenal. Just as a clinician in terms of trauma-informed care, and I’ve felt safe enough going to her for prenatal care to decide that I was ready to get pregnant. 

My joke is that I should tour high schools and be like it only takes once to have unprotected sex to become a parent. And I was really lucky that I got pregnant right away and at that point I was 37. So I should say I had my first baby at 33 and I got pregnant again at 37. And that’s not always the case for people. Obviously it can take a long time and especially after a C-section, secondary infertility is real. 

Meagan: It is. 

Rachel: Yeah. Not talked about enough. Really not talked about enough. 

Meagan: There’s a lot of things, right, about C-sections that is not discussed about. For personal, for the mom, for the individual, the infertility, adhesions, all those things. Just the emotional and the physical. Then even the baby. There’s risks for the baby, the allergies, the microbiome getting messed up. All the risks, it’s just not discussed. 

Rachel: No, it’s really not. And you kind of only find out later if you’ve had a C-section and you’ve had a problem down the road that you’re like, maybe that’s because of my C-section. It’s ridiculous.

So we got pregnant and I was not sure if I wanted to have a VBAC, but I started thinking about it from the beginning. And I also was like, if I don’t have a VBAC how am I ever going to get myself into an OR, I just don’t know. 

And I really think that VBAC is the under-discussed pain point for moms. And I’m preaching to the choir here but we’re talking about half a million moms every year have to make this decision, if it’s even available to them. 

Meagan: I was going to say, if it’s even offered. 

Rachel: If it’s even offered. Which is totally not a given. But theoretically, they do have this decision and I really have not…I should say, in the course of writing this book, but also just being a mom who had a bad C-section and then had a VBAC, I hear from people a lot about their journeys just like on the playground. Every person I’ve talked to, they agonize over it. No matter what they choose, no matter what. Why is that not talked about more? I mean that part of what this podcast is doing that’s so important, but I still can’t believe how under the radar it is, yet it’s such a big deal when you’re going through it. 

So anyway, I told myself I did not have to decide right away about a VBAC or a C-section. My midwife was like you can totally have a VBAC, you can totally have a C-section. Even if you have a C-section you can keep seeing me. I was worried like oh would I get bumped out of midwifery care. One of the things I’m really fortunate about and that I think is really good about that practice is that she has a very close relationship with one of the OB’s there. Like they kind of share patients, I should say that. And that’s because she’s worked with him for a long time and he really respects her clinical skills and vice versa. 

The other thing about her that’s unique and that I didn’t know how important it is she’s a Certified Nurse Midwife, so she attends births in the hospital. But she previously had been a homebirth practice and at a birth center as a CNM. So her skills are, like I said are phenomenal. A C-section is truly like we have to do this. I’ve run out of my bag of skills or like the baby or mom’s health suggests that like we need to do this now. 

She worked with me to work with the scheduler so that I saw her for every visit which helped me to learn how to trust her and she didn’t pressure me. Either way she was completely open. She also worked with me to make sure that I could see her for virtually every visit so that way she earned my trust. And I got to show her who I am. She got to understand me which was really important to the birth. 

Meagan: Yes, which I want to point out. There are a lot of providers these days that are working in groups. And I understand why they’re working in groups. They’re overworked, definitely not rested. There’s reasons why, both midwives and OBGYNs are working in these big practices. But the thing is it’s really nice to have that established relationship but for some reason specially for VBAC it’s so important to have that one-on-one relationship. So if you can, during your search for finding providers, if you can find a provider that is going to be like Rachel’s midwife where she’s just like I want to get to know you, I want to establish this relationship. Yes, we have this OB over here but I want to be your person. I definitely think it’s impactful.

Rachel: I totally agree with you and I didn’t even know that was possible. And she works for a big group and even so she told the schedulers, hey make sure you schedule her with me. She didn’t just do that with me by the way, it wasn’t just a special favor for this traumatized patient. 

And frankly it’s better for the providers too because they’re not coming in cold. Like ok who’s this person, and she’s saying this. And what’s her prenatal care like? What’s her pregnancy like? Of course they’re looking at the notes, but it’s not the same. 

Meagan: It isn’t. And I love that she said that. But I also want to point out that you can request that. 

If you’re in a group and you can connect whole-heartedly with someone and you feel it’s definitely who you need, it’s ok to ask hey. I know that I am supposed to meet Sarah Jane and Sally, but can I stay with whoever. 

And maybe you might not get every visit, but if you can get more visits than only that one? It’s worth asking. 

Rachel: Totally. And also then you know their style. So like she was not an alarmist. Let’s say I was over 35; I had to see a MFM just because of my age. That went fine, but if something had come up, like let’s say I had a short cervix or there was something I found in an appointment with an MFM specialist I would know her well enough to take that to her to be like, put it to me straight. How worried should I be about this? As opposed to maybe this one’s an alarmist, this one is more like ahh let me put this in…

And the only way you’re going to learn about that is from meeting with them again and again. And for VBAC that’s so so important. 

Meagan: It is. It kind of reminds me of dating. It’s weird. I had said this with my provider when I didn’t switch. I was like, I feel like I’m breaking up with him. Like he’s my second boyfriend, it’s just weird. It’s not really boyfriend but you know what I mean. 

But it is, we’re dating them. And anyone, in my opinion, can come off really great for that first date because they’re wanting to make that impression. They’re wanting you to like them. But the more you get to know them, the more they may show their true colors. And you also may realize, I don’t think I’m the right person for you. My desires aren’t something that aligns with you and so I don’t want to put you in this situation. And so if we date our providers, “date our providers,” a little bit more than just one time it really will help us know. And like you said, if something were to come up you could have that trusted person in your corner, which is so important for VBAC, that you can go to. 

Rachel: Totally. Yeah. So yeah, so pregnancy went well. And then right as I entered my third trimester it started to be COVID. 

Meagan: Mhmmm. The joys. 

Rachel: Nobody saw that coming. And then you know, things for the entire society obviously went completely off the rails. Obviously something like COVID is, we hope, not even once in a generation. Once in a hundred years experience. 

But given all the stuff that was up in the air, boy was I glad that there was one provider who I trusted. Who I could be like ok what do I do, what do I do. And I have to tell you that she and my daughter's pediatrician…I’m a professor. So I should say I’m in the classroom with young people who, you get sick a lot anyways. They’re living in dorms, like they’re not taking the best care of themselves. So COVID was circulating, and we live right outside New York City, COVID was circulating early here and I have a lot of colleagues that ended up getting it. And both my midwife and my child's pediatrician told me early you need to stop going in person, it’s too dangerous for you. 

And I trust my daughter's pediatrician a lot, you know we have a nice relationship and I really trusted my midwife. Right? So I followed that advice and was really fortunate because boy. You know what you don’t want while pregnant? COVID. And you know what you really didn’t want? COVID in 2020 when you were pregnant and nobody knew anything, you know?

Meagan: Right? 

Rachel: So, the blessing in disguise was that I was able to work from home. And it was super stressful because I had my daughter and my husband was here and you know, my husband is a photographer…I mean the funny thing is that I ended up, not my head but my body, being in these different photos he ended up taking and my belly was getting bigger and bigger and we kind of had to hide it. I’d be holding a book, or cleaning something. It was an absurd, crazy, isolating, scary, and also funny time. 

You know the blessing in disguise was that I wasn’t on my feet as much and I think that that was really good for me as a pregnant person. There is also data that preterm birth went down during the lockdowns because people got to stay home and they don’t necessarily get to do that leading up to birth, which tells us a lot about what we need and the rest we need and aren’t getting. 

So anyway, at first everything went virtual and then when I started going in again for my appointments I had met the OB who works closely with my midwife. And we talked about what would happen if I went over 40 weeks. And he was like well, we’re not going to automatically schedule a C-section, we would talk about potentially waiting or induction. And I really appreciated having that conversation with him because I understood where he was coming from and it wasn't again like we’re going to schedule a C-section right now. So we know if you get to 40+3 and you haven’t had the baby, bing bang boom. And that was very important information about his risk tolerance and his stance. 

Just like with my first birth I went into prodromal labor a few days before my due date. I had had a membrane sweep with my midwife. My in-laws came to stay with my daughter and we went to the hospital on a Saturday night. I didn’t know this but my father-in-law told my husband I think she’s getting ahead of her skis. And he was right in the end. 

So we get to the hospital and my contractions stop. And I’m like oh no. And my midwife was like, they put me on the monitor to get a strip which is like you know, what happens. 

Meagan: Normal.

Rachel: And my midwife was like listen, your baby, he’s not looking that good on the monitor. I want you to rest for a little bit and let’s see. So I’ll check back in with you in like half an hour. 

And I was so upset. I remember being like I can totally see where this is going to go and I had learned about VBAC in terms of like what could increase the chance of rupture or not and I was like I’m going to end up with another C-section and I’m going to be caught in the net. I didn’t even have a shot, is what I felt. 

And then she came back half an hour later and she was like, “He looks great. I think he was just sleeping, and if you want to go home you can go home.”  And it was like 1 o’clock in the morning. And I was like, “I think we should go home.” I just felt like he's not ready. He’s not ready to be born.  And remember, I trusted her so much. She would not tell me this if she thought that there was something…

Meagan: If there was something wrong. 

Rachel: Exactly. She wasn’t trying to be my friend. She was my provider. And so it felt really weird to leave and come home and not have a baby. And I thought was this the wrong thing to do, because I live like half an hour from the hospital, and was like no this is it.

And then everything was quiet for a few days. And then just like my first labor, my daughter, I went into labor in the middle of the night and I had intense back labor, and I knew like this is the real deal, here we are. And this time I tried to rest. I did like cat/cow and just like anything, child’s pose, just anything to feel more comfortable. And I called my midwife at 7 in the morning and she was like, “Okay, I want you to come in and be prepared to go into the hospital from this appointment.” 

So we did that and at that appointment, I had a headache, I had higher blood pressure, I was dilated to a 6, and she said to me, “Listen. Just so you know, they’re not going to let you go home. You’re going to the hospital, no matter what if your contractions stop or not whatever. This is what’s happening because of how dilated you are, the fact that you have this headache, this BP readings, whatever.” And I was like that’s completely reasonable, I felt that way too. You know what I mean? But I really appreciated she communicated that with me so clearly and explained why. 

So I planned initially to try to have an unmedicated, vaginal birth. My midwife and I had discussed these saline boluses you can have in your, by your, what’s it called. Like the triangular bone in your back? I’m totally blanking. 

Meagan: Your sacrum?

Rachel: The sacrum. Yeah, that that can alleviate some pain. And very quickly the pain was, I found it to be unbearable. And I asked for an epidural. And the anaesthesiologist came right away and did a very good job. And the nurses and the midwife who were at the hospital were using a peanut ball and helping me move and really supportive emotionally. 

And I was still really scared, right? Because I had had this terrible birth before, I thought something would happen to me. And nobody treated me like I was exaggerating or you know like, unreasonable. And that mattered a lot. And I think what’s important is you shouldn’t have to have gone through a bad birth for people then to take you at face value. With your first birth, it should be the standard for everybody. 

Meagan: Such a powerful saying right there. 

Rachel: And they were wonderful, truly, clinically and beside.

Meagan: Good.

Rachel: And then my midwife surprised me by showing up. She was not on call, she came in at like 9 o’clock, no she came in at like 5 o’clock, like once she'd seen her patients and I was just like oh my god,  so moved to see her. 

And you know, I was pretty far along at that point and she kind of helped me get into different positions and then it was like okay, it was time to push. And they had managed that epidural so I could feel when it was time to push, and I could feel how she and the nurse were telling me to like push here, right? Like use this, make this go. 

The pain was really intense but it wasn’t suffering, like okay, I’m getting instruction. And as I was pushing I could feel that it wasn’t going to work. I was like he’s not, his head…I could just feel it. Apparently he was kind of coming and kind of going back up, like his head forward and back. And my midwife was like do I have permission from you to try and move his head? I think his head is not in the best position. And I said yes, and she tried to do it and she couldn’t. Her fingers weren’t strong enough and then she went to the OB and she told me this later.

She said to him can you come and move his head? He’d been trained by midwives in the military, by the way, which is one reason his clinical skills are so amazing.

Meagan: That’s awesome. Okay.

Rachel: Awesome. And at first he apparently was like, oh she’s a VBAC, like I can’t believe you’re asking me to do this. And my midwife, again they trust each other right, and she was like the baby’s doing great and the mom’s doing great. I really think this is going to work. And he was like okay. 

So he came in, asked my permission, I said yes and he moved my son’s head. My water had not broken again, right? So it’s like the same thing as the first one. And once he got in position and I started pushing my water broke in an explosion all over my midwife. That’s why they wear goggles, now I know. And she went and changed her clothes. I pushed for 45 minutes and then he came out.

Meagan: Oh my gosh. 

Rachel: It was amazing and I felt so proud and I was completely depleted. I was so high and also so low. And I think what's amazing to me is that it was almost the same labor as my daughter, which just tells me that's how my body tends to do.

Meagan: Your pelvis. And some babies need to enter posterior or even in a weird position to actually get down. So that can happen. 

Rachel: Thank you. And also my water didn’t break until the very end so there was buoyancy to be moved, right? And again who knows what would have happened if I had been with this provider the first time. Like maybe these decels really meant that my daughter had to come out like then. That is possible. And that first team did not have the skills of the second team. None of this was even brought up, wasn’t even a possibility. 

And I should say that first birth, I didn’t even mention this. The OB that gave me that C-section, later told me that my daughter's head was kind of cocked when he took her out. Which suggests that it was just like my son. And how I’m grateful for my epidural. I’m grateful for, you know, all the things that technological kept me safe, but it was these skills of facilitating vaginal birth that made the difference for me to have that VBAC. 

Meagan: Absolutely. And the hardest thing for me is seeing that these skills are being lost. 

Rachel: Yes.

Meagan: Or maybe it’s not that they’re being lost, they're being ignored. And I don’t know which one it is. I really don’t know because I see people using them. So I feel like it’s got to be there. But then I go to other births and I’m like, wait what? You’re not going to do anything to help her right here? 

Or you know, it probably could have been a vaginal birth if we had a provider come in and be like we have  a little asynclitic head, why don’t we change into this position and let me see if I can just ever so slightly help this baby’s head turn. It just isn’t even offered. 

Rachel: Yes. 

Meagan: And that’s something that I think needs to be added to questions for your provider. In the event that my baby is really low and coming vaginally, but is in a wonky position, what do you do to help my babys’ position change to help me have a vaginal birth. And then even further what steps do you take past then if it doesn’t work and my baby’s so slow. Do we do assisted delivery? What do we do, let’s have this conversation. So if it does come up, you’re aware. 

Rachel: I love that. 

Meagan: I was going to say if your provider says, I don’t know/I don’t really help, then maybe that’s not your right provider. 

Rachel: And I think what’s so smart about that framing is that it’s not putting the provider on the defensive of like, what’s your training, right? Then it’s like, what is your problem? But you’re actually asking about their skills and you’re asking about their approach, without coming from a place of seeming doubt. Just like, I’m just curious. 

Meagan: Yeah. Like what could I expect if this were to happen, especially if in the past. Say your C-section was failure to descend, mostly based off on position, we know that this is a big thing. But if your past cesarean was failure to descend, ask those questions to your provider. What steps can you take? What steps can we do together, you and I, to help this baby come out vaginally? 

Rachel: Totally. And I think also, that way, let's say the VBAC doesn’t work out, you won’t then be looking back over your shoulder and being like I should of/could of/why didn’t I/if only. And you know, what do you want out of your birth experience? Well a lot, but part of it is a sense of peace. Right? That I did the best that I could. That my team did the best that they could.

Meagan: Yes. Yeah and really interviewing your provider. Again, dating your provider and asking them the questions, learning more about them and what they do and their view. Taking out the yes and no questions and really trying to get to know this provider and letting them get to know you. I think it’s just so impactful. I also, kind of like what you were saying with your first birth, also learning the other types of birth that could happen, you know learning about assisted birth. 

This is a new thing. Learning if assisted birth trumps a cesarean for you. Would you rather go for an assisted birth, even if it may end in cesarean, would you rather attempt that? Or would you just rather skip that and go right to the cesarean. Really educating yourself and trying not to push off the scary even though it can be scary. 

Rachel: Yes, yes. I love that you’re saying this and I was just thinking about this and talking about this with a friend; there’s stuff we hope doesn’t happen. But not talking about it or thinking about it isn’t going to protect us from it happening, it's just going to mean you’re not prepared. 

Meagan: Yeah.

Rachel: If it does happen. And yeah. 

Meagan: It’s a disservice to ourselves. And it’s weird. And it’s hard to hear those stories. It’s hard to hear the CBAC stories, it’s hard to hear the uterine rupture stories that we do share on this podcast. Kind of what you’re talking about the trigger warnings earlier, yeah it might be a trigger. It really might. But if we know all the signs of uterine rupture leading up to, we can be aware. And it’s not something to hyperfocus on. We don’t want it to be like oh my gosh I have this weird pain, right now, I don’t know. 

It’s not to make you scared, it really isn’t. It’s to just help you feel educated. Kind of what you were saying too. I don’t know what a C-section looked like until I was in my own C-section. 

Rachel: Yeah. I’ve been talking about this recently with an anesthesiologist, some anti-anxiety medicine which you might get during a C-section, can cause memory loss. That’s a side effect. So the time to decide…Let’s say you’re not planning on having a C-section. And then you’re having a C-section and you’re really anxious, really reasonable. The time to decide whether to take that anti-anxiety medicine which might cause memory loss; you should have an opportunity to reflect on that and talk about that  and think about that not only in the moment when you’re scared and should I take it right now or not. 

Meagan: Yeah.

Rachel: It’s just like that’s not a good way to make a decision, you know?

Meagan: Yeah. And also learning about alternatives. Okay, these are the side effects of this medication, and I don’t think I’m willing to accept that. So let’s talk about other medications and those side effects so we can see if we can switch it up.  They have a whole bunch of things in their toolbox when it comes to medication. 

Rachel: Exactly. 

Meagan: For nausea. You know I had a medication and it affected my chest. It went all the way into my chest and I had to consciously focus on my chest moving. It was the weirdest feeling. 

Rachel: Terrifying, yeah. 

Meagan: I wish I would have known the alternatives to that. Right? So having these educated discussions, learning as much as you can. It’s hard and it’s scary and it’s intimidating to not learn what you don’t want. It’s understandable, too.

Rachel: Completely, completely. But that's informed consent, right? The risks, the benefits, the alternatives. And to go back to the anti-anxiety thing. You might be like okay, what could you do for me non-pharmacologically? Let’s say I have a C-section and I’m feeling really anxious. Can I have a doula with me there who’s giving me a massage? Can I have a doula there who’s maybe put some lavender essence on a washcloth to hold to my nose. Can the anesthesiologist hold my hand and tell me it’s going to be okay? And then you start actually opening up real options. Like wow I can have a doula with me?

Meagan: Yes. That is something that I am very passionate about. We need to get doulas in the OR way more than we are. And I understand that it’s like oh we don’t have PPE, or oh it’s an extra body, and oh it’s a very big surgery, like I understand that. But I have been in the OR a good handful of times. And I understand my position in that room. I understand and respect my position in that room. And I always let an anesthesiologist know, if at any point something happens where I need to leave this room you just tell me. I will leave. No questions asked. But please let me be here with my client. Please let me stroke her hair. Please let me talk to her when dad goes over to baby so she’s not alone. 

When you were put under general anesthesia to be there by your side, whether or not you were waking up in the OR. Because sometimes you could wake up sooner, or waking up in post-operative. Let's get these people here. Let’s play music. Let’s talk to them. Let’s communicate the birth.

I mean with my first C-section, they were complaining about the storm outside, they weren’t even talking to me, right? And it would have impacted my birth in such a more positive light if I would have been talked to. And I wouldn’t have felt like, what’s going on. You know and all those things, you talked about it in your book. This drape that is separating us from our birth, it’s just wild. 

So one of the questions we ask when you sign up to be on the podcast is topics of discussion that you would like to share, and one of those things is you said, why it’s important to balance preparation for VBAC with an understanding of the systemic forces that promote C-sections. We’re kind of talking about that, but do you have anything else to say on that? 

Rachel: I think that there is so much self-blame for having a C-section, when you wanted to have a vaginal birth. And go back to pain and suffering, that causes suffering. And it’s heartbreaking to see that and to feel that. And when I think about it, I think what’s important to keep in mind is like there are the particulars of your experience, right? Like your providers had the skills or didn’t. They listened or they didn’t. Your baby had decels or didn’t. Like all that is real. And you’re not the first or only person any of that is happening to. 

So why are we hooked up to electronic fetal monitoring, EFM, as soon as we walk into the hospital? Well that is because of how technology reigns supreme right now in every aspect of our society, but medicine too. And also that like it’s an efficient system and medical birth, medicalized birth is all about efficiency and making as much money as possible frankly. 

Meagan: And there’s even deeper history, we talk about that in our VBAC course, about why that was happening around cerebral palsy and what it actually did for cerebral palsy rates. All of these things. It’s pretty fascinating when you get into it and understand one, why they do it and does it work? Does it make sense? They do it and just became practice and norm, but it did it actually impact the things that, okay how do I say this. Does it impact the things that they were originally creating it to impact? 

Rachel: Right. Totally. And it’s actually the opposite; it was supposed to bring down the number of C-section rates, or the number of C-sections, when the number was like 4.5% in the early seventies and it’s just gone in the opposite direction.There’s so much evidence that you use it and it makes you more likely to have a C-section. And so yeah, okay, not your fault. That’s the system. And I don’t mean it in this way like, that’s the system, give up, lay down, don’t try to make your own feet, but also just to accept that that’s what you’re operating in and that’s what your providers are operating in too. Right? Use it as a way to let go of the guilt and the shame and the, I messed up. My body messed up. 

Meagan: Yeah. Because there’s so many of us that feel that. 

Rachel: Yes. 

Meagan: And it goes into the next topic they were saying that I think really can help us walk away with less of, I messed up. My body messed up. My baby failed me. You know whatever it may be. And doing effective research about the hospitals and their employment patterns and the chances of you even having a VBAC. That does kind of go into the balls in our court where we have to get the education and understand. But even when we do that, even when we don’t have the best experience, in the end we’re still going to look back at it as we did, WE did, the best we could. Right? And it takes less of that blame on us in a way because we know we did everything we could. 

Rachel: Yes.

Meagan: And sometimes it just still happens. Even if you have the doula. Take the VBAC course. Read all the VBAC books, listen to all the podcasts, understand all the risks. Sometimes it still happens. 

Rachel: Totally. And I mean I think about in my case, like let’s say my midwife hadn’t come in for me and my OB hadn’t been the one who had been attending that night, maybe I would have had a C-section. Because maybe the people there wouldn’t have known how to effectively move my son’s head. Even though I like did my best and that’s okay. It has to be okay because you can’t kind of change it. 

And again, not to be defeat-ist. But to find peace, just to find peace. 

Meagan: Yeah. I wish that for our VBAC community is finding peace and giving ourselves grace along our journeys. Because we’ve had 100’s of podcast stories and there are so many of us who are still searching for peace. And still not offering ourselves grace, and putting that blame on us, or whatever, right? Everyone’s so different and again, we talked about this earlier, it’s just different. But I would love to see our community offering themselves more grace and finding more peace with their experiences along the way. 

And I don’t exactly know what that healing looks like and how that peace is found. Do you have any suggestions on ways you have found peace with a very very very traumatic experience that not only led to trauma in that experience, but even in future procedures, in future experiences you know. Do you have any tips on just, guidance on finding peace? 

Rachel: I mean, I struggle with this still. And it sounds counterintuitive, but I think like not pushing away your feelings. And in the sense of not wallowing, but also not like struggling against them, trying to quiet them, make them be like ugh I hate this. Ugh I hate that I feel this way. Ugh if only I could get over it. 

So I’ll say like, when I go to the doctor now, I get really scared especially if it’s a new person and my blood pressure goes up and sometimes my heart rate goes up and it just sort of happens. And I hate it. And there are times when I’m like ugh I hate this part of me. I just hate it.

But then when I’m kind of more accepting and it’s like, this is how my body responds. It’s understandable that this is how my body responds. And I take a Xanax actually. I say that to really take away the stigma I think that still exists around medical trauma and taking medication to manage your symptoms. I take a low dose Xanax before I go to see a provider and it helps me with my suffering. 

And also just like accepting. Because also there’s this saying, if you struggle against the feelings of suffering, then you kind of suffer twice over. Right?

Meagan: You do. 

Rachel: So I would say that, and then specifically for people who feel they had a traumatic experience, I’ve found EMDR treatment to be very effective, to deal with stuff in the body. That was pioneered more to deal with people who’ve been in like combat trauma, but it’s very effective for traumatic birth. Tapping is another thing that can be very effective. And you can find that online, like there are different…

Meagan: I was gonna say, you can go to YouTube and google trauma tapping or anything like that, and you can actually find some pretty great videos for free on how to do that. And it’s pretty wild actually how well it works. 

Rachel: It really is. 

Meagan: Sometimes it’s like wait, how is this working? It really does work. 

Rachel: Totally. And also I would say like in terms of again, peace, I think it’s really important to speak openly about what has happened to you. And to the extent possible, we’re conditioned to be like I’m just going to tie this up with a bow and it’s okay. Someone says to you, you’ve expressed something hard, and they’re like oh I’m so sorry and you’re like it’s okay, I’m going to be okay. Like you don’t have to worry so much about reassuring your listener. You can be like yeah I had this C-section, and I’m still kind of upset about it. 

And yeah, that’s how I feel. You don’t have to self-qualify that. You know, but my baby is healthy. But I’m okay. But I love my baby. We do that; there’s a lot of pressure to do that. And it’s okay not to do that. It’s okay to be like these are my feelings. And two things can be true at the same time. You can love your baby, and you can also be like I’m not that thrilled with the birth. 

Meagan: Awe yes. Julie and I have talked about that for years. They don’t have to be separate. They can go together. You can love your baby and feel connected to your baby and really not like your birth experience. And you can also, we have found that people prep and then they have a vaginal birth and they’re like I actually didn’t really like that either. 

So you know, they don’t have to just always be separate. You can be really happy and really be upset at the same time. It’s okay to have those feelings, right? I have had things in my life where I’ve done something and I’m like dang. I really like how it turned out, but I hated the journey to getting there. And that's okay. So I love that you pointed that out. 

Rachel: Yes. or if you think about how you feel on your children’s birthdays. So like I have very different feelings on my daughter’s birthdays then my son's birthday. I had a good birth with my son. And it was good not because it was a VBAC, but because I was respected and I felt safe. That’s what made that a good birth. Right? Just to be totally clear. I’m really glad I had a VBAC, I’m happy I got what I set out to do. One hundred percent. Recovery was easier, like I’m not going to lie. And like you said, sometimes you can have a vaginal birth and you don’t come out of it being like, that was a good birth, right? 

So I feel differently on my son’s birthday but I also still feel that mix of happiness and a little sadness that he’s getting older. Right? He’s four now. You can contain both of those and they don’t cancel each other out, they just make you have a more I don’t know, dynamic emotional person. 

Meagan: Well-rounded. 

Rachel: Yeah, right? I’m experiencing all these parts of life, right? Like I have access to all of them and they’re complex and that is okay.

Meagan: That is okay. Last but not least you say, what kinds of qualifications to look for in a midwife, obstetrician, and a doula to ensure your team is best experienced in supporting a safe VBAC? We talked about that a little bit. Asking those questions that seem kind of random, but also what to expect and what those trainings are. Do you have any tips or advice on any qualifications that you were looking for or you think impacts someone's qualifications. 

Rachel: I would say I learned this more having had a VBAC and having recorded my book. So in addition to the questions you suggested, which I thought were so excellent, like what would you do if whatever, we had failure to progress, would you proceed or would you use assistive technologies. I would look for a provider who has, especially if we’re talking about an OB or a midwife but especially an OB, who has been practicing for a long time. 

The providers who were trained earlier have more experience not only attending VBAC, and attending twin births, and things now we tend to automatically kind of have a C-section for. But they’re also more open to it typically. Not all the time, but I think that there’s this feeling in general like oh a younger person’s going to get me better and duh duh duh, but really sometimes these providers who are older would be a better match in terms of their clinical skills and their risk tolerance. 

A lot of time, some of the OB’s coming out earlier, or more recently from their residencies, their risk tolerance is not very high. Even some OB’s have joked to me, who are now really working to help bring down the C-section rate, like in the beginning my like auto reaction was like we should do a C-section. 

So they get better with time and age and that’s something to remember. 

Also providers who are trained not in the United States. So in Europe, for instance, VBAC in most of the countries, not every country, VBAC after C-section is the automatic choice. Here, it’s not even an option all of the time and the default is to have a C-section. So again, you're going have a provider who has a totally different mentality if they trained in the UK for instance. That’s another thing I would look for. 

I mentioned about my midwife, that she’s a Certified Nurse Midwife, but she also had attended births at home and at a birth center. If you can find someone with that kind of experience I think that means they’re drawing on all different types of skills that would really assist with a VBAC. And they have the bedside manner, and they know how long labor takes, and a deep interest in being with you through it. There are providers like that out there, she’s not the only one. 

Meagan: Yeah. She’s not, she’s not. We have some providers here that were out of hospital and then needed to go into hospital just because of schedules, and there’s a big difference in midwives lives I feel like sometimes in the two different locations. But there’s this weird sense of trust in these providers that, and it shouldn’t be weird let me just say that, but it’s this trust in the ability to birth that I feel like sometimes is lost in the system, in the hospital system. 

Rachel: I totally agree with you. 

Meagan: It’s just this weird thing. Where it’s like oh no, it’s been four hours and we've only gone 2 centimeters so we have to do these other things. Where’s it’s like no, let’s step back and let’s let this body go and progress. That’s something I learned with my third birth. I mean 42 hours long. My body takes its time. My babies, like you, go into weird positions. I had back labor and oh my gosh you guys, back labor is another beast of a labor. It’s so different. But you guys, trusting the process is so important. And so if you have a provider that’s like yeah after a few centimeters we’re not progressing we’re going to need to start pitocin or…well wait, that might be a red flag. 

Unless you want that. Some people want that. 

Rachel: That’s a great point. Think about it, if you choose any provider, do you want someone who is like more into like medical interventions, or like let’s see if we can address this with lifestyle changes. Right like more exercise and diet as opposed to like oh your blood pressure’s high, we’re going to put you on medicine right away. That’s a really personal comfort preference. But I think to your point, these providers who’ve been out of the hospital now are in the hospital midwives, they know. They have seen physiologic vaginal labor and birth. And so many people who attend birth exclusively in the hospital just haven’t. So they’re exposed to it. 

So they have the trust because they’ve seen it, they’ve attended it, and they’re like sit on your hands. Be with her. Comfort her. Let it be. 

Meagan: Yeah. Let it be. I love that. Last but not least…I actually just lost my train of thought, I wanted to talk about something very specific. What was it?

Rachel: Um, trained providers, trained overseas. Midwives.

Meagan: Oh my gosh. Oh! I wanted to go back to it. Last but not least I wanted to talk about what we talked about earlier in your first pregnancy where you didn’t have a provider who wasn’t jiving and then you went and they still didn't jive and we kind of said that you can change. Can we talk a little bit about the process of changing? We talked about it being scary. It can be very intimidating you guys, but it’s so impactful.

So as we’re learning about our qualifications about our providers and as we’re learning more, we’re realizing we’re not in the right place, right? We want to do something.

A couple tips. One, getting your own op reports from your history. So then you don’t have to request anything to be sent over to anybody else, you can just take them with you and go to another provider and meet with them. 

Two. If you’re like I know this is like my person, then you don’t even have to go in and say goodbye. You could just transfer it over. Guess what? If you find out, like Rachel did, that it’s not going to work, you can do that again. Okay? But do you have any tips for anyone who may be coming to terms with the fact that maybe they’re not with the best provider. Maybe say they’re 39 weeks. Do you have any tips, from your standpoint, to anyone going through that? 

Rachel: Well just to say that it’s really there’s a lot of evidence; meaning researchers have looked at this and people who seek VBAC, are likely to switch providers like through after week 33 even. And I don’t have the exact study in front of me but that it’s done, and it’s okay. And you will get pushback, I mean realistically providers are going to be like whoa whoa whoa. And that it’s really different to be seeking a different provider late in your pregnancy when you’ve been getting care all along. Just keep that in mind. You’re not like wandering in from the woods being like uh I haven't seen anybody, I don’t know. That’s a scenario that providers would potentially be very uncomfortable with, with good reason right? Because you know…

Meagan: They don’t know who you are. 

Rachel: Exactly. And there are some providers who, from talking with them, they’re really at the edge of what their hospitals will tolerate and they are the ones who are probably the most willing to take somebody right at the end. And I’m talking about, there’s probably one in like every cluster of states, you know what I mean, especially just, I don’t even know so much in the South at this point but in the Northeast. 

And I would think about, to that end, there are some OB’s who work with midwives to run birth centers and those OB’s will also sometimes see people in the hospital; and if you can find them, they deeply know what you’re up against. They understand the system in a way that moms can’t even put their hands around right? Because this is like their workplace and they're working against it. 

So I would look for, you’re probably not going to be able to have the baby in the birth center right, the birth center would like lose their accreditation, they can’t do that, but a lot of those OB’s will also attend births in the hospital. I would go that kind of back route if you know what I mean. If I were week 36 or 37 and my provider’s like alright let's get you scheduled, you know what I mean? Suddenly we’re not talking about, like wait I thought I was going to have a VBAC, that’s what I would do. 

Meagan: I love that, thank you so much for your advice. And to your point, what you were just saying, you know if the majority of people who do switch is around that 33-35 week period, there is a reason because this is what happens. We got this bait and switch, which then goes more into you guys, find the right provider if you can in the beginning. Ask all the equations, do the research, establish that relationship, and follow your gut. What is your intuition saying? 

And the second your intuition is saying something’s up, like mine did at 36 weeks, do something about it. It’s okay too. And I know it’s intimidating, I know. I do know. But it is worth it. And maybe it’s that you need to do a pros and cons list. Like what do you want for this birth, and what do you want to do to make it happen. 

Rachel: And I would also add like do you imagine having more children. I think that’s the other part of this. When people ask me like…I have a couple friends right now who are pregnant and have had C-sections and they’re like what do you think I should do, as my friend?

And I’m like well, what I would think about is like do you want to have another baby? Do you want to have a…because this person is facing a third C-section or trying to VBAC after 2 C-sections. Do you want to have a fourth baby? Would you be comfortable having a fourth C-section? If the answer is absolutely no, then that means it’s really important to find a provider who would potentially attend a VBAC and that is partly intuition. And sometimes you don’t know till you’ve had that third baby or whatever. Sometimes you do have an inkling, like I don’t want that potentially to be closed to me or I wouldn’t feel comfortable with that fourth or fifth cesarean. 

Meagan: Yeah. And it’s harder every time to find the support. Not only do the risks keep following us and keep growing, it is harder to find the support if you do change your mind after that third cesarean and you don’t want the fourth cesarean and want to VBAC after 3. Which we know can be done, and we know is relatively safe right. But it is really difficult to find that support. 

So even ask yourself then, really dig deep. Am I really okay with more? And if you are, that’s amazing and wonderful. If you aren’t, make change. It’s okay to make change. 

Rachel: Yes. Yes. Yes. I think that it is so important to call that attention to that. That the likelihood of finding that provider who will attend a VBAC after 3 C-sections, I know a handful of OB’s that will attend those, and it gets harder for them to do it even every year. I wouldn’t bank on that as like well next time.

Meagan: It’s harder. It’s hard enough after two. It’s hard enough after one. It’s way hard after two, and it’s extremely difficult after three. After three, we know again we know people do it but you guys they go through so much. And so really sit back and think about that. And also asking your providers what the risk of that repeat cesarean is. There are risks you guys, so yeah. 

Okay. Well, is there anything else you want to share? I feel like I’ve taken up so much of your time today. 

Rachel: Oh no. I wanted to say, when I was working on this book I was thinking about a lot of stuff, but I was really thinking about moms facing VBAC or not to VBAC. That was one of the driving forces for me and I just want to say you’re not alone. And it’s a tough road no matter what you decide. And you know I hope that you can share resources with the people around you to help them understand what it’s like for you. Because you’re not alone. And part of not being alone is like having your community, right? 

And for people who have not had to do this they really don’t know. They really don’t understand that first you have to find someone, maybe you have to find someone else, then you have to work up your own courage. 

Meagan: I know. 

Rachel: Right? Then you have to look at well why did I have that last C-section, why did I really have that last C-section. There’s so much involved in this, so to the extent that you can draw others into it with you I think that that is super super important. 

Meagan: Yeah, it’s really impactful. Tell us where you can be found and we’ll make sure to link you in the show notes. You guys there’s going to a lot of links in the show notes today, things like prodromal labor, what is it, what can we do to help. Membrane sweeps and things like, it’s not necessarily non-traditional, but non-medical induction methods things like the membrane sweeping and everything. Of course all your book links and now yeah, where we can find you. 

Rachel: Yeah. On Instagram it’s @rachelesomerstein with an O. I’m on Twitter and I have a website that’s just rachelsomerstein.com. And I will be in Providence doing an event on November 21st and then possibly on the West Coast in the spring but I’ll have details on my website. 

Meagan: Awesome, awesome awesome. And a reminder if you are not in the show notes and you have been on our Instagram, we’ll also have her tagged there so it will be really easy to just click and go follow and go check out when and where she’s going to be. Thank you so much for being with us today!

Rachel: Thank you. Thank you so much!

Meagan: Like seriously. Like just after reading the book and having this book in my hands and then getting to talk to you and see you and hear this story through your own words in a way that is not written, to hear them not read them, it’s just been such an honor. So thank you so much. 

Rachel: Thank you. Oh, it’s an honor for me too. Thank you 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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We hear SO many of our listeners say things like, “I wish every first-time mom listened to these stories” or “I wish as a first-time mom I heard these stories because I truly believe it could have helped me avoid my Cesarean.” 

First-time moms, we want to educate you to make informed decisions during your birth. We want your first birth to be an empowering experience, no matter the outcome. And if possible, we want to help you avoid an unnecessary Cesarean.  

Meagan shares some of her best tips for first-time moms regarding induction, big babies, ultrasounds, and more. We also asked members of our VBAC Link Community to send in their best tips for first-time moms. 

We hope this episode becomes a great starting point for you to then go on and listen to the powerful stories shared in our other episodes!

VBAC Link Supportive Provider List

Evidence-Based Birth: Evidence on Inducing Labor

The VBAC Link Blog: The ARRIVE Trial

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, Women of Strength. This is Meagan and you are listening to The VBAC Link Podcast. I am so happy that you are here. Normally, we have episodes that are filled with VBAC stories, CBAC stories, and guests sharing educational pieces on VBAC. However, today, I’m going to a quick episode for our first-time mamas out there. 

For years, we have had people write in a review saying things like, “Oh my gosh, I wish every first-time mom listened to these stories. This is not only for VBAC moms or VBAC-hopeful parents. This is for anyone who is giving birth,” or again, going back to the first-time mom, people saying, “I wish as a first-time mom I heard these stories and learned this education because I truly believe it could have helped me avoid my Cesarean.” 

Women of Strength, if you know someone who is expecting or if you are a first-time mama, listening on how to avoid unnecessary and undesired C-sections, listen up. This is going to be an episode specifically for you. 

As always, I have a Review of the Week so I’d like to dive into that but then get back into what first-time mamas and what our community wants first-time mamas to know. 

Today’s review is from Emmalyn. I don’t even know how to pronounce the last name, but Emmalyn. It says, “Uplifted and educated. I have been binging this podcast since I found it a couple of weeks ago and I’m addicted. As I prepare for my HBA2C” so for the listeners who are new, HBA2C means home birth after two Cesareans, “I have experienced so much healing and inspiration through hearing these stories after two attempts for vaginal deliveries with my first two kids. One preeclampsia hospital birth and HBAC (home birth after Cesarean) transfer to the hospital. The content they provide is diverse, thoughtful, and inclusive. There is so much stigma around home birth and VBAC and this is the first and only community plus the Facebook group I have found to truly be welcoming and nonjudgmental. I feel like this is going to be an instrumental tool to my birth prep for my baby coming this Christmas Eve.” 

You guys, I could not agree with her more. This is a place where we want you to know that you are safe, that you are heard, that you are understood. We in no way, shape, or form believe that there is only one way to birth. There just simply isn’t. We just want you to know your options and feel empowered to make the best decisions for you along the way. 

So if you are one of these first-time mamas listening today, I am so excited that you are here and I do encourage you to continue going on through all of the other episodes. Women who are sharing their stories likely have had a Cesarean before and I think this is such a great opportunity for you to learn how to avoid a Cesarean by listening through others who have come before you and have given birth and have also learned along the way. 

I’ll tell you right now that with my first baby, I was not ready to give birth. Although I felt ready, all I knew was that I was pregnant and I was going to have a baby and I could not wait. But there was so much more that I didn’t know that I wish I knew. I have learned throughout the way and I’m going to be sharing some more experiences with you along with, like I said, really tips from our own community members. You guys, I reached out on Instagram and asked for tips for first-time moms and I’m going to go over some of those tips along with learning how to avoid a Cesarean and unnecessary interventions. Here we go. 

Okay, everybody. Welcome to the show. Thank you for joining me. If you are new to the podcast, my name is Meagan Heaton and I am a VBAC after two C-section mom and a doula who wants to help educate and empower anyone who wants to learn more about their options for birth after Cesarean as well as learning how to avoid a Cesarean from the get-go. 

I had a Cesarean when I was pregnant with my first. I went into labor at 39 weeks and 5 days spontaneously with PROM which is called premature rupture of membranes. What that means is my body went into labor as far as my water broke, but then nothing really followed for quite some time. Contractions didn’t really get going and labor itself did not start. I, along with many first-time moms, was told that if your water breaks you go straight to the hospital. 

I went to the hospital and from then on out, it was induction. They wanted to induce my labor and they wanted to intervene instead of just letting my body do its thing. I started getting Pitocin and that led to an epidural. It unfortunately led to a Cesarean. 

Now, I want to tell you that Pitocin and an epidural do not always lead to a Cesarean but these are going to be common things that you’re hearing in women’s stories along this podcast that do seem to impact the end result of a Cesarean. 

With my second, I really wanted a VBAC, a vaginal birth after a Cesarean, and I went looking more into what it was and what my options were and what I should do. I ended up staying with my same provider who was a great guy. Do not get me wrong, but he wasn’t the provider for me and I didn’t learn that until after my second Cesarean. 

I stayed with him and I went into spontaneous labor again with premature rupture of membranes. This one took a lot longer for my body to kick in and unfortunately, I really never was allowed the time. I ended up walking down for a second repeat Cesarean with that one because I was told that my body just did not know how to do it. 

This is also another very common, common thing that so many Women of Strength are being told. Their body doesn’t know how to do it. Their body can’t progress. Their pelvis is too small. Women of Strength, if there is any pet peeve that I have, it is someone telling another person that their body is not capable of giving birth vaginally. I might sound grumpy about it. Let’s be honest, I am. You are capable of giving birth vaginally. 

What are some of the things that I would suggest you do as you are going along as a first-time parent?

Number one, I really believe that provider is key. If you have a provider who is on board with your birthing desires, that is going to help you so much during your labor and your pregnancy journey. If you have a provider who is very induction-happy, intervention-happy, and pushing you to even schedule an induction before you even reach 39 weeks or 40 weeks or 41 weeks, that’s a problem. That is a red flag. 

Take a moment if you can. Go to thevbaclink.com/blog or just click the link in the show notes and check out how to find a supportive provider. Now, this blog that we have is how to find a provider who is supportive in VBAC, but I think all around it goes in line with any provider whether you are a VBAC or not. 

You want to find someone who doesn’t put stipulations on when you have your baby and what happens during pregnancy meaning that if they are requesting or demanding that you do multiple growth scans in your third trimester and there is really no medical reason to indicate the reason to do that, that’s a problem. 

If they are talking about the size of your baby early on or the size of you and how you look and, “You must be carrying a big baby. You are so petite,” there is already doubt that is being placed. As I mentioned, if they are encouraging an induction at 39 weeks or just getting it on the schedule, let me tell you right now that being pregnant at 39 weeks is not always fun. Being pregnant at 40 and 41 weeks is not fun. There is a lot that goes into it. Your hips hurt. You’re tired. Your pelvis hurts. You’re peeing all of the time. You can’t sleep. Okay, it doesn’t sound that great, right? But it really is such a great time and it’s a time that we need to cherish and really just embrace but it’s hard to do that. That’s the fact. It’s sometimes really hard to do that so when we have providers giving us an “out” to give birth sooner, it’s very enticing. 

I don’t shame anyone for taking that opportunity of being induced and picking your baby’s birthday, but there are a lot of things that go into that. 

Now, as a first-time mom back in 2019 I want to say, a study came out and they called it the ARRIVE trial. The ARRIVE trial is where they had a whole bunch of people, and really actually not that many people, but a whole bunch of people in two groups. They had one group where they induced at 39 weeks and they didn’t always have a “favorable” cervix. Favorable versus unfavorable meaning the cervix was showing signs of readiness to give birth. 

They had these moms in one group who were induced at 39 weeks then they had another group who chose not to be induced or to wait for spontaneous labor but would not let them go past 42 weeks. There were a lot of things that their goals were to point out and study in this trial which you can find out more about on our blog. It’s in the show notes. We’ll make sure that we have the ARRIVE trial link in there. But they really wanted to also see what it did for Cesarean. 

In the induction group, 79 out of 82 people were induced at 39 weeks. The people in the expectant management group, meaning they were waiting for spontaneous labor or didn’t elect to induce at 39 weeks, 79 out of 80 waited. 44% of them gave birth spontaneously and 56% of them gave birth after induction for medical reasons. Now, medical reasons. 

There are a lot of things people can talk about or providers can talk about why you should be induced. So let’s talk about some of the main reasons for an induction or some common reasons for an induction that you’ll see but then always, I want you to know that you can question. If someone is saying there is a medical reason for you to be induced, question them. It’s okay for you to question them. It is always okay to say no and question, always. No matter what it is in any medical scene, birth or not birth, you are always able to question and say no or no, thank you. 

What are some medical reasons? Medical reasons may be preeclampsia. Maybe you’re having blood pressure issues or HELLP syndrome where now your liver is being affected. We’ve got high blood pressure or elevated liver enzymes and it really is best for you and baby to be born and to give birth. So preeclampsia may be one. 

Maybe you’ve got a unique health condition that is now impacting your personal health to stay pregnant. That may be a reason for induction. IUGR, intra-uterine growth restriction. Maybe your baby is no longer thriving inside the uterus and inside the womb and needs to come out so they can thrive on the outside. If IUGR is happening, that is a medical reason to consider induction. 

Those are just a few that you may encounter. Some other things may be low fluid– that one can be debatable for sure. It can be serious, or high fluids. There are so many situations. Just know that if you have a situation or if someone is suggesting an induction at 39 weeks or at any point due to medical reasons, discuss that with your provider. Definitely discuss and question and make sure that you are all on the same page and you are really understanding what the medical reason is for your induction. Don’t fear to question the evidence saying that induction is the best route. 

Okay, so the people in the expectant management group like I said– 79 out of 80 waited. 44% gave birth spontaneously 56% gave birth after induction. So what did this study really show, really, really show about C-section? Well, let me tell you. They really tried to show that it lowered Cesarean rates from 19% to 22% but if you really dig into it deeper, it really doesn’t say if Cesarean really is lowered or not. 

Between the two groups, there really were no significant difference in birth outcomes for the baby so again they showed that maybe 19% versus 22% were likely to end up in a Cesarean and then they also showed that they were less likely to develop high blood pressure– 9% versus 14%. That is a thing. We do know that blood pressure can elevate in the end, but overall, as of 2024, there really are a few studies that have been able to look at the effects of the ARRIVE trial and have concluded that the elective rate has significantly increased or decreased the Cesarean delivery. 

This is the problem though. It’s being so heavily– and maybe heavily isn’t the word– done. It’s being so heavily performed all over the world now after this trial came out. For some reason, we looked at that and we’re like, “Yep. See? It impacts the Cesarean rate. It lowers it.” But we are still having a really high Cesarean rate and first-time moms are still, still, still, still having Cesareans after induction is happening. 

Induction. Women of Strength, that is what we call the women who listen to our podcast, if you are being proposed for an induction or being offered an induction, maybe take some steps back. Do some research. Read our blog. Talk about induction methods. There are also a lot of different types of induction methods. 

I want to also say that coming back to your provider, if you have a supportive provider who is willing to induce very gently and understands the process of induction especially for a first-time mom whose cervix might not be favorable or ready, you may have a higher chance of giving birth vaginally. But if you are at a place where they like to push inductions really fast on you and all of the things, increase all of the interventions, you are going to likely have an increased chance of Cesarean. 

In 2023, the rate of C-sections in the United States was 32.4%. 32.4% which is really the highest it’s been since 2013 and just astronomically gross in my opinion. Years and years and years ago, it was 10-15%. Even before that, it was 5%. We are seeing a peak. We are seeing a serious peak and what’s happening is we are seeing a lot of the times first-time moms will have a C-section for whatever reason and then people are being told that they cannot have a vaginal birth after Cesarean, that the option is now gone or they won’t even approach VBAC as a topic. It’s just, “For the future, you will have to schedule a C-section.” 

Okay, now this is another one. If you are a first-time mom who has a friend who had a C-section and doesn’t know their option, please share this podcast with them. This is such a great place for them to come and learn and know their options. 

Okay, so let’s dive in. I asked our community. I mentioned that before. What do our community members want a first-time mom to know? What do they wish they would have known before as a first-time mom?

One of our followers, Elizabeth, mentions, “Wait as long as it takes for baby to come and to change positions frequently.” Oh my gosh, I cannot agree more. This is what we are talking about, right? Waiting for our baby to come and not inducing unless it really is medically necessary and letting our bodies do what they are made to do and are totally capable of doing.

Changing positions frequently is something I highly encourage and as a first-time mom or any mom giving birth, I highly suggest a doula. Doulas are amazing. I know they are not always affordable and I don’t know if you have ever heard of this, but you can go to behervillage.com and you can actually register for a doula so instead of getting all of the million onesies and wipe warmers or a million sized-newborn diapers, you can register for a doula and people can help pay for a doula. It is absolutely amazing. I highly encourage it. Check out behervillage.com. 

We also have doulas at thevbaclink.com/findadoula. They are VBAC-certified doulas but these are doulas who are trained and educated and certified in helping you avoid a Cesarean so I highly suggest a doula because they can help know what positions to change to and they can help guide you. If you don’t have a doula, that is okay. Change positions frequently. I mean, every 5-10 contractions, if you went from hands and knees and you want to stay on hands and knees, go hands and knees but put a pillow under and elevate that left leg or that right knee. 

Change things up because changing the dynamics of your pelvis is going to help bringing baby down. One of the main reasons for a Cesarean is that babies are in a wonky position or failure to progress or failure to dilate. That, a lot of the time, is because baby is not in a really great position and movement will help baby get in a better position and help your labor speed along. 

Okay, our friend, Emily, says, “Wait to go to the hospital.” I mentioned this earlier that I was told when my water broke to go straight to the hospital. Do your research to wait. Learn how long to wait, how long is too long, and again, that’s when a doula comes into play. They are really great on helping to guide you on knowing when to go. 

Emily also– she has a couple of tips here. She says, “Trust your own intuition and what your body is feeling in the moment.” I could not agree more. Your intuition is huge and if you continue listening to this podcast, let me tell you that you are going to hear about intuition a million times. Intuition is huge. You have it and it’s amazing. It’s super important to follow. Sometimes we question our intuition and that is hard. Try not to question your intuition and again, do what your body is feeling in the moment. 

Emily says, “I didn’t have a doula and it’s my biggest regret.” Okay, so we were just talking about that. Doulas are amazing, you guys. I didn’t have a doula for my first two. That was also a big regret. My husband was not on board with my second. After I learned about a doula and after having a doula, he said that there is no way we would have another baby again without a doula. They are just incredible you guys and there are actual statistics on doulas. They lower the chance of Cesarean. They lower the time of birth by 45 minutes. 45 minutes might not sound like a lot, but 45 minutes in labor is impactful. They also lower the chances of induction and interventions and they overall help you walk away with having a better experience. 

Okay, another follower says, “Trust your body. Don’t accept interventions. Plans can change and breathe.” Love that so much. We have Sarah who says, “Ask for help even if you feel fine.” I love that. It’s okay. Use your voice in labor. Use your voice during pregnancy. Use your voice during that postpartum experience. Even if you think you are feeling okay, it’s okay to ask for help or if you have a question that is bobbling around in your brain, ask it. Don’t be scared to ask it. 

Another follower says, “Be patient with yourself and your baby. Enjoy your pregnancy and push with an open lotus.” I love that so much. Oh my gosh, that just made me smile. We have a follower named Ash. She says, “Be informed so you can make decisions you are happy with under time and pressure.” Okay, this is something, Women of Strength, that we have found through many of these stories. These first-time mamas are going through labor who have not had a lot of education, me being one of them, going into birth. You guys, birth is a very big event. It is a very important day and impactful day. Sometimes things can change just like what one of our followers was saying. Plans can change and that means sometimes things can be offered to you that you don’t really know about. You don’t really know what is being offered to you so you feel like you have to say yes or no. You don’t really know what you’re making the yes statement to so being informed is so important.

We have a blog at thevbaclink.com/blog that shares so much information along with this podcast and then we actually have a course for parents to learn how to avoid Cesarean and how to navigate through labor and avoid a Cesarean so if you are interested in learning how to avoid a Cesarean and learning more about what this VBAC stuff is even like, check us out at thevbaclink.com. 

Gracie says, “Don’t let your doctor pressure you into unnecessary induction.” It goes along with the theme in the first part of the podcast. If you can tell, induction and pressure is something that a lot of first-time, even second and third, oh my gosh, many-time moms have. 

Ash says, “Have a clear but detailed birth plan.” I love that so much. Birth preferences are so important. As you get informed and get educated, you are going to learn what is important to you, what you want, what you don’t want. 

We had a story not too long ago how as a first-time mom, she didn’t realize how much her birth experience meant to her until she didn’t have that birth experience. You guys, this is such an important day. Oh my gosh, it’s just incredible and if you can be informed and you can have that clear birth plan– now, let me tell you that some of these birth plans don’t go exactly as you’ve written them down. Go in with an open mind but know your desires and know the evidence and the information behind those desires and why they are important to you. 

Okay, M says, “Be open to birth preferences changing.” This is just going right along here. Okay, like we were just saying, sometimes they change and it can be really hard. I have a sweet and sour view on birth plans because birth plans are incredible. It helps our team and reminds them what we need and what’s important and what we want, but sometimes if we write them down on paper and they don’t go as planned, we can view them or view ourselves as having failed or like we did everything and it didn’t work so it failed so what’s the use in trying that again or wanting that again? 

I also want you to know that if you can go into it having an open mind, it can help you. It can help you a lot and knowing again that birth preferences change is so important. 

Okay, so we have a photographer here. Lilabqz_photography. She said, “It’s not pain. It’s power. Breathe and it will be all over soon.” I love that. These contractions are powerful. They are amazing. Oh my gosh. Okay, hypnobirthingnorthyorkshire says, “You are amazing. First-time mamas, you are. You are amazing.” Everybody listening to this podcast, let me tell you that you are incredible. You are such a Woman of Strength and you are capable of more than you have ever known. 

Okay, we have another follower who says, “Give yourself all the grace. You did a big thing. You are your baby’s best mama.” Birth is amazing, you guys. It is a big thing and you are incredible for doing it. Another follower says, “Educate yourself and get a doula.” 

The next one also says, “Hire a doula.” You guys, hiring a doula is a common theme. Like I said, if you are not in a financial means or don’t have the financial means, check out Be Her Village. It is absolutely incredible and can make it possible for you to have the support that you deserve. 

Rachel says a couple of things here. She says, “Just because you feel good to do all the things so soon doesn’t mean you should. Find someone who will listen to your birth story without interrupting or opinions.” This is more for postpartum. I agree. Take it easy. Even for pregnancy, take it easy. Just because you feel like you can run a marathon doesn’t mean you should. Rest up. Rest easy. Give back to your body. Hydrate. Fuel with good nutrition and find someone who will listen to your birth story without interrupting or opinions. 

You guys, opinions will come in all around even before you have your baby. I mean, here I am. I’m sharing some opinions. Just find someone who will listen and validate you. You deserve it. 

Okay, Lauren says, “If you don’t want a C-section, listen to The VBAC Link. You’ll learn so much.” Oh my gosh, Lauren, thank you so dang much for that. That is what this episode is all about, to help you learn how to avoid a Cesarean. 

Our friend, Jess, says, “Eat to replenish yourself from birth and pregnancy. Meal trains are great.” Oh my gosh, I can’t say that enough. If you haven’t set yourself up for a meal train before and you haven’t had your baby yet or even if you had, they are incredible and they will help your birthing partners so much. 

Julie says, “Surrender. Surrender it all. Birth is incredible. You’re going to feel so many sensations.” Even if you don’t want to go unmedicated, you guys, you’re still going to feel so many sensations that are new and somewhat shocking but also incredible. You’re birthing a baby. It’s just absolutely amazing.

Then Rachel says, “Do your research. Be mentally prepared for either type of birth and recovery and have a postpartum plan or a birth photographer and take pics.” Okay, you guys. Such incredible information. 

I echo all of them. Obviously, we’ve also been talking about some of those topics. You are strong. You are capable. Don’t let anyone doubt you. Okay? Don’t let anyone doubt your ability. Keep listening to these stories. These stories are meant for you as well. They are meant to help you learn, to help empower, to help grow, and honestly, one mama at a time, we’re going to see the Cesarean rate drop, you guys. We’re going to see it drop. 

Thank you so much for joining me today. I’m absolutely honored that you are here listening to the podcast and like I said, if you want to learn more about The VBAC Link and what we have to offer along with so many free resources, you can join us at thevbaclink.com. We’ve got the podcast, the blog, the course, resources, and so much more.

Oh, and for kicks and giggles, I want to throw out the fact that we have a supportive provider list so if you are looking for a supportive provider whether it’s a VBAC or not, don’t forget to check out our provider list. You can find us at thevbaclink on Instagram, click on linktree, and you’ll find the supportive list there. Thank you so much and take care. 

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.

Advertising Inquiries: https://redcircle.com/brands

“Inhale peace, exhale tension.”

Did you know that the cascade of interventions can not only contribute to a Cesarean but may cause one? 

Melanie believes that was the case with her first birth. Her difficult recovery included going to EMDR therapy to help with her PTSD. Her OB/GYN did mention that she would be a great VBAC candidate. Not knowing VBAC was a thing, Melanie’s research began. Cue The VBAC Link!

Melanie vigorously dove into VBAC prep before she was pregnant again. Her journey is one that shows just how powerful intuition and manifestation can be. 

Melanie went from having PROM with her first to arriving at the birth center at 7 centimeters and even being able to reach down to feel her bulging bag of waters as her baby began to emerge en caul!

Other talking points in this episode include:

Achieving a VBAC without a doula

Husband support 

Birth affirmations

Recommended podcasts and books

Specific ways to avoid PROM

Hypnobirthing by Siobhan Miller

The VBAC Link Blog: 9 VBAC Books We Recommend

The Birth Hour

Down to Birth

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, everybody. Happy VBAC Link Podcast day, whatever day it is that you are listening. We are so happy that you are here. We have our friend, Melanie, from Texas. Texas, is that where you are? That’s where my mind is thinking. 

Melanie: Yep. Yep. Wiley, Texas just outside Dallas. 

Meagan: Perfect and did you have your VBAC in Texas?

Melanie: Yes. In Dallas. 

Meagan: In Dallas, okay. We have her sharing her stories with us today you guys. At the end, we’re going to be talking about PROM. Right before we got recording, I was talking about how important I think talking about PROM is which if you haven’t heard lately what PROM means, there are all of these acronyms all over the place when it comes to VBAC birth, but it’s premature rupture of membranes. We are both PROM moms here and so we are very passionate about the topic. If you have had your water break before labor really started and got going in the past, definitely hang on in the end because we are going to be talking more about that and maybe some ways that could or maybe not, we are hoping these are the ways that helped us avoid premature rupture of membranes. 

We are going to be talking about that and of course, her beautiful VBAC story. I do have a Review of the Week and this is by milka. It says, “VBAC Podcast Review.” It says, “Hi. I love listening to your podcast. I had an unplanned C-section with my first birth and am preparing for my second birth now. I didn’t know what to do to make sure I didn’t end up with the same situation. Hearing so many women’s stories and experiences validated mine but most importantly, I learned so many tips and ideas to help my VBAC. I had a successful VBAC and now recommend this podcast to all expecting moms. Just such a great no-pressure and enjoyable way to learn.” 

I love that she talked about no pressure because that is what this podcast is about. This is a place where people share their stories, where they share information both on VBAC and CBAC, and all topics when it comes to birth. We want you to just be here, be in this space, and have it connect with you how it connects with you and take these women’s stories and these providers who are coming on and the information given and apply it however, it looks for your journey. 

Melanie and I were just talking a little bit before the episode about how it just feels so full circle. So many of these Women of Strength who have come on before Melanie here and have shared their experiences and people listening, it really is so impactful. Right, Melanie? You were saying that I was in your ear. We were in your ear and these people’s stories were in your ear doing what? Empowering you. 

Melanie: Mhmm. Oh yeah, it’s incredible. It feels very full circle to be here. 

Meagan: Yes. We are very excited that you are and you guys, we are going to jump right into her story in just a second. 

Okay. The table is yours. 

Melanie: Okay, so happy to be here. Meagan, like you said, you guys have been in my ear for over a year so it just feels incredible to be here. As I was listening to these stories, I was always hoping to find that birth story that was like mine just to find out what went wrong with mine and also on the flip side, what did people do? What were people seeing in things that went right and how they were able to get a successful VBAC? I was very motivated and inspired by the podcast. I listened to every episode so hopefully, my two stories out there can hit home with anyone. 

But yeah. I’ll start with, of course, the C-section just briefly. I got pregnant in March 2021 so everybody remembers it was COVID times still. 

Meagan: Wild times. 

Melanie: Wild times. Actually, at the beginning of my pregnancy, my husband wasn’t able to come to the appointments. But thankfully, it being 2021, by halfway he was able to come. That pregnancy, I was really healthy. I ran. I’m a big runner so I ran every day. I had no morning sickness. I was very active. I never even until the very end– I ran the day my water broke and I never had that feeling like I didn’t want to be pregnant.

Not the case the second time as we’ll hear, but the first time—

Meagan: And you do that competitively, right? Did you compete during pregnancy at all? 

Melanie: I’ve ran my whole life so I ran cross country and track division one in college. Now, I do more marathons. Yeah. I ran both pregnancies. Not anything too crazy. During the second pregnancy, I did run a half marathon. I was 16 weeks but then it went downhill after that. But yeah. I run pretty competitively. I take it really seriously and it’s a passion of mine. 

Yeah, the only thing I got the first time and the second, but I did. I’ve heard it before on the podcast is SPD, symphysis pubic dysfunction. The first pregnancy, so the one I’m talking about, a prenatal chiropractor literally cured it. I had to go back a couple of times because it would get out of alignment again, but for anyone who is suffering from SPD like I was both times, it’s amazing. I would just call them witches because they would literally cure it and it would get me back to running. It was amazing. 

So my birth education the first time around, I thought I was educated like so many women here. I read the typical What to Expect When You’re Expecting. I did a podcast but it was more so of what size is your baby? What’s going on in utero? I didn’t listen to many birth stories and I became so obsessed with that the second time. And truly, I feel like you get the best birth education through birth stories because you just get the whole shebang. 

We did take a hospital birth class and now I know that a hospital birth class is really just the hospital policies. I remember there was a section that they had mentioned very quickly in passing, “If you’re going to have a C-section, you should take this class. Okay, the next thing.” I thought like so many women, That’s not going to be me. I’m not going to have a C-section. I’m healthy. I feel great. 

Most C-sections are not planned so I feel like it really did a disservice to not even mention anything about a C-section in that class, but anyway, I just assumed that you have a baby in the hospital. You get an epidural. You take a nap and then you wake up and you push out a baby. I was not against hospitals or anything. I was not against the epidural or anything like that. 

I mentioned that I ran the day my water broke. This was past 40 weeks. 40 weeks came and went. A couple of cervical checks I got I was not dilated at all. They had scheduled a 41-week induction date. When I was checking out at the front desk at the time, I just remember it feeling really, really wrong scheduling that date. 

Meagan: Your intuition was speaking right there. 

Melanie: 100%, yeah. Of course, I didn’t realize it at the time. It was my first baby and everything but when I look back, that just felt so wrong. 41 weeks came and I was supposed to go in at 9:00 PM that night but the interesting thing is that my water broke actually 4 hours before I was supposed to go in. It was 5:00 PM and I was supposed to go in at 9:00. Like you mentioned Meagan, it was PROM so it was a trickle. 

I was like, Wait. Am I peeing? What is happening here? No contractions at all. And with the little education I did, I knew that just because your water breaks, it doesn’t mean that you have to go in and you should labor at home as long as possible. However, because I was set to go in and I guess because I was 41 weeks, I called them and I just remember they were like, “No. You’re in labor. Come in.”

I was like, “Okay.” 

Meagan: This is labor? 

Melanie: Yeah, I was like, “Oh, okay.” So I got to the hospital literally not dilated at all. I was maybe half a centimeter and they inserted the Cervadil at 9:00 PM which hurt really bad because it turns out if you are not dilated, it really hurts to get Cervadil inserted. 

Meagan: And if your cervix is posterior, it’s hard for them to get it into your cervix so that can also cause a lot of discomfort. 

Melanie: That’s exactly what it was too because I think they had a hard time. I didn’t even think about that. It was probably posterior. Man. Yeah, see? My body just wasn’t ready for that. But contractions did come eventually. I don’t know if Cervadil can cause it or if it was just time. I was going into labor but that was around 1:00 AM. The contractions started to get uncomfortable. I had not practiced coping with contractions at all because I was planning to get an epidural. I never had any inkling of going unmedicated or anything so this is where I think everything went south.

This is where I just think it was the cascade of interventions. First I had fentanyl which I don’t know why because I think I was trying to delay the epidural for whatever reason. I don’t know why. I had fentanyl first. It was awful. It felt like I was so drunk. The room spun and it was terrible. 

Then an epidural, which has fentanyl in the epidural. That was fine. After the epidural, of course, you feel amazing, but you are stuck on your back forever. I just think this cascade of interventions, being stuck on my back, not moving, I never ever take medicine as it is. I think my body and my baby just hated all of this. So then eventually, terbutaline was given around 6:00 AM. 

Meagan: To stop the contractions. 

Melanie: Yep. I think that’s when some decels started happening then they did pull the Cervadil to stop the contractions. There were some decels then yeah, eventually it’s all a little bit fuzzy but at 6:45 AM the decision was made for a C-section. At 8:01, he was born. They called it an emergency C-section and now I look back and I’m like, yes. I do believe that it was needed. However, I’ll never really know but I really think it was caused and also, if it’s an emergency, I understand that they don’t wait hours like they did for me and they usually put you under. 

I think it was more unplanned and I look back and I really think it was caused. 

Meagan: That is the hard thing to know. A lot of these Cesareans, I would agree with you that they are caused by the cascade of interventions and things like that and then a lot of providers will say “emergent” so there are emergent Cesareans where we need to get this baby out quick and then there is a crash where they do put people under with crash Cesareans. But if they are waiting for hours, it’s almost like they gave the emergency title to make themselves feel better or make it look valid to justify that Cesarean. 

Melanie: Yeah, I definitely agree with that. That experience was really awful for me. I think for some women, I think it’s awful for a lot of women and then I think for some, it’s not that awful. For me, no skin-to-skin. I know that’s not very common at all. It felt like it was forever for them to bring him to me. No one was talking to you in this moment and I just don’t think these doctors realize in the moment that you’re being robbed of something that you envisioned and a really important experience. 

It just felt like forever for them to give him to me. It was 30 minutes or so. He was fine. He came out completely fine with great APGARS. I was fine. It just ended up in the way I didn’t want it to. I did have PTSD from that experience because I was having a lot of flashbacks to it. I went through some EMDR therapy. I had a great therapist and of course, I talked to her about it. She was there for my VBAC as well. 

But yes. That postpartum was just– the healing sucked. I just felt really awful and I think mentally, it took a really big toll on me. Breastfeeding was really hard. A lot of that I attributed to my C-section. It was not desired. It was just not great. 

So that was the first birth. I never knew VBAC was a thing or a big deal at all. I don’t even think I knew the term VBAC. I went to the 6-week post-doctor’s visit and I remember she was like, “Yeah, you’d be a great candidate for a VBAC. However, you have to go into spontaneous labor by 39 weeks.” I’m sitting here like, okay. He was just a 41-week baby. My mom has a history of going late. I don’t think that’s very likely that I’ll go into spontaneous labor by 39 weeks so I already made up my mind that I wasn’t going to go with her. 

I learned later that that is a very common thing that hospitals and OB/GYNs will say to you. 

Yeah, that was the first one. So then cue The VBAC Link. I started listening to The VBAC Link Podcast before I was pregnant. Maybe my son was a year old and I binged every episode. You and Julie were in my ear a ton. The thing that I heard from The VBAC Link was that the likelihood of a successful VBAC for many of these women did happen out of the hospital and like you yourself, Meagan. 

That’s not to say that of course, you can be in the hospital. You can have an epidural and get induced and have a successful VBAC, but when I just heard the overwhelming thing was how much of a better chance you have. 

I should also mention that my husband works in medicine too. He’s a physician assistant. I will talk about that. He had a little bit of a hard time just with the safety aspect of it. But once I let my mind go toward the possibility of an out-of-hospital birth– because I wanted a VBAC so badly. I was so motivated. Then I realized that it was something that I actually really desired, a physiologic birth and unmedicated. 

When I look back, I think that’s why I had such a hard time mentally with my first birth because I think I didn’t know that I cared how my babies come into the world and I wanted to experience that. I don’t know and in some weird way too, it felt like doing an unmedicated out-of-hospital birth made me almost feel connected to my ancestors. It seems really weird, but I was like, this is what they did. I just think it’s something really cool that our bodies do. I wanted to experience that. 

But I do. I recognize that it was a trauma response for me for sure to become obsessed with research. I binged all of the episodes. I would look for anything related to VBAC. I read so many books and I actually toured. I had a neighbor and a friend who was pregnant at the time and she was going with the birth center that I ended up going with. We would go on walks and she would talk about her experience and how amazing and wonderful it was. I was just like, man. I want that, especially knowing that we were planning to most likely have just one more child. 

I hated to have that thinking of, this is my last chance, but I did. 

Meagan: I understand that so much because my husband told me that too and I was like, “I really want this VBAC. I really want this VBAC.” 

Melanie: Yeah and that’s okay. We’re okay. It’s okay if we have these desires and these wishes. You only get one life. It’s okay to want what we want. 

I’ll never forget. I toured the same birth center that my friend was at and again, I was not pregnant yet. It was an education class. I was like, let me just see what these midwives are all about and what birth centers are like. It just immediately– again, it’s that intuition. It immediately felt so right. I remember I walked in and just before even finishing the class, before we even really heard them out, I just knew that this was where I wanted to give birth in my next pregnancy. It felt so right. 

And also, I’ll never forget. I had asked questions about VBAC because unfortunately, not all birth centers support VBACs which I don’t understand, but I had asked a lot of my questions related to VBACs and I remember the midwife saying, “Well, unfortunately and fortunately, we do a lot of VBACs.” I’m thinking, why would I not want to be with a provider who does the most VBACs? Hospitals don’t do a lot of VBACs comparatively. A lot of people are like me. They go to a birth center because they really want a VBAC. 

That just was really calming to me. I felt like I was with experienced hands. I was safe and there also was not really anything different about a VBAC. I’m with people who understand and trust birth. 

I brought this up to my husband and I mentioned that he had his reservations because he’s a physician assistant and he works in orthopedic trauma but he was in PA school, he had to do OB/GYN rotations. He unfortunately saw some bad birth outcomes so to him, the hospital was a safety net but I was so, so grateful that he was supportive of my desire to go out-of-hospital even though it seemed kind of crazy to him. 

He came to– we had one meeting with the midwife so he could ask questions and everything. She was so great and answered all of his questions and I actually was unknowingly pregnant at the time. I didn’t know it.

Meagan: No way. 

Melanie: It’s really weird. I toured the birth center first by myself and it’s almost like my body needed that to be like, boom. You found the place where you are going to give birth and then I got pregnant. It was really weird. We were trying but also, it takes my body after coming off birth control some time so it still was a shock. I was like, oh wow. 

So anyway, the second pregnancy was much harder as I mentioned. I was not able to be nearly as active. I ran that half marathon like I mentioned and then– it was the Dallas half– then my body just went downhill. It was much, much harder. My sleep was horrible. I have an Aura ring and it tracks your sleep and everything then at the end of the year, it will give you a summary of every month’s sleep. 

I will never forget because I got pregnant in September and it’s like, January, February, March, April everything is fine and you look at the bar graph time series and it plummets in September. It stayed that way. It was my deep sleep. My deep sleep really, really decreased a ton. Maybe that’s normal and I just didn’t know that the first time, but I did not tell many people I was going with a birth center. I lied about my due date which I learned from this podcast which is very smart to do. 

I highly recommend it just because I didn’t want to let in any of that negative energy or anything. The couple people I did tell, I did get a couple of people who would be like, “Oh, they’re going to let you do that,” like the “let you” language. 

Meagan: We both did the same thing at the same time with the air quotes. The “let you”. 

Melanie: Yeah, exactly. I don’t blame them. I just think that a lot of people don’t have that birth education. And in hospitals, it’s very normal to do a repeat C-section even though we all know it’s not evidence-based. 

So very briefly, I want to talk about the prep that I did in this pregnancy that made such a huge difference for me. Number one, all of the podcasts like I mentioned. This one, of course. The VBAC Link, I binged it. I found the Down to Birth podcast at the end and that’s a really, really good one. I know everybody does The Birth Hour as well which is good but that one has everything. I loved the more VBAC-specific ones. Then also, they haven’t produced any episodes in a while but the Home Birth After Cesarean Podcast was really good too because they were all unmedicated. I was hoping to do that and they were all VBACs. 

Then books– I read a lot but these were my favorites. Of course, Ina May’s Guide to Childbirth. Emily Oscar’s Expecting Better is really good. Natural Childbirth the Bradley Way is a little outdated but that one I really loved. It really taught me what productive contractions looked like because I didn’t really experience labor the first time. I never made it past a 3 the first time. I didn’t know what that meant. I didn’t have coping mechanisms. They really focused on breathing. 

The best book I read and I hadn’t heard this one on it. Maybe you know of it but I had never heard about it but it was Hypnobirthing by Siobhan Miller. There are a lot of books on Hypnobirthing but Hypnobirthing by Siobhan Miller. I was just thinking of Hypnobirthing as a possible way to cope. That book was the best book because I really like the science, the physiology, and what is actually happening in your body when you’re getting contractions and how do you work with your body. It just had such a great way of explaining all of that.

That was the last book I found. I was 3 weeks away from my guess date. That one was great. She also creates the Freya app if you’ve heard of that. The Freya app times contractions and it helps you with breathing. They give you a lot of mantras. Yeah. That book was amazing. I did get the Freya app too. I did not know I was going to rely on it so much in labor. Also, in that book, it was really big on affirmation cards. I would make affirmation cards then I would read them in the bath and sometimes practice my breathing through the app. 

I did some pelvic PT and then, of course, the prenatal chiropractor like I mentioned, I continued to do that. Like I mentioned, the care with the midwives was great. Very positive language. I noticed what was really important to me was not, “I hope I can do this,” because of course, I hope that. But my midwives were amazing because every time, they would just speak it. They would say, “You are going to have a beautiful, redemptive VBAC.” They would just say that. 

Of course, I know I am 50% of the birth story. The baby is the other 50%. Of course, I know that but it was so important for me to have that positive language. I really worked on my mindset this time around. I only followed accounts that served me. I unfollowed news accounts. I had to be very careful about what I watched and things like that. I don’t think women realize how important our mental state is. I get very sensitive. 

Meagan: Yes. So talking about that, protecting your space, our bubble, or whatever it may be. Protecting our space is so important because mentally, like you were saying, I don’t know if people really understand how precious our mental space is but mentally, if we are thrown off, it is sometimes really difficult to get back onto that rail. 

I had a situation on Facebook in a VBAC-supportive group. I’ve talked about it in the past. I was so excited to announce that I was going to birth outside of the hospital. I also wasn’t telling people that I was birthing out of the hospital. I didn’t really tell people my plan I thought I could in that group and I wasn’t supported. I had to leave that. 

Sometimes it means leaving groups. Sometimes it means staying off social media. Sometimes it means muting people who may be sharing their opinions or telling people flat-out, “I appreciate you so much but unfortunately, I can’t have you in my space,” because mentally, they are not serving you well. 

Melanie: 100%, yeah. I hate that that happened to you and I know that happens to so many women. It’s just so unfortunate and I hate that there is such a stigma with VBAC because if you do the research which people who have really “easy” births don’t have a reason to really do the research but if you are like us where we are all very motivated to have a VBAC because we already have this stigma going against us, it’s all unwarranted. It’s not evidence-based to not be supportive of a VBAC and if you really research and do the stats, you realize that it’s not a big deal. The craziest thing that I heard on the Down to Birth Podcast was, “You have a chance of uterine rupture even as a first-time mom.” 

Meagan: Yes, you do. 

Melanie: It’s not that much higher as a VBAC and first-time moms go their entire pregnancy never once hearing about uterine rupture but yet if you are a VBAC mom, that’s all you hear about. So it’s so crazy to me. 

Meagan: Yeah. Yeah. So mentally, you were unfollowing. You protected your space there. Is there anything else that you would give tip-wise to protect your mental space?

Melanie: I think just believing in your body and believing that we are made to give birth. I think that’s a really big one. Of course, like you said, unfollowing and maybe not talking about it with people, unfollowing accounts that do not serve you. I think the most important thing, I know we’ve heard it a million times on this podcast, but where you give birth and who you give birth with is the single most important thing because you want to be with a provider who believes that you can do it, whoever that is. 

Yeah, believing in yourself. I think that’s going to look different for everybody of what they need. For me, I am a data person so I needed the stats. I needed to read the books and also listen to lots of women who have done it before me. 

Meagan: Mhmm, love that. 

Melanie: So okay, here we are. I was 40+5 so again, not 39 weeks with spontaneous labor but 40+5. I woke up at 5:00 AM to what I thought was contractions. I had some Braxton Hicks at the very end which I never experienced before. I didn’t know if maybe it was prodromal labor but it didn’t feel like Braxton Hicks because it was waking me up. I just tried to move through them a little bit. They were coming very, very sporadically. I would get a short contraction one time an hour and this went on for most of the day and they were not long at all, like 30 seconds. 

In my mind, I’m thinking, I’m a hopeful first-time vaginal birther. So I’m like, okay. This could be 24 hours. It could be 48 hours. Who knows? But I did not want to waste any energy timing the contractions so I was just guessing the whole day. It was a Sunday. I stayed home with my toddler. Yeah, I should mention that he is 2.5 so I waited about 2.5 years between the two births. 

So yeah. I just labored at home with my toddler and my husband. We are big track fans so it worked out perfectly. There was a Diamond League track meet on so I did the Miles Circuit while I was watching that. I texted my midwives and kept everybody updated but I think again, we all thought I still had a ton of time. 

Then I would say around 4:00 PM that day, I started to notice them a little bit more. They were still pretty inconsistent. I would say maybe 8-10 minutes apart and still only 30-45 seconds long. That was something I learned from again, that Bradley Method book I read is that productive contractions for most women– I will say not for me. We will get into that. But for most women, they are a minute plus. Those are the most productive contractions. 

I texted my midwife then that I felt like it would likely be that night. I felt pretty confident that they were coming but I was like, it could be the middle of the night. It could be tomorrow morning. Who knows. She texted back and she advised that I take some magnesium, take an Epsom salt bath and then go to bed and try to reserve my energy for when they are 4-1-1. 

We had a birth photographer this time so I texted the birth photographer. I texted our friends who I’m so grateful for. We had a neighbor and a friend who was going to come to our house and be with my toddler. So, so sweet. 

Yeah. I took the magnesium and then my husband, Brandon, drew me a bath and then disappeared with our toddler. I sat in the bath and I was reading my affirmation cards. This makes me so emotional but I discovered that my husband had snuck in his own affirmation cards into my pile and that’s when I found them. Oh, it was so sweet. 

Meagan: That’s adorable. 

Melanie: I know. It still makes me cry when I think about it because it just meant so much. It makes me so emotional. It was super sweet and one of the best things he’s ever done for me. I found those and was reading through them in the bath and just trying to relax and really work with the contractions. 

I know from my research that you need to relax. To get them to be productive contractions, you have to relax. You have to get your body out of the way and it will go faster that way. 

They really started to ramp up when my husband was putting our toddler to bed around 7:30. I got in the bed and I put the pregnancy pillow in between my legs. I lay there and was trying to establish a pattern. Yeah. I know manifestation sounds pretty woo-woo but I want to say and this is where I’ll start sprinkling these in because there were 10 things that I had manifested or really, really prayed would happen and I was very intentional that I really, really hoped that this happened. 

This was the first one. I don’t know why I had envisioned laboring with my dog. You have a dog. You understand. My dog is my firstborn. She is my baby. I love her. You know, birth is so primal so I was just like, She’s going to know. She’s going to know when I’m in labor and she’s going to know what to do. She did. She followed me. I didn’t even realize it at the time. She followed me in my bed and I took a picture with her at 8:19. She was lying next to me on the bed as I was going through these contractions and it’s a very, very special memory for me. 

I was already starting to get the labor shakes at this point. It’s 7:30 and laying down in bed did really help to establish more of a pattern but they still were not a minute long. They were 40-50 seconds long. Then I moved to the toilet as many women do at this point, backward on the toilet. 

I lost more of my mucus plug because I had lost it sometime earlier in the day then at some point, I looked down and realized that I was having my bloody show. Again, none of this I had ever experienced before with my first. 

My husband was an absolute rockstar in this moment. He was so cute. He was running back and forth between the toilet and then packing up the car because I think he realized it was starting to get pretty serious. He brought me water and he put on the back of the toilet, cleaned it, gummy worms and things. That was not what I wanted at that moment but it was super cute. 

Oh, and I should mention that I did not have a doula so he was kind of like my doula. I was trying to prepare him as best as I could beforehand but he didn’t need it. He did really well. I know the hip squeezes are great and I learned that from this show of course. As they were coming, I would scream at him, “Hip squeezes! Hip squeezes!” He would come over and do it and he did awesome. He was saying that I left my body in this moment and I was possessed because when I was having a contraction, again, I was trying to do the deep moans and really trying to relax but it’s just funny. He was telling me about it after and he was like, “Yeah, it was like if you were looking at it from the outside, it’s like you were possessed then you would scream at me and just moan.”

Then by 9:24, they were coming. I mentioned they were not a minute long, but they were coming on top of each other. So every 2.5-3.5 minutes apart, but still not quite a minute long so my husband was calling the midwives and she still was like, “Well, they’re not quite a minute. Just have her keep laboring at home until they are a minute.” Eventually, he called her back and I think he put it on speaker so she could hear me and that’s what did it. 

Meagan: Uh-huh. She’s like, “Load her up.” 

Melanie: Yes. Because we live outside of Dallas. The birth center was in downtown Dallas so it’s pretty far. It’s usually a 45-minute drive for us so I think my husband was just like, “I don’t want to have a car baby.” 

Meagan: Sure. 

Melanie: Yeah. It was ramping up. So yeah. She called back. I mentioned the Freya app. I really relied heavily on the Freya app because when you are timing the contractions, it helps you with the breathing, in for 4, out for 8, and then one of the mantras I learned from that Hypnobirthing book that I did not know I was going to rely on so much– and I think you never really know when you’re going into it and when you’re in labor. You never know what’s going to stick. 

My mantra that I must have repeated to myself 500 times was, Inhale peace, exhale tension. Every single contraction, I just repeated that over and over and over. I was trying to make it until 10:30 PM when we called them again, but that’s when we got in the car and started heading there. 

He made it to the birth center in 33 minutes. The car ride was not fun like many women talk about. I think I hardly opened my eyes and I was just timing them, repeating my mantra, Inhale peace, exhale tension. 

I arrived at the birth center at 11:00 PM. I had a contraction on the step right there as I was trying to get out of the car and trying to make it. I eventually made it inside and I had my first cervical check of the whole pregnancy. I again, something I had manifested was that my two favorite midwives would be there and they were. One of them, she wasn’t even on call but she came anyway. So many sweet things happened. 

I got on my back. She asked if she could check me and I was like, “Yes. I really want to know.” One thing again, I manifested that I really wanted to be at least a 6 when I showed up. The first thing she said was, “You are much farther along than you ever were with Rhett.” You are a 7 and you are very stretchy. I can feel your bulgy back of waters and the baby’s head is right behind it. 

That’s the other thing. We mentioned PROM. Here I am and my water still had not burst and it was amazing. Being on my back felt awful by the way. That’s why I just don’t understand. Being unmedicated in a hospital must be so, so hard because I know a lot of the times they want you to be on your back and I just can’t imagine because that was the worst position ever. 

She started filling up the tub right away. Like many women, I was like, “I have to poop.” I get on the toilet and I was like, “I swear I do.” But no, I don’t. Nothing was happening but it feels like I do. 

I got in the tub right away. I did a couple of contractions. They were still coming on top of each other. I was sitting down and eventually, I moved to hands and knees. Very shortly after, that was very fast. That was only about 5 minutes after getting checked. Very shortly after, my body was starting to push and I was like, “This can’t.” I mentioned something. I don’t really remember this but I mentioned something to my midwife about how it seemed to soon to push. 

I was like, “You just checked me and I was a 7-8. Why is my body pushing right now?” I was really wary of a cervical lip or a swollen lip which I learned from this podcast. I can’t remember exactly but she said something to the nature of, “If your body is ready to push, let it push. This is your body getting ready to birth your baby,” which is again, something else I had really, really envisioned. I would have loved my body to do the pushing and it did which was amazing. 

My water had not broken still at this point and the really cool moment was that the baby was en caul for a while. I remember her saying something on the phone about baby being en caul. I was birthing the sac before I birthed the baby. It felt like a water balloon. She kept telling me, “Feel down. Feel the sac.” It felt like a water balloon coming out of you. It was so weird. 

Yeah, my midwife stayed behind me so quietly the whole time. I never knew she was there. My husband set up my birth playlist and music and he just was such a rockstar in this moment. He was getting a cold rag and putting it over my shoulders which felt amazing, getting water and electrolytes and continuing to help me with that. 

Yeah. My body pushed for about 30 minutes and I don’t want to scare anybody, but truly, that was the worst part. I remember– I guess maybe it’s the ring of fire, but I just remember feeling like my body was ripping in half. But then it goes away. 

Meagan: Yeah. It’s intense. It’s intense. 

Melanie: It’s so intense. I don’t think anything can really prepare you for that. I follow that account, Pain-Free Birth. I don’t understand and I would watch videos of women who were smiling and they look great. I’m like, oh my gosh. That part was so, so painful. Handling and dealing with the contractions is one thing and I felt like I was really strong. I felt like I did a good job with that, but that pushing part is something else. 

His head was out. It was a boy. His head was out for a little while but nobody panicked and my husband was ready to catch him. His hand was right there. At some point, I remember my midwife was like, because again, my body was doing all of the pushing. I didn’t do any of it. I guess after the head was out of a little bit, she was like, “You can try to push.” My husband told me because his hand was right there that my pushes were nothing. They were baby, tiny little pushes compared to the ones my body was doing. 

Then at some point, my midwife asked if she could help or something and I was like, “Yes, please.” I don’t know what she did. My baby was kind of big which I’ll say in a second, but I think maybe his shoulder was stuck or something. She did something that was pretty painful but then within a second–

Meagan: A sweep. 

Melanie: Yeah, like a maneuver because I definitely felt more stretching then a second later, he shot out. He did have the cord wrapped around his neck one time but nobody freaked out and they just literally took it off then he pinked up right away, cried, and he ended up being 9 pounds, 5 ounces. My first was 6 pounds and 14 ounces. I’m like, “No wonder running felt awful. He was pretty big.” 

I look back and I just feel very proud. I was never once scared for myself. I never once thought about uterine rupture and I never was scared for my baby. I do have some memories of– they did the intermittent checking and I have this memory of the decels. That is why I ended up having the C-section so I was always very curious to see how he was doing during the check. 

He was always fine and I was never scared. Yeah. We got out of the tub quickly. They waited for me to deliver the placenta on the bed. It was about 30 minutes and yeah. My baby latched right away which was such a relief because I mentioned we had some struggles the first time. The crazy thing was– we sat there. We ate. We chatted for a little bit then once they did all of the newborn tests right there, we were home by 3:45 AM. 

My toddler went to bed as an only child and then he woke up to a little brother. And that’s his story. 

The postpartum has been so different and it’s been so much better. I can’t help but think that a lot of that is because of such a smoother birth and the recovery has been so much better than a C-section. Different, but still so much better. 

Meagan: Yeah. 

Melanie: Yeah. I just thank this community so much. I also was on the Facebook page and I just got so much strength from all of the women before me. 

Meagan: Yes. Oh my gosh. Such an incredible story. I love– okay, a couple of things. One, we talk about it on the podcast. I love when people go and look for providers before they are pregnant. I absolutely love it. I think it’s very powerful. But two, you were actually pregnant and you didn’t know it. 

Melanie: I know. 

Meagan: That’s so cool that you were doing that and it felt so right and not only was your intuition before pregnancy kicking in but you were actually pregnant and it felt right. You were like, this is the place. This is the place. Then you showed. You went past that 39-week date. You never had gone past 3 centimeters before. So much strength and power happened through all of this and then you pushed out a 9-pound baby. 

All of these things that a lot of the world doubts. Did you look at your op report? 

Melanie: I did and everything was normal. Then the main thing was the decels and that’s why they said was the reason. 

Meagan: Decels. I just wondered if they said anything like CPD or failure to progress. 

Melanie: Yeah, no they didn’t. I was looking for that specifically. I just barely made it. I was 2-3 centimeters before the decels started happening and then they called it. 

Meagan: Yeah. A lot of the time we are told and the world doubts us in so many ways so if you told a lot of people who are uneducated about VBAC the things that happened with the first and then the stats of your second, I bet people are like, “You did that?” But you guys, this is normal. This is beautiful. This is what you deserve. You deserve these experiences and these joyous moments. I’m just so proud of you. I’m proud of you. I’m proud of your husband. He sounds absolutely adorable. Shoutout to him. 

Melanie: He’s so sweet. 

Meagan: Your midwives and everybody. You did it. 

Melanie: Aw, thank you. 

Meagan: I’m so happy for you. 

Melanie: Thank you. Thank you so much. I’m glad I didn’t know how big he was before but also with my midwives, there was no pressure at all to even see how big he was. 

Meagan: Mhmm, yeah. 

Melanie: The second baby, I always say that he healed me because he really did. My first birth was really traumatic for me but then my friends all laugh because they say, “You’re the only person who would say a 9-pound baby would heal you.”

Meagan: Seriously, though. But how amazing. It’s so amazing. Our bodies are incredible. 

Okay, we talked about PROM. This time, total opposite. Encaul for a little bit. I did some things. You did some things. Let’s talk about if you’ve had PROM, premature rupture of membranes, there are things you could do to try to encourage no PROM next time. 

I am PROM, PROM, then with my third, I was contracting. My water did break way earlier than pushing but it still waited a little longer. I still feel like my efforts in a lot of ways helped. 

So anyway, tell us what you did. 

Melanie: Yes. So mainly two things. Again, being with providers who are more holistic, they are more likely to mention nutrition. We talked about nutrition a ton during the whole pregnancy. I think two main things. The first thing was collagen. They got me on collagen from the get-go. I know research shows that upping your collagen helps a strong sac. Then the second thing was Vitamin C. I didn’t take any Vitamin C supplements or anything, but again, your body is amazing. I was craving oranges in my pregnancy so I think that’s part of it. My body was craving oranges. I ate a lot of oranges so I think the combination of collagen and oranges really made my sac strong. And it was. It literally did not break until he came out. It was so different. 

Meagan: So incredible. I would echo that. Vitamin C and you can supplement with Vitamin C 100mg a day starting anywhere between 18-20 weeks. Some providers even say to do it from the very beginning as the placenta is forming and things like that. Collagen absolutely and protein. Protein and collagen. I know you guys have heard about Needed but I absolutely love their protein collagen. As pregnant women, we don’t get enough collagen and we don’t get enough protein in our daily eating habits so supplementing with that and getting more collagen really, really can create a healthier, thicker sac. 

Something that was interesting that I found out after my second– so back story. I had kidney stones. I don’t know if you had any infections or anything like that with your first that made you be on antibiotics but antibiotics is what an OB told me can also weaken membrane sacs. I got UTIs and kidney stones and was put on antibiotics. The OB described to me that my OB was fighting in other areas so the nutrients that my body was getting was going to fighting and healing versus creating a stronger sac which is interesting. I’ve never seen any research about it but he was pretty adamant about avoiding antibiotics during pregnancy with my next one and I did. I didn’t have what I had before. 

Melanie: That’s interesting. I never heard that. 

Meagan: I know. I know. This is a doctor who doesn’t even practice anymore. This was years ago but I was like, it kind of makes sense. It kind of makes sense. I haven’t researched it. 

Melanie: Yeah. I can see that. 

Meagan: Antibiotics wipe our gut flora and things like that anyway so I can understand that but protein, collagen, Vitamin C, and possibly avoiding antibiotics. Nutrition is so huge with our bag of water. 

Then big babies. You guys, big babies come out of vaginas. I just have to say that. It happens. 9 pounds is a healthy, beautiful baby. 

Melanie: Yeah. When he came out, everybody was very shocked even before weighing him. He’s thinned out now but he was swollen. Everybody was taking bets on how big he actually was. 

Meagan: I love it. I love it. I’ve seen so many babies when they come out and their cheeks are so squishy and you’re like, that’s a big baby. You can tell just by their face. 

Melanie: Yes. That’s exactly it. 

Meagan: Oh my gosh. Well, thank you again so much for completing the circle, for helping other Women of Strength out there. I too believe that women listen to these podcasts and they want to find stories that are similar with theirs in so many ways. You didn’t dilate past 3. An induction that didn’t turn out to be a vaginal birth so an “unsuccessful” induction that turned VBAC. A lot of people, I think, do doubt their body in that way. They are like, “Well, I was induced. Not even medicine could get me there,” but there is a lot that goes into that. Sometimes our body is just not ready or our babies aren’t ready or something is going on. It doesn’t mean that’s your fate for all future births. 

Melanie: 100%. Yeah. So well said. 

Meagan: Awesome. Well, thank you again so much and huge congrats. 

Melanie: Thank you so much, Meagan, and thank you to everybody. Everybody who has told their story, the community, and everything was so helpful for 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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“Labor is supposed to happen naturally. It’s not this big medical intervention that occasionally happens naturally. It’s this natural process that occasionally needs medical intervention.”

Paige Boran is a certified nurse-midwife from Fort Collins, Colorado. She and her colleague, Jess, practice independently at A Woman’s Place. They have rights to deliver babies at the hospital but are not employed through the hospital system so they are not subject to physician oversight. Their patients benefit from a low-intervention environment within a hospital setting but without the restriction of hospital policies.

Lily Wyn, our Content Creator and Social Media Admin, joins us today as well! Lily shares why she chose Paige to support her through her current VBAC pregnancy. Lily is a beautiful example of how to diligently interview providers, keep an open mind, process past fears with the provider you choose, and what developing a relationship looks like to create an empowering birthing experience. 

Paige shows us just how valuable midwifery care can be, especially when going for a VBAC. If you’re looking for a truly VBAC-supportive provider, this is a great episode on how to do it! 

The VBAC Link’s VBAC Supportive Provider List

A Woman's Place

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Paige: Yeah, so I’m a certified nurse-midwife. I work in northern Colorado in Fort Collins at A Woman’s Place. We’re a small midwifery-owned practice. Right now, there are just two CNMs. That’s the whole practice. It’s just me and my colleague, Jess, who owns it which is really cool because we get to push the boundaries because we are not really locked into the hospital system. We are able to catch babies there but we are not actually employed through the bigger hospital systems which is nice because we don’t have that physician oversight and stuff like that. I think we are able to do a lot more and honor that midwifery care model which is really cool. 

Sometimes people feel locked into policies and their overseeing physician and things like that but when it’s just two midwives, we get to do what we want and what feels best for the patient. I really like that. That was a big thing when I first got into the certified nurse midwifery world. I was like, where do I want to work? I had offers from bigger hospital systems and it just didn’t feel like the right fit so working at a small, privately-owned practice felt like the right answer for me so I was able to practice in a way I felt was right for people. 

I didn’t want to be locked in by a policy and overseeing physicians. I just wanted to grow with other midwives. 

Meagan: Yes. I love that so much. I don’t know. Maybe I should say I know it feels to me– I don’t know it as an actual fact, but that feels like a unique situation and a unique setup to me. We don’t really have that that I know of here in Utah. We either have out-of-hospital CPMs or we have in-hospital CNMs who are just hospital. I know that one hospital system is trying to do the attached birth center, but it is still very different. They are still the hospital umbrella midwives I guess I could say. 

So is that unique or is that just something that feels like it?

Paige: I think it’s unique because where I came from in Florida, if you were a CNM, you 100% practiced in the hospital which we do but it was that you were owned by a larger group of physicians essentially. Florida was working towards independent practice when I was there. Colorado is an independent-practiced state for nurse practitioners which is really cool because we don’t have to have that oversight. I don’t know if Florida ever got there but I know it varies state to state on if you have to be overseen by a physician or not. 

Honestly, that’s why a lot of people when they are ready to become a midwife, if they don’t have independent practice rights as a CNM even if they are a nurse, they will go for a CPM which is a certified professional midwife because they actually have more autonomy to do what they want outside of the hospital because they are not bound by all of the laws and stipulations which is interesting. 

Meagan: Exactly. I think that’s a big thing– the CPM/CNM thing when people are looking for midwives. Do you have any suggestions about CPM versus CNM? If a VBAC mom is looking at a CPM, is that a safe and reasonable option?

Paige: Absolutely. Yes. I think CPMs and CNMs are both reasonable, safe options. They both have training in that. They both can honor your holistic journey. I would say the biggest thing is who you feel most connected to because I think trusting your team, you will have people who have the worst birthing outcome and horrible stories but they are like, “I look back and I feel so good about it because I trusted my team.” I think that is what’s important. If a CPM seems like your person and that’s who you are going to trust, then that’s who you should go for whereas a CNM, if that seems like that’s your person and who you trust, I think that would be a good route too. 

I think a lot of people think, “Oh, they do home births. They must catch babies in a barn and there is no regulation. Even sometimes when I say, “midwife,” people are like, “What? Do you dress like a nun and catch babies in a barn?”

Meagan: Yes, this is real though. These are real thoughts. If you are listening, and not to make fun of you if you think this, this is a real thing. This is a myth surrounding midwifery care, especially out-of-hospital midwives where a lot of people think a lot of different things. 

Paige: Absolutely. 

Meagan: I think I had a chicken chaser or something where a dad was like, “Do you chase chickens?” I was like, “What?” He said, “Well, that’s what the midwives do so that’s what the doulas do.” I’m like, “What? No, we don’t chase chickens.” 

Paige: That is such old-school thinking but realistically, midwives started in the home and that was their history. It’s cool that they’ve been able to step into the hospital and bring some of that back into the hospital because I think that is needed. 

Meagan: It is needed, yeah. 

Paige: We are starting to see that physicians are starting to be a little bit more holistic and see things in the whole picture, but I’m glad that the midwives did step into the hospital because I think that needed to be there but I’m so glad that people are still doing it at home because I think that is such a good option for people. 

Meagan: Yeah, so talking abou the midwives in the hospital, a lot of people are talking about how they are overseen by OBs. Is this common? Does this happen where you are at? You kind of said you are separated but do the hospital midwives in your area or in most areas, are they always overseen by OBs? 

Paige: Not necessarily. It would vary state to state and hospital to hospital. We actually just got privileges and admitting privileges a couple of years ago. Actually, my boss, Jess, who owns the practice where I work, had worked in Denver where they were allowed to admit their patients and everything. They didn’t have to have any physician oversight but when she was there, she had to have physician oversight. 

She was like, “It’s an hour drive north, why would that make a difference?” It was the same hospital system so she fought when she bought the practice and the physician who owned it prior left, she was alone and she had to have that physician oversight so she fought for independent practice privileges and she got it. Some of the midwives at first weren’t so happy about it because they had liked being overseen by the doctor and someone signing off on all of their things. Some of the midwives were like, “Finally. We should be able to practice independently.” It’s going to vary at each place. 

But I think that’s a good thing to ask, “If something is going wrong, will a physician just come unannounced into my room in the hospital?” That’s not the case with ours. We have to invite them in and if we are inviting them in, we’ve probably had a conversation multiple times with the patient where it’s like, we need to have this. 

Meagan: Yeah. For the patients who do have the oversight of the OBs, do you have any suggestions? I feel like sometimes, at least here in Utah with my own doula clients when we have that situation, it can get a little confusing and hard when we’ve got an OB over here saying one thing but then we’ve got a midwife saying another. For instance with a VBAC candidate, “Oh, you really have a lower chance of having a VBAC. I’ll support it. I’ll sign off, but you have a really low chance,” but then the midwife is like, “Don’t worry about that. You actually have a great chance. It is totally possible.” It gets confusing. 

Paige: Yeah, and it’s like, who do you trust in that scenario? I think that’s where evidence comes in because I think midwives and physicians both practice evidence-based but some people may have newer evidence than others. I’ve worked with OBs who probably roll over in their grave when I say certain things because it wasn’t the old way but it is the new way. 

If somebody can come in with their own evidence and they’re like, “I’ve looked into this and I think I’m a good candidate for x, y, and z,” I think physicians respond well to that because they are like, “Okay, they’ve done their research. Maybe I need to do some research.” 

Meagan: Yeah. 

Paige: When they have that thought, they know that this is an educated person and I can’t just say whatever I want and they’re going to take my word as the Holy Bible. 

Meagan: Yeah. No, really. Exactly. It always comes down to education and the more information we can have in our toolbelt or in our toolbox or whatever it may be, it’s powerful so I love that you point that out. I think it’s also important to note that if you do have two providers saying different things, that it’s okay to ask for that evidence. “Hey, you had mentioned this. Can you tell me where you got that from or why you are saying that?” Then you can discuss that with your other provider. 

Paige: Yeah, and following intuition too. I think you can have all of the evidence in the world. What is your gut telling you too? Who do you trust more and what feels right in your body in the moment? I think we are all experts of our own bodies and there’s a lot that goes into a VBAC and stuff like that. It’s more than just the evidence. People have to feel mentally and physically ready for it too. 

I wish more people focused sometimes on the mental and spiritual aspect of it because I think a lot of people get ready physically but maybe mentally they weren’t prepared for the emotional switch there. 

Meagan: Totally. Thinking about that, Paige, I mean Lily, tell us a little bit about why you went the midwifery route. I know you really wanted to find the right provider. 

Lily: Yeah. So I think for me, I have always been drawn to midwifery care. I was a little bit of a birth nerd prior to even working for The VBAC Link or even having my own kiddos. Prior to my son, we had a miscarriage and an ectopic pregnancy so I experienced OB care with my ectopic. I was bounced around a lot in a practice and had OBs who were great and equally some OBs where it was such a rushed visit that I had an OB miss an infection in my incisions because my pain was dismissed and just some really tough stuff. 

When it came to getting our rainbow rainbow baby, I was like, I really don’t want to be in a hospital at all. I want midwives. That’s the route that we went. The very brief story of my son is that he flipped breech 44 hours into labor and that’s when we legally had to transfer to the hospital and I had my Cesarean. 

So in planning my VBAC, I planned to go back to the birth center and was a little devastated when it was out of our financial means this time. I was so panicked. I remember texting you, Meagan, and being like, “What do I do? I can’t be at the birth center anymore and I don’t want to be in a hospital.” We interviewed another birth center that’s about an hour away that is in network with our insurance and talk about trusting your gut, it just didn’t feel right. It didn’t feel warm and fuzzy. Those are the feelings I got with our first birth center. I loved them so much and I still do. 

Then I met with Paige and her practice partner, Jess, and I came in loaded to the teeth. I was prepared to fight with someone because that’s what I had in my brain and that’s what I expected. I sat down with them. They met me after hours after clinic. I sat down with my three pages of questions and by the way, if you are listening and you have questions, we have a great blog on it and some social media posts of the questions that I specifically used. We talked for over an hour and every question I asked, they just had the ultimate answer to. 

I felt so at peace after talking with both of them and I remember telling my husband going into it, “I’m really worried that I’m going to like these people because I don’t want to deliver at a hospital and then I’m going to have to choose a far away birth center that is out-of-hospital or providers that I like but it’s a hospital.” It just feels like everything has been serendipitous for us. Our hospital opened a low-intervention portion of their birth floor so I’ll still get to have the birth tub and all of the things, but truly have just been blow away by Paige and have just buddied up. She’s dealt with all of my anxiety in pregnancy and VBAC and all of my questions. It just feels like such holistic care compared to my experience with OBs in the past. 

Meagan: That is so amazing and I was actually going to ask how has your care been during this pregnancy? It sounds like it’s just been absolutely incredible and exactly what you needed. I remember you texting me and feeling that, oh crap. I don’t know what to do. What do I do? You know? I just think it’s so great that you have found Paige. Did you say that Jess is your partner? 

Paige: Yes. 

Meagan: Jess, yeah. I’m so glad that you found them because it really does sound like you are exactly where you need to be. 

Lily: Yeah. It made a huge difference for me and I just tell Paige all the time I truly didn’t know that care in a hospital setting could look the way that it does. I feel like I’m getting– I experienced birth center care. I had an out-of-hospital experience until we transferred and I can say with confidence that my care has been the same if not better with Paige and just having the conversations and the good stuff and feeling really safe and confident. 

One thing that they pointed out that I thought was great when I went in and asked all of my questions is that Jess looked at me and she was like, “Okay, it sounds like you have a lot of anxiety around hospital transfer.” And I did. With my son, that was my worst fear and it came true. I had a lot of anxious, what if I have to transfer? 

She was like, “The thing is there is no transferring. We can induce you if you need to be induced and we can come with you into the OR with your Cesarean if that ever happened to be another thing.” For me, that brought a lot of peace to know that no matter what, the provider that I know and feel comfortable with is going to be with me. I again, didn’t expect to feel that way, but it’s been a really great reassurance for me personally. 

Meagan: Yeah. It’s the same with a doula. Knowing that there’s someone in your corner that you know who you’ve established care with who can follow you to your birth with you in your journey is just so comforting. 

So Paige, I wanted to talk about midwifery care and also just lowering the chance of Cesarean. Sometimes people do choose midwifery care specifically because they are like, “I think I have a lower chance of a Cesarean if I go the midwifery route.” Can we talk to that a little bit?

Paige: Yes, that’s true. A lot of people know that there are benefits to midwives but I think when people think of midwives, it’s just like, “Oh, it’s just a better experience. I trust my team more.” That’s definitely there. There have been studies and people felt more at peace and empowered through their birthing journeys with midwives than they did with OBs. It’s been studied but there is also a decrease in C-section risk. Your C-section risk drops 30-40% when you have a midwife which I think is a pretty significant drop. 

Meagan: Yeah. 

Paige: Yeah, especially when we look at the United States at our birthing outcomes and birthing mortality and C-section rates, it is way too high for as developed of a country as we are. I think that’s really where midwifery care is stepping in and starting to help lower those rates to get it down to where it should be. The World Health Organization has been nominating and promoting midwifery care because it really is the answer to how we get these C-section rates lowered and these bad outcomes lowered. 

Midwives also have lower chance of an operative vaginal birth. That would be with forceps or a vacuum or an episiotomy so lower chances of those things as well. Lower chance of preterm birth which is interesting and probably because one, we do take lower-risk people. I think that’s true but also because we are looking at it holistically. We are looking at everything. We are not just looking at you as a sick person. 

A lot of people look at pregnancy as an illness and pregnancy is not an illness. It’s just a natural part of life and we’ve got to look at the whole picture of life if we’re just going to look at the one thing too. 

I think that helps to reduce preterm birth risk. We also have lower interventions just overall. We’re more in tune with people’s bodies and we want to honor what their bodies are meant to do. Labor is supposed to happen naturally. It’s not this big medical intervention that occasionally happens naturally. It’s this natural process that occasionally needs medical intervention. 

The midwifery model is so important. I think when you go to the traditional medical model, you look at the present illness so they see pregnancy as an illness. What can go wrong? Don’t get me wrong. There are a sleu of things that can go wrong in pregnancy and you do have to watch for them. But I think with midwifery care, you know when to use your hands but you also know when to sit on them. 

Meagan: Yes. Oh my gosh. I love that so much. I feel like we need– we used to get quotes from our podcast episodes and turn them into t-shirts and I feel like that is a t-shirt podcast quote-worthy. Oh my gosh. It’s a worthy quote. That is amazing and it’s so true though. 

Paige: It is. 

Meagan: It’s not to rag on OBs. You guys, OBs are amazing. They are wonderful. They do an amazing job. We love the. But there is something different with midwifery care. 

You mentioned preterm birth. I remember when I was going through my interview process to have my VBAC after two C-section baby and I finally established care mid-pregnancy because I switched. That was one of the things in the very beginning that my midwife was like, “Let’s talk about things. Let’s talk about nutrition. Let’s talk about supplements. Let’s talk about where you are at.” It was just honing in on that which I was surprised by because I figured she’d be like, “Let’s talk about your history. Let’s talk about this,” but it was like, “No. Let’s talk about what we can do to make sure you have the healthiest pregnancy,” but also started commentingo n mental stuff. It helped me get healthy in my mind. 

I just would never have had that experience with OB where they wanted to learn what I was scared about and what I was feeling and all of those things. Not only was I learning how to nourish myself physically, but mentally and it was just a really big deal. I do feel like it played a big impact in my labor. 

Paige: Yeah. A lot of people discredit how much nutrition and debunking fears and stuff like that can go because I think a lot of that– I mean, we look at nutrition-wise and we could avoid almost all of preeclampsia with nutrition alone which is incredible. I’m like, “I really think you should read Real Food for Pregnancy and people are like, “Oh, but it’s such a big book,” and I’m like, “But it’s so important to know this information about what we should be putting in our bodies.” 

100 grams of protein– you’ve already got it. 

Meagan: I want to see how many pages for it. It’s got, okay. We’ve got 300 pages but it has recipes and all of these amazing things in the end so it’s not even a full book. 

Paige: Yes. People are like, “Oh man, I don’t know if I want to read the whole thing,” but I’m like, “It’s so important.” I think when people do read it, they come back and are like, “Did you know that I could decrease my risk of this if I ate more Vitamin A?” I’m like, “Yes. That’s why I wanted you to read this book.” It is a wealth of information and I have such healthier pregnancy outcomes when people follow that high protein diet and looking at micronutrients with their Vitamin A, their choline, and all sorts of things. 

Meagan: Yeah. All of the things that we talk about a lot here on the podcast because we are partnered with Needed and we love them so much because we talk about the choline and the Vitamin A and the Vitamin B’s and the Vitamin D’s. Lily Nichols, not this Lily on the podcast today, she also wrote Real Food for Gestational Diabetes and that’s another really powerful book as well. 

But yeah. It’s just hard because OBs don’t tend to have the time. I think some OBs would actually love the time to sit down and dig deep into this but they don’t have the time either. I do think that’s a big difference between OBs and midwives. 

What does your standard prenatal look like? When a mom comes in, a patient comes in, what do you guys do through a visit? 

Paige: Yeah. We follow the standard what everywhere in America does like once a month roughly in the first trimester and second trimester then when you hit 28 weeks, every 2 weeks, and then when you hit 36 weeks, every week. If you go to 41, we’ll see you twice in that week. We follow those stipulations but our appointments are a little bit longer. 

When you are in a big practice, a lot of time it’s driven by RVU use so the more patients somebody can see, the more they are going to get paid and the bigger their bonus is at the end of year. A lot of people feel like they are running through the cattle herd and they’ve been in and out in 15 minutes if that. 

At my practice, it’s a little bit different because we are not RVU based. We’re not getting any bonus. We’re not trying to see as many patients as we can. Will we ever be the richest at what we do? No, but that’s okay with me and Jess. We are small on purpose and we love to take the time. At Lily’s appointments, we always book her for at least 30 minutes because we know that me and her like to talk. We’ve done an hour for some people because we know there is always going to be that long conversation. 

Don’t get me wrong though, that fourth mom whose had three vaginal births and going for her fourth, she may be like, “Paige, there’s really nothing to talk about today and that’s okay.” Sometimes they are 15 minutes. Sometimes they are 30. Sometimes they are an hour. Our first appointment is always an hour because there is just so much to dive into with how we can be preparing ourselves, what does your history look like especially if they are brand new to our practice and we’ve never met them before, starting to build that relationship early on. It just depends on how far along they are, who the person is, and those things. 

But I do like that I can spend as much time as I need. Sometimes I tell my people, “Bring a book because I tend to get behind because I tend to talk to people longer than I book for,” but that’s okay. We know that we can do that because we are a smaller practice. I think when people are thinking about what kind of care they want, they should probably consider how are these people paid? Is it by how many they can see in a day? Because you’re probably going to get a different level of care than a practice that isn’t drive by those RVUs. 

Yeah, that’s a really good point. I feel like my shortest visit with my midwife was 20 minutes. 

Paige: Yeah. 

Lily: Yeah. 

Meagan: Which to me is pretty dang long because when I was going with my other two daughters, I think it was probably 6-7 minutes if that with my provider. I mean, it was get in. My nurse would check my fundal height and all of that and then oh, the doctor will be in here. Then came in, quick out. Yeah. It is really, really different. 

Lily: I know for me too, I love that we don’t just talk about nutrition and things like that but even in my last appointment, I was talking with Paige about the things that can be triggering coming back into labor and going back into a hospital so my ectopic pregnancy was at the hospital that I’ll be delivering at and I had to go into the emergency room and the way that you go to labor and delivery after hours is through the ER so Paige and I were talking. She was like, “I can just meet you outside. We will badge you in and we will avoid the emergency room if that feels triggering.” It’s just those things that you don’t get with an OB necessarily to talk through tiny little triggers. 

They are probably generally less accommodating to those little things of, “Well that’s just the standard. You’re going to have to get over that and just go through the ED and come on up.” I think that’s been huge. I also have a dear friend who is going to school to be an OB. I told Paige at my last appointment that she may possibly be at my birth. She’s my crunchy friend so she’ll be a great OB but I have such a desire to be like, “Come see a VBAC. Come see it so that you have it in your brain and you know that they can be safe and look at what can be done,” so I think that is so huge too as we continue to train and uplift our next generation of providers. What does that look like to show them? I think her internship or something is going to be a midwife and OB partnership practice which is really cool but I’m like, “Yes. Come. Come to my birth. Please. I want you to see all the things.” That’s really cool too and that Paige is open to, “My friend might be there.” 

Meagan: Yeah. 

Paige: Bring whoever. 

Meagan: I love that. I love that you were pointing out too this next generation of providers. Let’s see that birth and VBAC is actually very normal and very possible because there’s a lot of people who have maybe seen trauma or an unfortunate situation which could have happened because we blasted them with interventions or could have happened out of a fluke thing. You don’t know all of the time. 

But I do think if we can keep trying to get these providers, these new provider to see a different light, we will also see that Cesarean rate drop a little bit. We really, I always tell people that we have a problem. They’re like, “It’s really not that big of a deal.” I’m like, “No, it’s a very big deal. It’s a very, very big deal. We have a problem in this medical world.” I do believe that it needs to change and midwifery care is definitely going to impact that. I hope that what you were saying in the beginning how policies don’t trump a lot of the midwives. 

I wanted to ask you. This isn’t something we talked about, but is it possible to ask your midwife, “Hey, what policies do you lie under?” Is that appropriate? 

Paige: Yes. Actually, that was one of my favorite things when Lily came in to meet and greet us. She came and she was like, “What are the policies for a VBAC?” We dove into that. We’ve been diving into that and what are we going to be okay with and what are we not going to be okay with? That’s the beauty is that I’m not employed by the larger hospital system that I work under so I feel like a policy is not a law. I feel like there is informed consent and I think informed consent is so important but at the same time, there is informed declination and you should be able to decline anything. 

That’s true. We can never force anybody into surgery. We can never force anybody into anything. I think a lot of people aren’t having those conversations where it’s actually informed so then people are like, “Oh, they are just refusing everything.” I hate the word refuse because no, they are not refusing it. They are declining it because they are informed. They know the risk. They have all the information at their fingertips and they know that this is the best decision for them and their baby and we have to honor that. 

That’s why I’m really glad that I’m able to practice in that way, but I do know I’ve met and I’ve worked with people who feel like they are boxed in and have to follow those policies. We’ve started to talk about what our policies are with TOLACs and VBACs and things like that. One of them is that they are supposed to have two IVs. I’ve already gone against that before and I’ve had a beautiful, unmedicated VBAC. She walked in. I said, “We’ve talked about it. She was also laboring outside when we talked about it. It’s not an issue when you come in. You know what? When we get up there, I’m just going to tell them that you know why they recommend two IVs and you are declining.” 

She walks in and she’s clearly going to have this baby within the hour. I told the nurse, “We’re not doing the IVs. We’ve talked about it. We’re going to decline them.” That was the end of the discussion. We didn’t have to talk about it again which was nice. She shouldn’t have had to advocate in that moment for herself. We’ve already had those conversations. 

Meagan: Yes. 

Paige: Another one is continuous monitoring and the whole idea is if you start to rupture, that’s how we are going to catch it. The baby is going to tank and that’s how we are going to save the baby’s life. Don’t get me wrong. I think continuous monitoring can be really valuable for a lot of things but it’s actually not evidence-based. We have not improved neonatal outcomes with continuous fetal monitoring. We’ve talked about that with Lily and she’s going to opt for intermittent oscillation and I think that’s very appropriate because she plans to go unmedicated. Let’s be honest, if you are unmedicated and your uterus starts to rupture, moms will tell me that something is not right. This is beyond labor. 

Her saying that and being aware of that, we would notice it a lot sooner than we would the baby tanking kind of thing. 

Meagan: Yeah. I do know that with uterine rupture, we can have decelerations but like you were saying, there’s usually so many other signs before baby is actually even struggling and I know a couple of uterine rupture stories where providers didn’t believe the mom that something was going on because that one thing wasn’t happening. The baby wasn’t struggling. 

Paige: Yes. 

Meagan: It’s like, you guys! When it comes to continuous fetal monitoring in the hospital, people have to fight to have that intermittent. It’s yeah. Anyway. These policies are not law. I love that you said that too. There’s another t-shirt quote. 

Paige: I think people should start asking if they are planning a VBAC, start asking what is the policy and start thinking, is that what they want? I do have some moms who are like, “No, I want the two IVs because it’s hard for me to get a stick,” and they need that backup in case. That makes them feel more at peace but other people are like, “It makes me feel like a patient. I don’t like it.” People don’t like needles and that’s okay. They have that right to say no. 

I tell people that in a true emergency, we will get an IV in you if something really, really bad were to be happening. That’s part of training if somebody walks in off the street. We’re not going to be like, “Oh, when was the last time you ate? Sorry, you can’t have the surgery.” We know something bad is happening right now. We will get the IVs. We will do all of the things. Getting the IVs really won’t save as much time as people think it will. 

Meagan: Yeah, and there are other things. Say we are having our baby and we are having higher blood loss than we would like or we have some concern of some hemorrhaging, there are other things that we can do. We can put Pitocin in a leg. We can do Cytotec rectally. There are things that we can do. We can get that baby to our breast and start stimulating and try to help that way. There are things that we can do while we are waiting for an IV, right? 

Paige: Yes. I tell people that all the time. Most of the postpartum hemorrhage meds that we use can be given without an IV. There is only one that truly has to be given through an IV and that’s TXA but the rest can all be given other routes. A lot of times, those work better than IV Pitocin. Sometimes the ion Pitocin works better. Sometimes the ion Methergine works better. It’s not this, oh we have to have a little just in case kind of thing because if there was a just in case moment, yes. We can be working on the IV and doing other things. 

I have to be kind of secretive about it. I have tinctures and stuff with shepherd’s purse and yarrow. Those things actually have great evidence. They are really helpful for postpartum blood loss. I have a lot of moms who are more interested in doing something more holistic and natural before they try medication. Cypress essential oil, you can rub that in. I’ll have doulas use my cypress roller and give them a massage while I’m trying to manage the hemorrhage and that cypress oil can help a lot too. 

Sometimes going back to our instinctual, old medicine that we have been using well before medicine was used for birth. 

Meagan: Yeah. This is a random question for both of you. Lil, I really wonder if you have seen it or heard about this too because you are so heavily in our DMs. This is going to be weird. People are going to be like, what? But I did this. We did this because we weren’t sure. We cut the umbilical cord and put it in our mouth. It’s really weird. Paige is like, what? You put it down in the gum area like in between your teeth and your cheek. It sits there. Okay, you guys. I’ve seen it just a couple of times, myself included. Yes, I put my umbilical cord in my mouth. Yes, it’s weird. 

Paige: That’s okay. 

Meagan: It felt like a little gummy. It was fine. I wasn’t chewing on it. It was just sitting there. But anyway, it’s weird but with my other client too we did it and all of her hemorrhaging symptoms just went away. 

Paige: That’s cool. 

Meagan: I know this is really random but we just cut a little piece of our umbilical cord and put it in their mouth. 

Paige: That’s so interesting. So a piece of the umbilical cord or the entire thing once it’s clamped and cut and still attached? 

Meagan: They clamped and cut it, cut a piece, and put it in my mouth. 

Paige: I would be so willing to try that. I mean, what is there in that nun? 

Meagan: I don’t know. I don’t know, but it did diminish the hemorrhaging symptoms. 

Paige: Cool. 

Meagan: So very interesting, right? 

Okay, so are midwives restricted when it comes to VBAC on what they can accept? Lily, you are a VBAC. I was a VBAC after two C-sections. You can obviously take Lily. Could you accept me?

Paige: Yes. Luckily in midwifery care, at least in Colorado, there is a lot of gray for certified nurse midwives. It’s not always black and white. VBACs are okay but there is no direct, “Oh, if you have this many C-sections, we can’t do it.” I think that’s because ACOG also strangely doesn’t have an opinion on that. They actually agree. There is limited evidence beyond one C-section. My practice has done several VBACs after two Cesareans. I don’t think we’ve ever done one for a third or greater than two probably because I think those people a lot of times don’t even consider VBAC and they just already have been seeing their doctor for their repeat C-section with each pregnancy. 

But I’d love to see more people going for a VBAC after multiple Cesareans because I think VBACs after two Cesareans have a whole different level of feeling empowered after that. I thin that’s really cool and even special scars and stuff, there is really limited evidence on all of these things and I’d like to see more people pushing the limits a little bit. Especially since I am in a hospital, I do have an OB hospitalist on call 24/7 at the disposal of my fingertips if I need them. We are close to an OR so I think if for somebody the fear is there and they are like, “I just don’t know if it’s more risky because of this,” I think it’s worth it to try because the more people who go for it and are successful, the better evidence we’re going to get from it. 

Meagan: Yeah. That is exactly what I am thinking. There’s not a lot of evidence after two Cesareans because it’s just not happening. It hasn’t really been studied and a lot of that is because people aren’t even given the option. 

Paige: Yeah. I’ll have people where it is their third or fourth C-section and they were never even given that option. They were told, “Oh, I was told I have CPD.” I’m like, “The chances of you actually having CPD are low.” Then you look at their records and it was fetal distress or something like that. Yeah. CPD is so rare. I’ve heard it so many times. “Baby is never going to come out of that pelvis ever.” That breaks my heart every time I hear it because there are times when I’m like, I don’t know and then an 8-pound baby comes out. We can’t go off of those things because the body does what it’s supposed to in those moments. 

Don’t get me wrong. Things do go wrong and C-sections do happen sometimes but yeah. To hear everybody has CPD just because they’ve had three C-sections, I’m like, I don’t know. That would be quite a few people. Way more than we know are true. 

Meagan: Yeah. We’re all walking around with tiny pelvises. That’s just what everyone thinks anyway.

Lily, being in our DMs, hearing the podcast, understanding and seeing so many of these people and what they say, do you have any advice for them when they are looking for their provider or just any advice in general? Do you have any advice from a VBAC-prepping mom? 

Lily: Yeah, I think for me, it is to go into it open-handed. I think we hear so many horror stories about providers often and I think that’s why I went into looking for a provider with both fists up ready to fight and what has surprised me the most is just I think I said earlier that I didn’t know hospital care could look like this. I remember we even posted something and I had posted on The VBAC Link that a hospital birth can be equally as beautiful as an out-of-hospital birth and there were people arguing and people saying, “No, absolutely that’s not possible. That’s not a thing.” 

Gosh, how discouraging if we go into things thinking that we can’t have beautiful outcomes in different settings. Certainly, there are areas around our country that need improvement. There’s not a low-intervention floor at every hospital and there are not midwives who are doing what Paige is doing everywhere but I think the more that we seek out that care and look for that care and advocate for that care, the more we will see it. 

As much as it sucks that we have to be our advocates, it’s also a really cool opportunity that we pave the way for VBAC moms and the moms who have never had a C-section that we are paving the way for care that doesn’t end up in a Cesarean. 

I would just say to be open-handed and yes. You can be prepared to fight and you can be prepared with your statistics. Be prepared to ask the why behind questions, but ultimately, I think that care can be so much more than we expected if we go into it thinking, Gosh, well what can I get out of this and how can I make these things happen? 

Like Paige said, we’ve had lots of conversations around, Well, this is the policy, but the policy is not the law. I’m here to support you in that. At our last appointment, she was like, “Hey, make sure you bring your doula to your appointment where we are going to talk about your birth plan because I want to make sure that she is there, that we all hear each other, that we are on the same page.” I think that’s helpful too. 

And then having a doula. My doula was my doula with my C-section. She was with us. She was whoever was on call at the birth center actually and again, I think it was so serendipitous because she is a VBAC mom. I think I needed her then and I’m so stoked to have her now that she is just a really special human who I know is also always in my corner and constantly texting her like, “Oh my gosh, look at the new birth rooms. Oh my gosh, I had this great conversation. Oh my gosh, I’m so excited.” I think having your doula there to be your partner in advocacy is really helpful too. 

Meagan: Yes. Okay, that’s a good question too when it comes to doulas and midwives. Sometimes I think people think that if I’m hiring a midwife, I don’t need a doula and then we of course know that a lot of people just mistake doulas and midwives together. But Paige, how do you feel about doula care and working with doula care? Is it necessary? How do you work together as doula and midwife?

Paige: Yes. I love doulas. I wish everybody had access to a doula truly because doulas, just like midwives, have been studied and they have better birth outcomes, more empowered births, and all of the things. Doulas are so important and doulas and midwives work really closely. I think a doula is there with that constant presence, that constant helping with anything and a really good advocate which I think is important especially if you don’t have a good relationship with your provider maybe or you don’t know who you’re going to get. Maybe you see 7 different providers and you get who you’re going to get when you’re in labor. 

So to have that doula there to constantly be advocating for you is such an important piece. Yeah, I really wish everybody could have access to a doula because it just makes a world of difference. 

I can’t think of any bad outcomes I’ve ever had when a doula was present. It’s just a different level of care. Usually, people who have sought out a doula have also taken the time to seek out and do all of the things that are going to make a healthier pregnancy and a better birthing outcome. It’s why I think everybody deserves doula care. It’s because it does lead to better outcomes. Midwives are always known to work closely with doulas and really support them. It’s a team effort. 

Meagan: Yeah. Yeah. We love our relationships with our midwives here. It’s really great to just know how we work and know how we need to support the client and it is sometimes hard when we go to a hospital and we don’t know who we are getting. 

And sometimes that OB or that midwife we have worked with before and sometimes it’s a whole new face so it does bring us comfort to know that the client and the family know us and we know them and we can all work together. 

I love that. Okay, do either of you guys have anything else that you would like to say to our beautiful VBAC community before we go? 

Paige: I don’t think so. Yeah, thank you so much for having me. This was wonderful and I just hope that everybody who is thinking about a VBAC really does their research and looks for the best provider and really finds that perfect fit because there are so many good providers out there– OBs, midwives, professional midwives, all the things. 

Meagan: I agree. It’s okay to interview multiple people. It’s also okay that if mid-pregnancy, the end of pregnancy, during, and even in labor that if something is not feeling right, you can request a different provider. You can go out and start interviewing again and find that provider that is right for you. 

Paige: Yes. 

Meagan: Well, thank you Paige and Lily for joining us today, and thank you so much for doing so much in your community. I really love your setup and hope that we can see that type of setup happening in the US because it just feels perfect in a lot of ways. Yeah. Yes. I’m loving it. 

Okay, ladies. Well, thank you so much. 

Paige: Thank you. 

Lily: Yeah, thanks, Meagan. 

Meagan: Bye. 

Lily: Bye!

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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Happy National Midwifery Week!

We are so thankful for and in awe of all midwives do. Great midwives can literally make all the difference. Statistical evidence shows that they can help you have both better birth experiences and outcomes.

Meagan and Julie break down the different types of midwives including CNMs, CPM, DEMs, and LPM as well as the settings in which you can find them. They talk about the pros and cons of choosing midwifery care within a hospital or outside of a hospital either at home or in a birth center. 

We encourage you to interview all types of providers in all types of settings. You may be surprised where your intuition leads you and where you feel is the safest place for you to rock your birth!

Midwifery-led Care in Low- and Middle-Income Countries

Evidence-Based Birth Article: The Evidence on Midwives

Article: Planning a VBAC with Midwifery Care in Australia

The VBAC Link Supportive Provider List

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hey, hey, hey. You guys, we’re talking about midwives today, and when I say we, I mean me and Julie. I have Julie on with us today. Hello, my darling. 

Julie: Hello! You know, sometimes you’ve just got to unmute yourself. 

Meagan: Her headphones were muted, you guys. 

Julie: Yeah. That’s amazing. 

Meagan: I’m like, “I can’t hear you.” 

You guys, guess what? This is our first month at The VBAC Link where I’m bringing a special subject. Every month we are going to have a week and it’s usually going to be the second week of the month where we are going to have a specific topic for those episodes of the week and this is the very first one. It is National Midwives’ Week so I thought it would be really fun this week to talk about midwives. We love midwives. We love them. We love them and we are so grateful for them. 

We want to talk more about the impact that they leave when it comes to our overall experience. 

Julie: Yes. 

Meagan: The overall outcomes and honestly, just how flipping amazing they are. We want to talk more and then we’ll share of course a story with a midwifery birth. 

Okay, Julie. You have a review. I’m sticking it to her today to read the review because sometimes I feel like it’s nice to switch it up. 

Julie: Yeah. Let’s switch it up. All right, this review– I’m assuming “VBAC Encouragement” is the title of the review.” 

Meagan: Yes. 

Julie: “VBAC Encouragement”. It says, “My first birth ended in an emergency Cesarean at 29 weeks and I knew as I was being rolled into the OR that I would go for a VBAC with my next baby. Not long after, The VBAC Link started and I was instantly obsessed.” I love to hear that. 

“I love the wide range of VBAC and CBAC stories. Listening to the women share honestly and openly was motivating and encouraging. As a doula, this podcast is something that I recommend to my VBAC clients. I’m so thankful for the brave women sharing the good, bad, and ugly of their stories and I’m thankful for Meagan and Julie for holding space for us all.” 

Aww, I love that. 

Meagan: I do too. I love the title, “VBAC Encouragement.” That is what this podcast is here for– to encourage you along the way no matter what you choose but to bring that encouragement, that empowerment, and the information from women all over the world literally. All over the world because you guys, we are not alone. I know that sometimes we can feel alone. I feel like sometimes VBAC journeys can feel isolating and it sucks. We don’t want you to feel that way so that’s why we started the podcast. That’s why I’m here. That’s why Julie comes on because she misses you and loves you all so much too and we want you to feel that encouragement. 

Meagan: Okay, you guys. We are talking about midwives. If you have never been cared for by a midwife, I think this is a really great episode to learn more about that and see if midwifery care is something that may apply to you or be something that is desired by you. I know that when I was going along with my VBAC journey, I didn’t interview a midwife actually at first. 

I interviewed OB after OB after OB. Julie did interview a midwife and it didn’t go over very well. 

Julie: No, it was fine. It just didn’t feel right at that time. 

Meagan: What she said didn’t make it feel right. What I want to talk about too and the reason why I point that out is because go check out the midwives in your area. Check them out. Go check them out. Really, interview them. Meet with them but guess what? It’s okay if it doesn’t feel right. It’s okay if everyone is like, “Go, go, go. You have to have a midwife. OB no. OB no.” That’s not how we are in this podcast. We are like, “Find the right provider for you.” 

But I do think that midwives are amazing and I do think they bring a different feel and different experience to a birth but even then sometimes you can go and interview a midwife and they’re not the right fit. We’re going to talk about the types of midwives. This isn’t really a type. We’re going to be talking about CPM, DEM, and LPM. 

Julie: In-hospital and out-of-hospital midwives, yeah. 

Meagan: Yeah, but I also want to talk about the word “medwives”. We have said this in the past where we say, “Oh, that midwife is a ‘medwife’” and what we mean by that is just that they may be more medically-minded. Every midwife is different and every view is different. Like Julie was saying, in-hospital, out-of-hospital, you may have more of a ‘medwife’ out of the hospital, but guess what? I’ve also seen some out-of-hospital midwives who act more like, ‘medwives’, really truly. 

Again, it goes back to finding the right person for you. But can we talk about that? The CPM or DEM? CPM is a certified professional midwife or direct entry midwife, right? Am I correct?

Julie: Right. It’s really interesting because all over the world, the requirements for midwifery are different. You’re going to find different requirements in each country than in the United States, every state has its different requirements and laws surrounding midwifery care. In some states, out-of-hospital midwives cannot attend VBAC at all or they can as long as it’s in a birth center. 

Or sometimes CNM– is a certified nurse midwife which is the credential that you have to have if you are going to work in a hospital but there are some CNMs who do out-of-hospital births as well. There is CPM which is a certified professional midwife which a lot of the midwives are out-of-hospital. That means they have taken the NARM exam which is the national association of registered midwives so they are registered with a national association.

Meagan: Northern American Registry of Midwives. 

Julie: Oh yes. They have completed hundreds of births, lots and lots of hours, gone through the entire certification process and that’s a certified midwife. Now, a licensed midwife which is a LDEM, a licensed direct-entry midwife just simply means that they hold licensure with the state. 

Licencsed midwife and certified midwife is different. Certified means they are certified with the board. Licensed means they are licensed with the state and usually licensed midwives can carry things like Pitocin, Methergine, antibiotics for GBS and things like that which is what the difference is. Licensed means they can have access to these different drugs for care. 

Meagan: Like Pitocin, and certain things through the IV, medications for hemorrhage, antibiotics, yes. 

Julie: Right, then CPMs who are certified, yeah. There are arguments for both. And DEM, direct entry midwife means that they are not certified or licensed. That doesn’t mean that they are less than, it just means that they are not bound by the rules of NARM or the state. 

Now, there are again arguments for and against all of these different types. I mean, there are pros and cons to holding certification, holding licensure, and not holding certification and not holding licensure. Each midwife has to decide which route is best for them. Certified nurse-midwife obviously has access to all of the drugs and all of the things. They are certified and licensed. You could call it that but they have to have hospital privileges if they want to deliver in the hospital. You can’t just be a CNM and show up to any hospital to deliver with them. They have to have privileges at that hospital. They have to work and be associated with a hospital just like an OB. An OB has to have privileges at any hospital. They can’t just walk into any old hospital and deliver a baby. 

Meagan: Right. I think it’s important to know the differences between the providers who you are looking at. Like she was saying, with a CNM, you are more likely to have that type of midwife in a hospital setting than you would be outside of the hospital but sometimes there are still CNMs who have privileges and choose to do birth outside of the hospital. 

I think it’s an important thing to one, know the different types of midwives and two, know what’s important to you. There are a lot of people who are like, “I will not birth with anyone else but a CNM.” That’s okay. That’s okay but you have to find what works best for you. 

Julie: Sorry, can I add in? 

Meagan: You’re fine. Yeah. 

Julie: It’s also important that you are familiar with the laws in your state if you are going out of the hospital. I don’t want this episode to turn into a home birth episode. It should be about all of the midwives in all of the locations, but also, know what the laws are in your state and in your specific area about midwives. In Utah, we are really lucky because we have access to all the types of midwives in all the different locations, but not everywhere is like that. Yeah. Just a little plug-in for that. 

Meagan: Yes. I agree. I agree. 

I did mention that I didn’t really go for midwifery care when I was looking for my VBAC– Lyla, my second. I don’t even know why other than in my mind, this is going to sound so bad but in my mind, I was told that midwives are undereducated. 

Julie: Less qualified? 

Meagan: Less qualified to support VBAC. I was told this by many people out in the world and I just believed it. Again, I have grown a lot over the years. It’s been so great and I’m glad that I have. That’s just where I was.

Julie: A lot of people think that though. People don’t know. They just don’t know. 

Meagan: No, they don’t know so I wanted to boom. Did you hear it? I’m smashing it. 

Julie: Snipping it. 

Meagan: That is a myth that is going to be smashed. Midwives are fully capable of supporting you during your VBAC journey. We are going to start going over some stats and things about how midwives really actually do impact VBAC in a positive way but you may even run into and at least I know there are some places here in Utah where providers kind of oversee the midwifery groups in these hospitals and a lot of them will say that midwives are unable to support VBAC. That’s another thing that you need to make sure you are asking if you are going in the hospital when you are birthing with midwives because a lot of times you are being seen with your midwife, you’re treated by your midwife and everything is great. You’ve got this relationship with these midwives and then you go into labor and all of a sudden you have an OB overseeing your care because that midwife can oversee your pregnancy but not your birth. 

Know that that is a thing so make sure that if you are birthing in a hospital with a midwife that you ask, “Will I be birthing with the midwives or am I going to be seen by an OB?” But also know, like I said, you can be seen in a hospital by a midwife. 

Okay, let’s talk about some evidence and what midwives bring to the table and maybe some differences that midwives bring to the table because I do think that in a lot of ways, it is scary to think, Okay. If I have to have a C-section, if I do not have this VBAC and I have to go to a C-section and I have to be treated by an OB– because midwives do not perform Cesareans. They do assist. Let me just say, a lot of midwives come in and they assist a Cesarean, but they do not perform the main Cesarean, that can be intimidating because you want your same provider but I don’t know if that’s necessarily needed all of the time. Maybe to someone that is. 

But just know that yes, they cannot perform a Cesarean but they often can assist. That’s another good question to ask your midwife, especially in the hospital. If I go to a Cesarean, who will perform it and will you be there no matter what?

Okay, let’s talk about it. Let’s talk about the evidence. Let’s talk about experiences and how they can differ. 

Julie: Do you know what is so funny? I want to go back and touch on the beginning where you said you didn’t know and you thought that midwives were less qualified and honestly especially in-hospital, in-hospital midwives– I want everyone to turn their ears on right now– have the exact same training and skills to deliver a baby vaginally as an OB does. The difference between a midwife and an OB in a hospital is a midwife cannot do surgery. 

I just want to say that very concisely. They are just as qualified. They can even do forceps deliveries. They can do an episiotomy if an episiotomy is necessary. They can do vacuum assist. Well, some hospitals have policies where they will or will not allow a midwife to do forceps or a vacuum but they can administer all different types of medications. They can literally do everything. They can do everything except for the surgery in the hospital.

Out of the hospital, I would argue that they still have similar training depending on if they are licensed or not. They may or may not be carrying medications like Pitocin, Methergine, antibiotics, IV fluids, and things like that. But out-of-hospital midwives, many of them, at least the licensed ones, carry those things and can provide the same level of care. The only difference between– not the only difference, a big difference between out-of-hospital midwives and in-hospital midwives is they don’t have immediate access to the OR and an OB. 

But guess what? In states like Utah and many, many states operate similarly, there are very strict and efficient transfer protocols in place so that when a midwife decides you need to transfer, say you are birthing at home, first of all, a midwife is going to be with you a big chunk of the time. They are going to be with you. They’re going to be noticing things. They’re going to be seeing things. They’re not going to be there for just the last 10 minutes of deliveries like these OBs are. They are going to be in your house. 

I feel like out-of-hospital midwives are more present with you than in-hospital midwives even. They’re going to notice things. They’re going to see things. They’re going to notice trends a lot of the time before a situation becomes emergent if you need to be transferred. There are those random last-second emergencies and there are protocols for how to handle those too, but the majority of the time when there is a transfer needed, you are going to be received at the hospital. The hospital is already going to have your records. They’re already going to know what you’re coming in for and they’re going to be able to seamlessly take over your care, no matter what that looks like there. 

Now there are rare emergencies when you might need care within seconds. However, those are incredibly rare and that is one of the risks. Those are some of the risks that you need to consider when you think about out-of-hospital versus in-hospital care. But often, I have seen many instances where things have safely gotten transferred to a hospital before they reach the level of needing that severe emergent care. I think that is the biggest thing people don’t understand. 

I don’t know how many people I’ve talked to as a doula and as a birth photographer where they don’t want to birth at home because they don’t understand the level of care that is provided by out-of-hospital midwives. I’m thinking of a birth I just went to last summer and she was thinking about home birth but the husband was like– this was 36 weeks so they weren’t comfortable transferring or anything like that, but I was like, “These home birth midwives are trained in emergencies. They know how to handle all of the same obstetric emergencies in the exact same ways that they do in the hospital. They know how to handle them and address them. If a transfer is necessary, they are going to transfer you. They carry medication. They have stethoscopes and fetal monitors and everything that they do in the hospital to care for you.” 

The dad was like, “Oh, I didn’t know that.” It’s not your mom coming to help you deliver your baby. It’s a trained, qualified medical professional. I don’t know. I saw this quote. Never mind. I’m not circling back. I’m going in a completely different direction. 

I saw this quote or a little meme thing on Facebook the other day. I was going to send it to you but I didn’t. It said something like, “Once your provider and birth location is chosen and locked in place, choice is mostly an illusion.” 

Meagan: Wow. Mostly an illusion. 

Julie: Yes. Like the fact that you have a choice in your care is mostly an illusion. I was thinking about that and I was like, Is it really? I’ve seen some clients really advocate hard, and stuff like that. But I have also seen the majority of clients where providers, nurses, and birth locations have a heavy sway and you can be convinced that things are absolutely necessary and needed by the way that you are approached and if you are approached a different way, then you might make a different choice, right? 

The power of the provider and the birth location is so big and massive that choice, the fact that you have a choice involved, is mostly an illusion. I was sitting with that because I see it. I’ve said it before and I’ll say it a million more times before I die probably that birth photographers and doulas have the most well-rounded view of birth. Period. Because we see birth in home, in birth centers, in hospitals, in all of the hospitals, in all of the homes, in all the birth centers, with all of the different providers. We can tell you what hospital– I mean, there are nurses at one hospital that will swear up, down, and sideways that this is the way to do things and the next hospital 3 miles down the road is going to do things completely different and their nurses are going to swear by a different way to do things because of the environment that they are in. 

Meagan: Yeah. 100%.

Julie: So if you want to know in your area what hospitals are the best for the type of birth that you want, talk to a birth photographer. Talk to a doula because they are going to be the ones with the most well-rounded view. Period. 

Meagan: Yeah. We definitely see a lot, you guys. We really do. Remember, if you are looking for a doula, check out thevbaclink.com/findadoula. Search for a doula in your area. You guys, these doulas are amazing and they are VBAC-certified. 

Julie: What were we going to circle back to? You were saying something. 

Meagan: Well, there’s an article titled, “Effectiveness of Midwifery-led Care on Pregnancy Outcomes in Low and Middle-Income Countries” which is interesting because a lot of the time, when we are in low and middle-income countries, the support is not good. 

Anyway, they went through and it said that “10 studies were eligible for inclusion in the systemic review of which 5 studies were eligible for inclusion in the meta-analysis. Women receiving–”

Julie: I love meta-analyses. They are my favorite. Yeah. Sorry, go ahead. Go on. 

Meagan: I know you do. It says, “Women receiving midwifery-led care had a significantly lower rate of postpartum hemorrhage and reduced rate of birth–” How do you say this, Julie? It’s like asphyxia? 

Julie: Asphyxia? 

Meagan: Uh-huh. I’ve just never known how to say that. It says, “The meta-analysis further showed a significantly reduced risk in emergency Cesarean section. Within the conclusion, it did show that midwifery-led care had a significantly positive impact on improving various maternal and neonatal outcomes in low and middle-income countries. We therefore advise widespread implementation of midwifery-led care in low and middle-income countries.” 

Let’s beef this up in low and middle-income countries. But what does it mean if you are not in a low and middle-income country? 

Julie: Well, I see the same and similar studies showing that in the United States and all of these other bigger countries that are larger and more educated. It’s interesting because– sorry. I have a thought. I’m just trying to put it together. 

Meagan: That is okay. 

Julie: Midwifery-led care is probably more accessible and maybe accessible isn’t the right word. It’s more common probably in lower-income countries. I’m thinking third-world countries and second-world countries because it’s expensive to go to a hospital. It’s expensive to have an OB. In some countries like Brazil, the C-section rate is very, very high and it’s a sign of wealth and status because you can go to this private hospital with these luxury birth suites and stay like a VIP, get your C-section, save your vagina– I use air quotes– “save your vagina” by going to this affluent hospital. Right? 

Meagan: Yes. 

Julie: I think in lower-income countries, it’s going to be not only an easier thing to do but kind of the only thing to do, maybe the only choice. And here, it’s funny because here, out-of-hospital births– first of all, insurance is stupid. In the United States, insurances are so stupid. It’s a huge money-making organization, the medical system is. Insurance does cover a big chunk of hospital births and they don’t cover out-of-hospital births so a lot of the time, an out-of-hospital birth is kind of the opposite. You have to have a little bit of money in order to pay for an out-of-hospital midwife because your insurance isn’t likely going to cover it. 

More insurances are coming on board with that but it will be a little bit of time before we see that shift. But there are similar outcomes in the United States and in wealthier countries that midwifery-led care, not just out of the hospital, but in-hospital midwifery-led care has lower rates of Cesarean, lower rates of complication, lower rates of induction, lower rates of mortality and morbidity than obstetric-led care. You are going to a surgeon. You are going to a trained surgeon to have a natural, non-complicated delivery. 

Meagan: It’s interesting because going back to the low income, in our minds, we think that the care is not that great. But then we look at it and it’s like, the care is doing pretty good over there in these lower-income, third-world countries. Yeah. 

This is actually in Evidence-Based Birth. It says, “In the United States, there are typically 4 million births each year.” 4 million. You guys, that’s a lot. The majority of these births are attended by physicians which are only 9% attended by certified nurse midwives and less than 1% are attended by CPMs, so certified professional midwives or traditional midwives. 

You guys, that is insane. That is so low. She says in this podcast of hers which we are going to make sure to link because I think it’s a really great one, “If you only look at vaginal births, midwives do attend a higher portion of vaginal births in the United States, but still it’s only about 14%.”

Julie: Yeah. If you have a normal– I use normal very loosely– uncomplicated pregnancy, there is absolutely no reason that you cannot see a midwife either out of the hospital or in the hospital. Now, I would encourage you to go and interview some midwives in your local hospitals. I would encourage you to look into the local birth community and see what people recommend because even if you are going in a hospital and have a midwife, you have the same access to the OR and an OB that can take care of you in case of an emergency. 

A lot of people are like, “Well, I’d just rather see an OB just in case of an emergency so that way I know who is doing my C-section,” I promise you that the OB doing your C-section, you are only going to see for an hour. They probably are not going to talk to you. It doesn’t matter how personable they are or what their bedside manner is or if you know anything because I promise you, when you are on the operating room table, you’re not going to be worried about who’s doing your surgery. You’re just not. I’m sorry. That’s maybe a harsh thing to say, but it’s going to be the farthest thing from your mind. Plus, in the hospital, your midwife is more than likely going to be assisting with the surgery too so you are going to have a familiar face in the operating room if that happens. 

I also think everybody knows by now that I am not on board with doing something just in case when it comes to medical care. Just in case things can cause a lot more problems that they are trying to prevent. So yeah. Anyway, that’s my two cents. 

Meagan: Yeah. You know, I really think that when it comes to midwives, there is even more than just reducing things like interventions and Cesareans and inductions which of course, lead to interventions and things like that. I feel like overall, people leave their birth experience having that better view on the birth because of things like that where midwives are with you more and they seem to be allowed more time even with insurance. You guys, insurance, like she said, sucks. It just sucks. It limits our providers. 

I want to just point that out that a lot of these OBs, I think that they would spend more time with us. I think they want to spend more time with us in a lot of ways, but they can’t because insurance pulls them down and makes it so they can’t. But these midwives are able to spend so much more time with us in many ways. 

Okay. Let’s see. What else do we want to talk about here? We talked about interventions. Midwives will typically allow parents to go past that 40-week mark. We talked about the ARRIVE trial here in the past where they started inducing first-time moms at 39 weeks and unfortunately, it’s stuck in a lot of ways so providers are inducing at 39 weeks and that means we are starting to do things like stripping membranes at 37 and 38 weeks. It seems like providers really, really– and when I say providers, like OB/GYNs, they are really wanting babies to be born for sure by 40 weeks but by 40 weeks, they are really pushing it. 

Midwives to tend to allow the parents to go past that 40-week mark. That’s just something else I’ve noticed with clients who choose VBAC and then end up choosing midwives. They’ll often end up choosing midwives because of that reason and they will feel so much better when they reach that point in pregnancy because they don’t feel that crazy pressure to strip their membranes and go into labor or they are going to be facing a Cesarean and things like that. 

I feel like that’s another really big way to change the feeling of your care with midwives is understanding when it comes down to the end of things, they are going to be a little bit more lenient and understanding and not press as hard. Like we said in the beginning, there are a lot of people who do press it– those “medwives” where they are like, “No, you need to have a baby.” We just recorded a story where the midwife was like, “Well, you need to see the OB and you need to do a membrane sweep,” and they were suggesting these things. 

But really, typically with midwives, you are going to see less pressure in the end of pregnancy. 

Midwives spend more time in prenatal visits. We were just talking about that. Insurance can limit OBs, but a lot of the time, they will really spend more time with you. They are going to spend 20+ minutes and if you are out of the hospital, sometimes they will spend a whole hour with you going over things. Where are you mentally? Where are you physically? What are you wanting? Going over desires and the plan for the birth. Past experiences may be creeping in because we know that past experiences can creep in along the way. 

So yeah. Okay, Julie is in her car, you guys. She’s rocking it with her cute sunglasses. She is on her way. She is so nice to have the last half hour of her free time spent with us. So Julie, do you have any insight or any extra words on what I was just saying? 

Julie: You know, I do. Hopefully, you can hear me okay. I’m going to hit a dead spot in two seconds. 

Meagan: I can hear you great. 

Julie: Okay, perfect. I have this little– there’s a spot on my road where I always cut out so stop me if I need to repeat what I said. I wanted to go back to the beginning and just talk for half a second because we know my first ended in a C-section. For my first birth, I actually started out by looking at birth centers because I wanted an out-of-hospital birth. I knew that from the beginning. I interviewed a couple of midwives and there was one group that I was going to go with at a birth center and I was ready to go but something didn’t quite feel right. It wasn’t anything the midwives did. It wasn’t anything that the birth center was. It wasn’t that I didn’t feel safe there. It was just that something didn’t feel right. 

So I just stayed with my OB/GYN. I had to get on Clomid to get pregnant. I just stayed with that guy who is the same guy that Meagan had and the same guy who did my C-section because something didn’t feel right. I mean, we know now and I can look back in hindsight. This was, gosh, 11.5 years ago. I know that I ended up having preeclampsia and I ended up having to get induced because of it. 

Had I started out-of-hospital, I would have had to transfer. There was nothing– I would have had to transfer care before I even got to 37 weeks. I had a 36-week induction. That’s the thing though. Out-of-hospital midwives have protocols. Each state has different guidelines, but there are requirements for when they have to transfer care– if your blood pressure is high, if you have preeclampsia signs, if you deliver before a certain due date, or after a certain gestational age. You’re going to be safe. If you have complications in pregnancy, you’re going to be safe. You’re going to be transferred. You’re going to be cared for. 

But also, I just want to put emphasis on this which is what I’m tying into the last thing I want to say which is going to be forever long, is that you can trust your intuition. My intuition was telling me that the birth center was not the right place for me even though it checked all of the boxes. Your intuition is not going to tell the future every time, but what I wanted to lead into is that– oh and do you know what is so funny also? I had three out-of-hospital births after that, but with my fourth birth, I started out with the same midwife I had for the other two home births, and for some reason, I felt like I needed to transfer care back to the hospital so I went back to the hospital for two months and all of a sudden, my insurance change and the biggest network of hospitals in my state wasn’t covered by my insurance anymore so it felt right to go back to out-of-hospital birth. 

I don’t know why I had to do that whole loop-dee-loop of transferring to a hospital just to transfer back to the same out-of-hospital midwife that I had in the first place but I believe there was a purpose to that. I believe there was a purpose to that. 

I want to tell you guys that if seeking midwifery care whether in the hospital or out of the hospital feels uncomfortable to you or feels like, I don’t know. These midwives still sound like chicken-dancing hippies to me, I would encourage you to go talk to some local midwives whether in a hospital or out of the hospital. Just sit down and talk to them and say, “Hey.” 

It’s easier to talk to an out-of-hospital midwife. Out-of-hospital midwives do free consultations for you. In-hospital midwives, you might have to make an appointment and it might be harder but you should still try and see and get a vibe or just transfer care to them and go to a few appointments and see. You can always switch care back to a different provider or an OB because your intuition is smart but it does not know, it cannot guide you about things that you do not know anything about. 

I would encourage you to go and chat with these different providers, even different OBs if you want because your provider choice is so, so, so important. It is one of the most important decisions you’re going to make in your care for your birth. It should be a good one. Your intuition can’t tell you to go see x, y, z provider if you don’t even know who x, y, z provider is. 

Gather as much information as you can. Talk to as many providers as you can. Go see the midwife. Interview the doula. Check out the birth photographer’s website. See what I did there? See how it feels because even as a birth photographer, whenever I’m doing interviews with people, I’m not a fly-on-the-wall birth photographer. A lot of birth photographers brag about being a fly on the wall. You won’t even know I’m there. No. I don’t buy that because who is in your birth space is important. I am a member of your birth team just like every other person in that space, just like your nurses, your OB, your midwife, your doula– everybody there is a member of your birth team. I am a member of your birth team too and I will hold space for you. I will support you and I will love you. I am not a fly on the wall. 

Now, your provider is a member of your birth team. They probably arguably are one of the biggest influencers about how your birth is going to go and you deserve to be well-informed about who they are. You deserve to have multiple options that you know about and have thoroughly vetted and you deserve to stick up for yourself and do the provider who is more in line with the type of birth you want. 

How do you do that? You do that by finding out more about the providers who are available to you in all of the different birth locations and settings. 

Meagan: Yes. So I want to talk more about that too because there are studies and papers out there showing that the attitude or the view on VBAC in that area, in that hospital, in that birth center, both midwives and OBs, but we are talking about midwives here, really impacts the way that a birth can go. 

So if you don’t interview and you don’t research and you don’t find those connections and even try, you will not know and in the end, it may not be the way you want. Even then, even if we find those perfect midwives, even if Julie went to the hospital midwife, she probably would have had a great experience, but who knows?

Julie: Also, arguable too though, you could be seeing the most highly recommended VBAC provider in your area in the most VBAC-supportive hospital in your area that everybody goes to and everybody raves about, and if you don’t feel comfortable there for whatever reason, you don’t have to see the best, most VBAC-supportive provider if it doesn’t feel right and if it doesn’t sit right with you. 

Meagan: Yes. 

Julie: It goes both ways. 

Meagan: Yes. 

Julie: Sorry, I’m really passionate about this clearly. 

Meagan: No, because it does. It goes both ways. I mean, that’s what this podcast is about is conversation and story sharing and finding what’s best for you because even with VBAC, VBAC might not be the right option for you, but you don’t know unless you learn. You don’t know unless you learn more about midwives. Really though, people usually come out of midwifery care having a better experience and a more positive experience. I think that goes along with the lines of they do give a little bit more care. They do seem to be able to dive deeper to them as an individual and what they are wanting and their desires. They are a little less medically minded and a little bit more open-minded. 

You are less likely to have interventions. You are less likely to have those things that cause trauma and that causes the cascade that leads to the Cesarean. I’m going to have all of the links but I’m just going to read this highlighted. 

It’s a study from Europe actually. It says, “A recent qualitative study in Europe explored the maternity culture in high and low VBAC countries and found that–” I’m talking a lot about high and low countries. Sorry guys, I’m realizing I’m talking a lot about it but a lot of these studies differ. It says, “Clinicians in the high VBAC countries had a positive and pro-VBAC attitude which encouraged women to choose VBAC whereas the countries with low VBAC rate, clinicians held both pro and anti-VBAC views which negatively affected women who were seeking VBAC. Both of these studies have shown that having midwifery care can have a positive influence on VBAC rates with an increase in maternal and neonatal morbidity.”

Right there, not only doing the research on your provider, but doing the research within your location, what their thoughts are, what their views are, what their high-VBAC attitude or low-VBAC attitude is. If they are coming at you, even these midwives you guys, and they have all of these stipulations, it might be a red flag. It might not be the right midwifery group for you. 

Julie: Absolutely. That’s where the intuition comes in. I like what you said about the VBAC culture. You can tell at different hospitals. We have been to many, many hospitals in our area. Sorry, can you hear my blinkers? It’s distracting. 

Let’s see. I absolutely guarantee you that every hospital has a culture around VBAC. Some of them are positive and supportive and uplifting and some of them are fearful and fear-based and operate on a fact where they are going to be more likely to pull you toward a repeat C-section or other interventions. I encourage you to look into the culture of your hospital but not only hospitals too. I realize it’s not just hospital-specific. It’s also out-of-hospital midwives. They all have their culture around VBAC. Your out-of-hospital midwives and your in-hospital midwives, all of the midwives, your group whether you see a solo practice or a group OB practice or you see a group midwifery practice or whatever, there is a culture surrounding VBAC. You need to do yourself a favor and figure out what that culture is. 

I got to my appointment and I need to head in so I’m going to say goodbye really fast. I’m going to leave Meagan alone to wrap up the episode, but yes. My parting words are honoring your intuition, talk as much to your VBAC provider as you can and find out what the culture is surrounding that no matter who you choose to go with and also, do not automatically write off midwives. You are doing yourself a huge disservice if you are not considering a midwife for your care. It doesn’t mean you have to go with one, but I feel like everybody should at least look into them. 

I love you guys! Bye!

Meagan: Okay. And wrapping up you guys, I am just going to echo her. I think that completely discrediting midwives without even interviewing them at all is something that is a disservice to ourselves. I’m going to tell you that I did that. I did that. I didn’t even consider it. I interviewed 12 providers, 12 providers which is crazy and I didn’t interview one midwife. Not one. I was interviewing OBs and MFMs and I realize I don’t remember interviewing a single midwife. 

The only thing I can think of is that I let the outside world lead me to believe that midwives were less qualified. Yale has an article and they say, “First-time mothers giving birth at medical centers where midwives were on their care team were 75% less likely to have their labor induced.” 74% less likely to have their labor induced, 74% less likely to receive Pitocin augmentation, and 12% less likely to deliver by Cesarean which is a big deal. 

I know most of us listening here are not first-time moms. We’ve had a Cesarean. Maybe we’ve had one, two, three, or maybe four, but the stats on midwives are there. It is there and it’s something to not ignore so if you have not yet checked out midwives in your area, I highly encourage you to do so. Like Julie said, you don’t even have to go with anybody, but at least interviewing them to know and feel the difference of care that you may be able to have is a big deal. 

I highly encourage you. I love you all. I’m so grateful for midwives. I’m so grateful for my midwife. My VBAC baby was with a midwife and I did have an OB. I was one of those who had an OB backup who could care for me and see me if I needed to. That for me made me feel more comfortable but it’s also something that can get confusing. I think we’ve talked about where sometimes you will do dual care and you will have one person telling you one thing and the other provider telling you the other thing. That can get stressful and confusing so maybe stick with your provider. 

But do what’s best for you. Again, another message. Don’t just completely wipe out the idea of a midwife if you have midwives in your area as an option. It may be something that will just blow your mind. Thank you all so much for listening and hey, if you have a midwife who you suggest or you’ve gone through a VBAC with, we have our VBAC-supportive provider list and we would love for you to add to it. Go check out in the show notes or you can go over to our Instagram and click in our Linktree and we have got our provider list there for you. Or if you are looking for that midwife to interview, go check them out. We definitely love adding to this list and love referring it for everybody looking for a VBAC-supportive provider. 

Closing

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