The VBAC Link

Every pregnancy and birth experience is different. That is true for everyone, but especially for Kristen. Kristen joins us from Provo, Utah, and shares her experiences with an initial vaginal birth, a diagnosis of omphacele with a Cesarean and infant loss with her second that left her with a special scar, an induced, medicated hospital VBAC with her third, and she is currently expecting twins!

Kristen’s journey has not been easy, but she has learned and grown so much. She talks about how a safe and supportive birth team truly makes all the difference. Your intuition will help guide you to the best provider for you. When you know, you know!

Meagan concludes the episode by touching on some myths and facts about doulas. 

The VBAC Link Blog: Myths and Facts About Doulas

The VBAC Link Blog: Special Scars

Special Scars, Special Hope

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

01:50 Review of the Week

04:02 Kristen’s first vaginal birth

09:41 Coping with grief and hospital communication issues

15:17 A low transverse incision with a J extension

19:59 Finding VBAC support in Salt Lake

23:10 Foley induction at 41.5 weeks

29:29 Changing plans

30:37 Myths about doulas

38:55 Facts about doulas

41:05 Kristen’s advice to other women with special scars

43:26 Listening to your intuition when choosing a provider

Meagan: Hello, Women of Strength. Thank you for joining us for another amazing episode here at The VBAC Link. Today’s story is from someone who is local to me which I think is always kind of fun to have someone who when they are telling the story, I know the birthing place, I know the provider, and here I even know the doula so that is super exciting. 

Welcome, Kristen to the show. 

Kristen: Thank you, Meagan. 

Meagan: Thank you so much for being here and I’m excited for you to share your stories. I would like to get into a review really quickly so then we can do that. 

Kristen: Sure. 

01:50 Review of the Week

Meagan: Okay, we have a reviewer from Apple Podcasts and it says louuuuuhuuuu. I think that’s how it is and it says, “Very Inspirational.” It says, “I knew I wanted a VBAC with my third pregnancy, but I wasn’t sure if it was possible. However, I knew I didn’t like being flat-out told no at my first appointment. Listening to the podcast was definitely the start of me really researching birth and looking into my options. I ended up with a successful HBAC” which is home birth after two Cesareans, actually HBA2C, “and I definitely don’t think I would have had the courage or believed it was possible without the podcast. Thank you, Meagan, for all of the work that you do to provide this information.” 

And thank you, louuuuuhuuuu. I don’t know how to say it. I’m just butchering your name. If you are still listening, thank you so much for your review, and as always, we love your reviews. They really do help the podcast. They help Women of Strength find these incredible stories and information just like she was able to receive. You can drop that review at Apple Podcasts or Google or wherever you listen to your podcasts. 

04:02 Kristen’s first vaginal birth, Cesarean, and infant loss experience

Meagan: Okay, Kristen. Thank you again so much for joining us. I would love to turn the time over to you to share your stories. 

Kristen: Well, thank you. It’s hard to know where to start. There are a lot of details to mine. 

We had our first little boy in April of 2018. That was its own experience. That was a vaginal birth honestly. That was as hard as it was as a first-time mom and a first-time pregnancy/birth. It had its own set of interesting details to go along with that but we soon found ourselves unexpectedly pregnant with our second one just four months later after he was born. 

Meagan: Really soon. 

Kristen: Yeah, they would have been 11 months apart. I say would have been because my daughter who I had via Cesarean ended up passing away a few hours after she was born. She had a few congenital defects and when we got our first ultrasound, we found out she had a condition called omphalocele which means she had some of her organs on the outside of her body in a little protective sac. It was mostly her liver. I saw the ultrasound. I looked at it and I was like, That doesn’t look normal. 

It was one of those moments where the ultrasound tech was like, “I’m going to get the doctor.” Your heart sinks and your heart drops. At the time, it wasn’t a big deal after the doctor came to us and talked to us and said, “She’ll be fine. You can deliver safely. It would most likely be a scheduled C-section.” I was expecting that from the very beginning because it wasn’t just, “Oh, this is going to be a big baby. This is going to be a big baby with a large–”

Meagan: 100% necessary Cesarean. 

Kristen: Exactly. 100% necessary. 

Meagan: Yes. 

Kristen: That was to be expected even though I was like, Darn. I don’t want that, but obviously, I wanted her to be her in the best and safest way possible because this is just such a crazy anomaly. 

That was around 18 weeks and then around 24 weeks, we were at Maternal-Fetal Medicine at our local hospital down here where I live in Provo, Utah and they discovered something else which is a lot more serious. She had a diaphragmatic hernia which means her diaphragm didn’t really develop all of the way and allowed some of her other internal organs to be pushed up into her chest cavity. 

Meagan: Oh wow. 

Kristen: Whatever was left in her abdomen was pushed up. I think some of her spleen was in there and pushed. They essentially squished her lungs so they couldn’t develop all of the way which is essentially what happened at the end of her life. That’s not something– we’ve grieved and healed a lot from that but it’s also something that I consider one of those things that now I can be there for somebody else now who has gone through infant loss in whatever way that means. I can be a sounding board for anybody else who has been there. 

Meagan: Yeah. It’s crazy how sometimes we have some of the most unfortunate or horrific experiences that we could ever imagine going through and life-jarring and after we get through them, we are still super there but we are also stronger in a weird way where you can be that support for other people and you can relate. It’s just this weird but most amazing thing that there are people like you who are like, I went through this really not great experience, but now I’m here and I want to support those who need it. 

Kristen: Yeah, totally. It took a long time to get there. 

Meagan: I’m sure. 

Kristen: She was born on March 25, 2019 and so she would have turned 5 this year. We celebrate her birthday as a family every year. 

Meagan: Good, yes. 

Kristen: My 6-year-old is excited because we always release a balloon up for her and he said, “I’m so excited. My sister’s going to get this balloon.” It’s still very innocent and sweet. We love being able to do that as a family because she is very much still to us a part of our family. 

Meagan: Absolutely. That just gave me the chills thinking about your little boy doing that. That’s so awesome. 

Kristen: He’s very tender-hearted and sweet. It’s one of those things that means a lot to him. Even though he was barely one when this happened, he wouldn’t have remembered her at all. 

Anyway, with those things going on, her outlook from the very beginning was bleak. That was a hard piece of the puzzle to deal with, but it also plays into what happens later. Although this was a scheduled Cesarean and absolutely necessary, we wanted to give her every possible chance just in case she could beat the odds or whatever. Me as mom, I’m like, There is still a 20% chance this could be okay. That’s something. It’s not nothing. 

Meagan: Exactly, yeah. 

Kristen: You’ve got to hold onto something and that’s what I did. 

09:41 Coping with grief and hospital communication issues

Kristen: The Cesarean itself was fine. The process in the hospital for me, nothing went overly wrong with me physically. But afterward, that was where it gets a little complicated. We had to leave the hospital with just my husband and myself which was obviously very hard but we also had a few different things that left me baffled and confused but really frustrated. 

Anyway, the first thing was that after our daughter had passed and while I was recovering, the hospital staff didn’t seem to be on the same page with a lot of things. First being their communication. I remember it was the anesthesiologist who came in the day after my daughter had passed and they asked, “Oh, how are you? How is your baby?” Did you not read the notes? Is there not a sign on the door that says she’s not with us anymore? I had to clarify. Of course, he was very apologetic. “I’m so sorry.” Okay. 

That seemed like one of those things where it’s like, okay. You should have been informed. I don’t know why. 

After that, we had the resident doctor and the doctors in training at the time. He comes in and says, “We had to do a mid-transverse incision on your uterus and so you should plan on Cesareans from here on out. It’s not safe and don’t plan on having a vaginal birth.” It’s like, “Okay, no one told me that was happening.” 

I felt like there was again that lack of communication and just that misstep between doctors and the other providers and stuff. I was told that in the hospital as I was recovering so that was another blow of course because I was very much expecting, Okay, I know I can have a vaginal birth after a Cesarean. That’s totally a possibility. I go in with that strand of hope again for myself thinking that I could totally do this later. I’ve heard it’s possible. I’ve just got to find somebody who can help me with it. I’m fine, then someone tells you like your reviewer today. I hate it when someone tells me no. Don’t tell me no. Don’t do it because I will literally make it my life’s work to prove you wrong. 

That was really hard to hear, of course, in that setting and in that moment. It’s really deflating to hear that. 

But I was like, Okay. If that’s what they think, that’s fine. I’m going to prove them wrong later. Whatever. I’ll do it.

Then we ended up going home. I ended up calling back the doctor’s office saying, “Okay. You said mid-transverse. What does that actually mean?” I was trying to clarify things. 

Meagan: It’s higher up. 

Kristen: Yeah. The nurse who answered said, “Well, we had to do a mid-transverse incision. We had to make more room for your baby to get out.” I was kind of expecting that they might have to do that. They did forewarn us that it may be a possibility but no one ever said that was what happened in the hospital when we were delivering her. 

Anyway, they never told us that happened until I called back and said, “Hey, what actually happened?” She said, the nurse I remember was like– it still makes me baffled why you would say something like this– but she goes, “We had to show a mid-transverse incision with a double-J extension,” so one on either side. 

Meagan: On each side? Wow. 

Kristen: Yeah. That’s what she told me. She said, “Think of it like a smiley face on your uterus.” It’s like, why would I ever think of it like that? It was just the weirdest verbiage. Why would you say that to somebody? I don’t know. I was like, Okay. That was weird. Why would you say that to me? 

Then it gets even better. You can request your op-notes. 

Meagan: Yes. 

Kristen: I did that. I requested them. I feel like people are just going to be doing the facepalm like, Oh my gosh, seriously? What were these people thinking? On my op-notes, they have little bullet points. 

The first one says, “Uterine incision”. The uterine incision they told me they had on there said “classical”. 

Meagan: Oh. 

Kristen: Which is wrong, totally wrong. Immediately beneath that, it says, “Detailed C-section notes”. Then it says, “Mid-transverse incision. Patient should not labor in the future.” That was the note. First it says classical. Then it says mid-transverse incision. Then they tell me I have a mid-transverse incision with a J extension or double J’s. What do I have? What did you do? 

Meagan: Yeah. Yeah. 

15:17 A low transverse incision with a J extension

Meagan: That’s frustrating. 

Kristen: Yeah, so fast forward to when I have my new provider. We’re pregnant with our third now or we were at the time. He was a wonderful, wonderful guy and a wonderful provider. He said, “Do you know what? I’m going to go off of the actual written notes from the person who says they were watching the procedure.” It’s like, oh that’s really smart. They said I have a low transverse incision with a single J extension to my right side. 

Meagan: Wait, so different again? 

Kristen: Different again. So I was like, Oh my goodness. Where does this end? It stopped there, thank goodness. Yeah, he said, “I’m trusting more the person who was basically looking and saying, I was here in the moment taking physical notes and this is what was done. I’m trusting this more than somebody’s bullet points.” 

Meagan: Everybody’s bullet points, yeah. 

Kristen: Exactly. 

Meagan: And the nurses who are just randomly saying what they did. Okay. 

Kristen: Yeah, exactly. Exactly. 

Meagan: Wow. 

Kristen: So I was like, “Thank goodness I have you to translate for me,” because I was like, What did they do to me? I have no idea. Probably any other doctor who wasn’t super VBAC-friendly would be like, “Well, this is too risky. I don’t want to take any chances.”

Meagan: So technically you have a special scar. 

Kristen: I do. I have a special scar. 

Meagan: Low-transverse with a J. 

Kristen: With a J. In those op-notes, I actually did notice just the other day when I was reading them again, it said that they extended it bi-laterally which in my mind, I didn’t call and ask obviously, but in my mind, that would translate to making the low transverse incision just a little bit longer. Again, I don’t know. But at least at the bare minimum, I have a low transverse incision with a J extension. So yes, I have a special scar. It was one of those crazy things like, Oh, now I’ve got to look this up. 

Again, I’m gung-ho at this point about, I can do this with a special scar. I’ve listened to the podcast. So many women have done it. I can do it too. I’ve just got to find somebody who is willing to meet me in the middle. 

Meagan: Support you. 

Kristen: Yeah and like I said, luckily I did up in Salt Lake where it’s not too far of a drive from where we are from. It was definitely worth it. He said, “It shouldn’t be a problem from what I’m reading. We’ll just go with it and if anything changes, I’ll keep you posted.” He was just supportive from day one which was super awesome. 

Meagan: He’s wonderful. 

Kristen: Anyway, so yeah. That’s the complication from my fun story. Hope that all makes sense. Hope we are all able to piece that together. Sorry. 

Meagan: Well, that’s so hard because it’s like, I’m being told this and this and this so what is it? All of these things impact my decision or maybe it doesn’t. But you want to take all things into consideration so it’s frustrating to not know what you have. 

Kristen: Right, totally because yeah, like you said, it could totally impact somebody’s decision. 

Meagan: It could affect somebody’s decision, yeah. 

19:59 Finding VBAC support in Salt Lake

Meagan: Okay, so you found out it was a low transverse extension J special scar. You found a provider up here in Salt Lake that was like, “Yep, okay. We’re going to do this.” How did that go? 

Kristen: That was really good. Honestly, it was one of those things where you start looking online first and then go from there. I just found his name. At the time, unfortunately he doesn’t practice that anymore, but he had his own little personal video posted about that. I was like, I feel this. I’m getting really good vibes from this guy and I really like it. So I called his office. I scheduled myself in. Great. Okay. Then yeah, it was really comfortable from day one. I told him. I said, “I’ve got some weird things going but at the same time, I am really motivated. I’m really determined to do this.” 

He was like, “Okay. I’m with you.” 

Meagan: There was something about him that brought this overwhelming sense of calm when he was with you. 

Kristen: Mhmm. 

Meagan: Fun little side note, I was actually under his care as well for my VBAC. 

Kristen: Oh cool. 

Meagan: For a little while until I decided to go out-of-hospital. 

Kristen: Yeah. 

Meagan: Yeah. He’s just awesome. 

Kristen: Yeah. I completely agree 100%. 

Meagan: He transformed the VBAC community here in Utah. They just flocked to him because there was just something about him that wasn’t anywhere else here in Utah. 

Kristen: Yeah. Now you’re giving me chills. I’m going to get emotional about it because I feel like it’s so true. 

Meagan: Yeah. Yeah. He’s a special OB for sure. 

Kristen: Yep. It does. It makes you sad that he’s not doing that anymore but at the same time, I’m sure he is one of those doctors who will refer you to somebody who he trusts and you can be like, Well, if he trusts them then I can feel safe about it.

Meagan: Yeah. Yeah. And you hired a doula. 

Kristen: I did. I hired a doula. 

Meagan: Who was one of my clients. Crazy, huh? 

Kristen: She’s one of my good friends. I was like,  You know what? I’m going to do a total 180 on this one. It was the best thing ever and the best decision ever. It happened to work out super nicely because my husband was there, yes. He is the best– she calls them daddy doulas. He’s the best daddy doula, but he had to take some breaks too and having that other person there was like, If you weren’t here, I don’t know what I would do because I feel like my husband needs a break and I have to do this by myself, but no. I wasn’t left by myself. It was one of those things that helped with the whole VBAC process go so much more smoothly especially because it ended up being an induction. 

Meagan: Oh, okay. 

Kristen: Yeah, so just add more to my docket here of fun things that I chose to do. 

23:10 Foley induction at 41.5 weeks

Kristen: We ended up going to 41.5 weeks with my daughter and at that point, I think this is probably biased but I feel like a lot of OBs, not matter how supportive they are, they are like, “Well, we could go this far if you wanted to, but it’s getting to that point.” It’s like, Okay, fine. 

It was my choice obviously to do it. We went in for the induction. I chose to use the Foley bulb. I had never done that before. That was hands-down so much better because my son was an induction as well and about the same time. My babies just go late. They are just 41+ weeks and they are still just cozy. 

So with him, it was not the same. They tried to push me in and out with a much faster style of induction. I was not a fan. The one, I was like, Okay. This is going to be different. Like I said, a 180. With her, it was a very slow, gentle induction and yeah. 

She arrived and it was pretty awesome just to feel at the end of the day like, Yeah, maybe an induction wasn’t exactly how I pictured this to happen, but my thoughts and feelings that I put out there into the universe was just that, I want a VBAC and I want it to go well. And it did. She’s here. She’s 3 now. It was one of those things that gave me that really big sense of accomplishment and that “ha” moment like, “I told you I could do it.” 

Meagan: I understand that “ah-ha” feeling so much. I definitely did that when my son came out as well. 

25:10 Pitocin, epidural, and pushing for 10 minutes

Meagan: You mentioned it was a lot slower of an induction and things like that. A lot of people don’t think that it’s really possible to do a low and slow induction. You started with a Foley then what happened from there? Did they start with Pitocin right after that? 

Kristen: They did. They started with Pitocin and we had to have some conversations with the nurses too. It was another reason I was glad I brought my doula. They started going a little bit faster than I wanted. I remember being a little bit earlier on and I was like, These contractions should not be on top of each other like this already. They were again, really good about backing off and letting me do it. 

Again, like I said, there are still things I would change but I feel like we all maybe have this ideal, I want it this way, especially for me. I’m very much like, I want this and this and this to happen. I have to be realistic. It’s not going to go exactly how I want it to. There are some things I can tweak and change along the way, but having a realistic viewpoint of how things might go is good. 

Meagan: Yeah. 

Kristen: Yeah. They ended up starting Pitocin and I was trying to go as natural as I could for as long as I could. I think I got to about 5 or 6 dilation and then I was like, Okay. I think I’m ready to just get a little relief. So yeah. I got an epidural. Again, then my brain switches over to how my induction births were different. 

With my son, I was cranking that thing up to 10 as high as it would go. It was my first time doing it. I didn’t know how it works. I ended up with him being flat on my back. I couldn’t feel my legs but with her, I was like, I don’t need to do that this time. So I was a lot more, that education. It helps having prior experience. But yes, it was as low as I could bear. I could still move around. I could sit up. I think I was even on my hands and knees for a little bit with it too. 

Meagan: Awesome. 

Kristen: Yeah. Having my doula there, she was wonderful helping. We were doing rebozo and stuff like that. Again, it was all of the good, natural stuff that I was looking forward to. 

Meagan: Yes. 

Kristen: Yeah, so I got myself to a 5 or a 6 and then I had a little help, but yeah it didn’t really take much longer after that. It’s hard to remember all of the details but once I got to a good place, they ended up breaking my water which was fine. After that, it only took a couple of hours to get her down and out. 

I pushed for 10 minutes and she’s here.

 

Meagan: Nice. 

Kristen: She’s our biggest one, 8 pounds, 14 ounces. Well within normal range. 

Meagan: Yes. 

Kristen: But still it’s just so funny how the nurses react, “Oh my gosh. She’s big.” Not really. For you, maybe. I don’t know. 

Meagan: I swear. Anytime the babies are over 7 pounds, they are like, “This baby is huge.” I’m like, “No, the baby is not that big. It’s perfect.” 

Kristen: Right? I know. She had a full head of hair. That was their biggest comment. “Look at all of that hair.” It was so funny. 

Meagan: I love that.

Kristen: But yeah, she was much more alert than my son was when he was born. Again, just different vibes, a different environment and a different style. 

Meagan: It probably wasn’t as long so he didn’t have as much in his system too. Yeah. 

Kristen: Exactly. Yeah, but it was one of those things where she came and then it was like, oh my gosh, that sense of relief. It went off without a hitch. In my mind, I was like, This was just perfect. 

29:29 Changing plans

Meagan: I love that you mentioned things along the way like change with induction. There are things within our labors and things that may not go exactly as we envisioned or wrote down on paper, but there are so often times where we can sit back and decide, Okay, yes. I’ll go for an induction. Okay, yes. Let’s try a Foley this time. Okay, I’ll actually go for that epidural. 

We’re changing plans or making decisions and in the end if we were part of that decision, it really resonates differently for our minds. We feel better about the experience even if it wasn’t exactly how we would have put it on paper. 

Kristen: Yeah, exactly. 

Meagan: I love hearing that you were like, Yes. This was a good experience and I got my doula and I had my provider and honestly, you were in a really great hospital. I really, really like them. 

30:37 Myths about doulas

Meagan: I wanted to share a little bit about doulas because obviously, I love them. 

Kristen: Sure, yes. 

Meagan: I am a doula and so maybe that is biased, but I really had a long labor myself and was able to truly benefit from doula support. Like you mentioned, my husband was exhausted and he got to a point where he was starving. He needed food and I remember he actually left the birth. He full-on left the birth to go get food. He felt very confident that I was in good hands and I was being supported. 

I love that so much, but there are a lot of things that people think about doulas that aren’t necessarily true. I wanted to go over some myths and then some really good pros and facts about doulas. 

Number one is that doulas are expensive. Now, doulas– 

Kristen: False. 

Meagan: It’s so funny because after services with our clients, a lot of the time they will be like, “You are worth your weight in gold. You need to charge more.” 

Kristen: Right. 

Meagan: When you see a doula who ranges from $800-$2000, that is a lot of money. That is a lot of money, but then when you break it down and look at really what a doula offers–

Kristen: Totally, from start to finish, correct me if I’m wrong, you can hire them as early as you want and then, especially for me, it was the postpartum support that was a really big deal so it’s not just, “Okay, I was here. I helped you while you had your baby. See ya. Good luck. Let me know if you need anything.” No, “I’m going to bring you supplies.” Of course, my doula is a little bit more special because she was one of my friends. 

Meagan: But she is amazing. 

Kristen: She is. She is wonderful. 

Meagan: Her natural ability to care and help you feel supported, she–

Kristen: Mhmm. She has this way of connecting with people that is quite rare, I think. 

Meagan: Yes. I love that. And myth number two is that doulas replace the birth partner. 

Kristen: Like we just both said, nope. They don’t. 

Meagan: I think that they help the birth partner. A lot of people don’t realize that doulas are there for our partners as well. It’s definitely more focused on mom because mom is giving birth, but there is a lot that partners go through during childbirth that really is important to be loved because you are in a very vulnerable state. You are watching someone who you love so much go through a very big event and they are also bringing another human into this world who is yours. 

There is a lot of fear and uncertainty and desire to help but again, uncertain as to how and needing rest and things like that. As doulas, we are never there to replace a birth partner ever unless that is something specifically where you are like, “Hey, my partner is not going to be here. I would like you to replace and be there in place of that.” 

But no, we definitely don’t do that. 

Myth number three, doulas are the same as midwives. Just before we started recording, I was telling Kristen how even to this day in 2024, people are like, “What do you do?” I’m like, “I’m a birth doula.” They’re like, “Oh you catch babies?” I’m like, “No. I don’t.” “Oh, you do this?” I’m like, “No, I don’t do any of that.”

We’re not midwives. We are doulas. We are there for loving, educational support and information and all of those things, but we are definitely not trained midwives. We work with midwives and OBs. 

Another one is that doulas are only for the mother which is kind of what I was just saying a second ago. No, we are not only there for the mother. 

Doulas are hippies who chant and sacrifice chickens during birth. 

Kristen: That is quite the specific myth. 

Meagan: That is very specific. This is something that was on our blog, but it was something that someone said and we are like, Oh, yeah. Okay. This is perfect. We are putting this as Myth #5. 

Kristen: That’s hilarious, yep. 

Meagan: But really, we are hippy. We are hippy. 

Kristen: That’s funny. 

Meagan: Okay, maybe. Maybe doulas are a little bit more natural-minded. That’s true, but just because someone wants an epidural or even a scheduled C-section or doesn’t want to go in and do weird sacrificing of chickens apparently, I don’t know, that doesn’t mean it’s true. We don’t. We are there to support you and we are going to be there in the way that you want us to be there. 

Doulas only support home or unmedicated births. This is a big myth. So many people when I start telling them about what I do, they are like, “Oh, so you just only do home births.” I’m like, “Actually, it’s a rarity. It’s more rare to do a home birth than a hospital.” I would say that 97% of our births are in-hospital. As far as medicated go, we don’t support them, that is B.S. Kristen, you are living proof that that is not true.

You guys, it is not for us to judge anybody on the way they birth. We are there to love and support them. If that means that they choose the epidural route, that means they choose the epidural route and that is great. We support them. 

So, no. If you are wanting to get an epidural and you don’t know if you want to hire a doula because you want an epidural, let me tell you. We as doulas do a lot actually with epidurals. Sometimes when there are epidurals at play, we actually have to work differently. It’s more in a different way because there is more to do as far as movement. You can’t just get up and move. 

Kristen: Yes, it’s true. 

Meagan: Right? Or being on hands and knees, you need that extra support. Whatever it may be, we are now restricted a little bit with movement so as doulas, we are going to be doing more with epidural. A lot of people think if I got an epidural, a doula is not worthless or it’s pointless. Go ahead. 

Kristen: Sorry to interrupt, but if I hadn’t have had my doula when I got my epidural, I probably wouldn’t have known if I could actually do certain positions. I was like, Oh, well I have this epidural so I’m not really supposed to move. No, actually you can do this. And laying down, due to my prior induction was like, I know it’s bad. Don’t lay on your back. She was like, “Well, actually if you sit yourself up just a little bit, you’re actually going to be just fine. This is actually okay. It’s like, “Okay. I’m so glad you are here. If you weren’t here, then maybe the nurse would have told me I’m okay or maybe she would have helped me. Nope, probably not. She’s got her own stuff that she’s doing.” 

Yeah, that was a really big deal for me too especially for a VBAC and an induction on top of each other. I’ve got so many things in my mind while you’re giving birth. I can get this baby out with no problems. I can do this. That’s where your focus is so having that doula say, “Hey, you know what? Change this a little bit,” and being there to support you in that way was awesome. 

Meagan: Absolutely. Absolutely. I love that you pointed that out. 

38:55 Facts about doulas

Meagan: Here are some facts. Doulas help you cut costs. There is a 39% decrease in the chance of having a Cesarean which is an increased cost a lot of the time. Some insurances are amazing, but there is that. There’s a 15% increase in the chance of having a spontaneous vaginal delivery which is non-induced. We know that induction is also an added expense. A 10% decrease in the need for any medication for pain relief, a 41-minute average reduction in the length of labor, a 38% decrease in a low 5-minute APGAR score, and a 31% increase in satisfaction for the overall birth experience. 

Holy cow. This is what a stat says on our blog. It says, “In the U.S., an epidural alone costs an average of $2,132.” Now, this was written back in 2021 and we know that since a lot of things in our lives have happened, things have increased. I would put money on that that is definitely more now for sure. 

There are a whole bunch of other facts on here. We’re not going to go over all of them, but I would encourage you to check out our blog. It’s going to be listed in the show notes. We’re also going to list in the show notes a couple of other groups especially if you are a special scar listener, we want you to know about an amazing group. 

Did you ever go to Special Scars, Special Hope? 

Kristen: I did not actually. 

Meagan: Okay, that is a Facebook group and honestly, it’s amazing for special scars. We’re going to link that. We’ll have a special scar blog so you can read more about special scars and their chances. Definitely check out the podcast even more for some more special scar episodes. If you are looking because you have a special scar, know that there are risks involved, but there are also very high chances that you can. You do need to find the support. 

Do you have any other tips, Kristen, that you would suggest for moms who may have special scars or gone through similar experiences like you where you were not even exactly sure what happened? 

41:05 Kristen’s advice to other women with special scars

Kristen: For me, it’s always come down to not just doing research by yourself, but take your time with everything. I think we get into this, I have to find this supportive provider right now and if it doesn’t work out the first time, then we get flustered and stressed about never being able to find the right person. If it didn’t work out the first time, then I’ll never be able to find it. 

I took my time and really tried to do my research honestly even before we got pregnant with our daughter who we had the successful VBAC with. 

As soon as I was mentally and emotionally ready to start thinking about having another baby, I was telling myself, I can do this. Granted, like I said before, no one is going to tell me no. That’s just my motivation. I know some people where that might be intimidating to think about. I just don’t know. That’s okay. Accept yourself where you are and go from there. If it’s something that you want to pursue, then do your research on providers and find women who have been there. I think that was a big deal for me knowing that, Oh, there are a pretty decent number of people who have had special scars like me. It’s not impossible to make it happen. 

Like we said about my particular provider, it’s almost like that cliche phrase, “When you know, you know.” 

Meagan: When you know, you know. 

Kristen: It’s like, Oh, I found my provider. That’s just how it was for me personally. I know it may not be like that for everybody, but yeah. You take your time. I’m sure you guys have had many, many episodes in the past where it’s like, I changed providers halfway through. It probably happens all of the time or more often than you think it does. Don’t be afraid to say, “You know what? I’m not feeling the support exactly how I want right now so it’s time to go a different route. Be confident in that. That’s it. 

43:26 Listening to your intuition when choosing a provider

Meagan: Absolutely. One of the things I want to talk about when you were saying that is even if you were with a provider that the world is saying they are supportive of VBAC– I want to take it personal and share my own experience. I was with probably the most supportive provider in Utah at the time and I felt very, very good but then there was something that was telling me I should switch. It seemed so weird. It seemed so weird, but I had to take the time to really ponder and listen to my intuition and I had to follow that. I couldn’t deny my intuition. 

I know Julie and I for years talked about it and I’m still talking about it today. Follow your intuition. Sometimes it might not make sense to someone else and that’s okay, but if it makes sense to you and it feels true to you, then follow it. Follow it and take your time like she said. 

Kristen: Totally, yep. That was a big deal and now that we found out that this is our fourth pregnancy now that I’m on right now. I’m pregnant right now expecting twin girls in August and who knows how this is going to go obviously, but I’m shooting for another VBAC. Here we go. 

Meagan: You’ve got this. 

Kristen: This is a very different scenario. 

Meagan: Very. 

Kristen: Every pregnancy is so different. They say that. You hear that all the time. “Every pregnancy is different. Every kid is different.” But I feel like seriously, okay. Everyone is so different. 

Meagan: You ring it real true. 

Kristen: So this is a totally new way to navigate this. From what I understand correctly, every birth after even if you have had a vaginal birth between like I did, I had a Cesarean and I had a VBAC, this is still considered a VBAC so this will still be considered a VBAC twin birth. Wish us luck and hopefully, I will have some updates later for you. I don’t know.

Meagan: Yes, please keep us posted and congratulations on the pregnancy and congratulations ahead of time on your birth. Yes, please keep us posted on how things go and thank you so much again for being here with us. 

Kristen: You’re so welcome. Thank you, Meagan. 

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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Julie Francom joins Meagan on the podcast to talk about checking the validity of the information you see surrounding VBAC. There is so much information out there and so much misinformation that we want to help you figure out what is actually evidence-based! 

Julie and Meagan draw on their personal experiences with making corrections to information they understood and have shared. They talk about how the structure, size, and date of a study can influence the statistics. Julie shares why Cochrane reviews are her favorite.

The VBAC Link is committed to helping you have the most evidence-based and truthful information as you make your birthing decisions. We promise to update you with all of the new information as we receive it!

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

03:30 Checking the validity of social media posts

08:01 Our corrected post about VBA2C

12:56 The production behind a statistic or article

18:37 Cochrane reviews

19:06 Checking the dates of studies and emailing us for verification

23:29 Nuchal cords

25:21 Julie’s sleep training story

29:45 Information at your fingertips

Meagan: Hey, hey everybody. Guess what? We have Julie today on the podcast. 

Julie: Hey. 

Meagan: Hey. We’re going to be doing a short but sweet, maybe also a little sassy because as Julie has said, she likes to get sassy these days. 

We’re going to do a short but sweet episode on how to tell if VBAC or HBAC or really just anything–

Julie: Any. 

Meagan: Yeah, any information you see online is real or fake. Now, if you’re following along on our social media, you likely have seen a lot of our myth and fact posts. I think we share them probably once a week honestly because there really are so many things out there that are myths and things that are facts, but on a whole other side and a whole addition to myth and fact is really what should we be believing? What should we be resharing? Right, Julie? I think that this definitely is something that is close to our hearts at least I’m going to say is close to my heart. I think it’s close to Julie’s heart. 

Julie: Oh, for sure. 

Meagan: We want to protect this community and we want this community to find the real information, and not the false information. We know. You can Google anything. 

Julie: So much false information. 

Meagan: You can Google anything and find the real and false information but when it comes to VBAC, like she said, so much false information. 

We’re not even going to do a Review of the Week. We are going to jump right in in just a second after the intro. 

03:30 Checking the validity of social media posts

Meagan: All right, Julie. Are you ready to get spicy?

Julie: Yeah, I think maybe the biggest reason we decided to do this episode and at least for me anyway why I brought it up is because there is so much information out there that looks good, right? You can be like, Oh my gosh, yes. This is amazing. We’re passionate. We as in me and Meagan, but we as in you too who is listening. Clearly, you’re passionate. 

But we really need to be careful what we’re sharing both from our business accounts and what we’re resharing from other people because sometimes if you share this information and it’s incorrect and wrong and it goes viral which there is a recent post that has and sparked this thing, and we’re not going to call anybody out, but when you share misinformation and it goes big and people start believing this incorrect information, it can really do damage to the efforts that we’re trying to make here which is increasing access to VBAC for everybody. 

If you have this entire group of people who think that their chances of having a VBAC at a hospital let’s say are 30% or something like that when really your chances of having a successful VBAC if you get to try– get to try I’m using very loosely– are really between 60-80%. Those are the numbers. 

But there was a post recently that went viral that said it was around 32% in the hospital and that is just simply not true. The post went viral and everybody is jumping on board like, Look how much better home birth is than hospital birth, but those statistics were very flawed from a flawed study that was super small from Germany 20 years ago. 

Meagan: Less than 2000 people. 

Julie: Yeah. Yeah. It could give you some pretty conclusive. Some, but it’s not big. It’s not a meta-analysis. It’s definitely not something to be definitive. It’s from Germany and there are a lot of flaws in the study as well. 

But everybody saw this thing, Oh, HBAC success is 87% and hospital VBAC success is 32%, or whatever the number was. People are like, Look how much better it is at home, and spreading this information which don’t get me wrong, having three HBACs myself, I love home birth. I love home birth after Cesarean for whoever feels it is appropriate for them, but I also know that those numbers are just wrong and if you share that information and these people believe it, they might be choosing HBAC out of fear. 

Meagan: Well, yeah. Absolutely. 

Julie: Instead of having the right information and making the right choice for them. I don’t know. That’s what we want to do here. We want to help you spot misinformation easier and learn to question the things that you see on the internet which sounds so silly. 

For me, I’m like, Okay. Let’s challenge everything. But I saw that post and my first thought was, Heck yeah. That’s crazy. I’m all for home birth but then I was like, Wait a minute. These numbers don’t feel right to me. 

Meagan: It doesn’t make sense. 

Julie: So then I dug a little bit deeper into it. We just want to equip you with knowledge so you are doing your best to get the most accurate information and spot the information that is not necessarily true. I think we are all guilty of it. I’m just going to keep talking, Meagan::. 

Meagan: I know. I was going to say really quickly. Just like what you said, you were like, Heck yeah, as someone who is passionate about birth or maybe someone who may have trauma. I’m talking about this specific post but really in any general post, someone who may have trauma surrounding the opposite of what that post is supporting, it’s so easy to just be like, Boom. Share. You know?

Julie: Yeah, you’d be like, Oh my gosh, yes. I love HBAC. Let’s share this. Let’s increase VBAC. Everyone needs to hear this. This is important information. We get excited, right? 

Meagan: Right, but we need to do exactly what Julie said and take a step back and I mean, this goes for anything. It might be sharing the correct age of a child being out of a car seat. I mean, just random and you’re like, Yeah, that looks good. Boom. Share. 

Make sure that you are sharing the right stuff. 

08:01 Our corrected post about VBA2C

Meagan: So let’s talk about this. Keep going, Julie. I know you were on a tangent going into it. Let’s talk about how to understand if it’s real. 

Julie: Well, first of all, I think before we do that, I want to admit that we have been guilty of sharing, I don’t want to say misinformation because I guess it kind of was. A few years ago, we misquoted an ACOG bulletin about VBAC. 

Meagan: Yeah. 

Julie: It was me. I did it. It was me. I’m the problem, Taylor Swift fans. 

What had happened was that ACOG, in their bulletin about VBAC after two C-sections, cited two studies. One study that they cite– first of all, they say that VBAC after two Cesareans is a safe and reasonable option for parents to attempt and the decision should be patient-based. Anyways, so they cite two studies. 

One study that they cited about VBAC after two Cesareans shows no increase in rupture rates with VBAC after two Cesareans compared to one. The second study that they cited showed risk of almost double the rupture rate for VBAC after two Cesareans compared to one. 

It’s really interesting because they cite these two studies that are equally credible that had drastically different results. So when I made the post, I paraphrased the bulletin that said something to the effect of, “VBAC after two Cesareans shows no increase of rupture risk.” 

Now, that was only really kind of half true because I saw the study and I was like, Oh my gosh, like Meagan:: said, This is exciting! Everyone needs to know this. 

I made the post then we started getting some kickback on it and so we looked again because I was like, Oh, well I will show you where in the ACOG bulletin it says this, and then I went and I was just like, Oh yeah, it doesn’t say exactly that. I unknowingly spread this misinformation so what we did is we updated the post and we posted an additional post that was a correction because here at The VBAC Link, we want to make sure we are giving you 100% accurate information all of the time. 

The reality is that we are humans. We are going to make mistakes sometimes but as soon as we realize that we make these mistakes as long as they are actual mistakes and not just people wanting to talk crap, we’re going to correct ourselves. That’s the biggest thing. 

I want to say that it’s okay to not be perfect all of the time, but I think it’s also important that when you realize you’ve made a mistake that you correct it in the same space that you made it. Anyway, I just wanted to say that. 

Meagan: Yes, not wanting to shame anyone for being excited and making these posts. 

Julie: You should be excited. We’re excited. 

Meagan: Yeah. We were really excited to even see that post earlier and then we had to take a step back. It’s not to even shame that person. They are probably really excited to share that information but again, as a poster, one, take a step back before you share, and two, take a step back before you post. 

If you post and there is question which unfortunately there were a lot of questions on this post, change it. It’s okay. It’s okay to be like, Oh, I actually misunderstood this. 

Julie: Update it. I didn’t see this. Yes. 

Meagan: Or, I didn’t realize this wasn’t as credible as it felt. 

Julie: Or seemed. Right. 

Meagan: One of the best ways to find out of the research or the study or what you are looking at is really, really credible is if it’s peer-reviewed honestly. Right? 

Julie: Right. I think before you even go into that is if you see data or information like this post shared and it doesn’t seem quite right or even if it does seem right and you don’t see a source cited, ask for a source. 

Meagan: Ask for it. 

Julie: Mhmm, especially if they are throwing out numbers like, Home birth has an 87% success rate for VBAC and hospital birth only has 32%, everybody wants to get on board with those numbers, but there were no studies posted. There was no anything so I actually went on and made a comment. I asked about it and she posted four different studies. I was like, Three of these studies aren’t even relevant at all and this one where you are getting numbers from is incredibly flawed. 

I think it’s really cool to get on board with something that shows these fancy numbers, but it’s really important to at least see a source cited I would say. Bare minimum, see a source. Ask for a source and then go through and verify the source. Meagan, yeah. Let’s talk about what makes a source credible. 

12:56 The production behind a statistic or article

Meagan: Yeah. 

Julie: These are just some things. Not all of these things are going to be true all of the time for a credible source, but these are things to look for and why they are important. Sorry, go ahead. 

Meagan: No, yeah. I think one is looking at who even produced it. Who produced this stat or this article or whatever? A lot of the time, someone who produced the article may not be the person who produces the stat or the evidence. That’s something to also keep in mind just because if Sally Jane at whatever company shared an article, it doesn’t mean that she’s not a credible person but I think sometimes when we are digging deep into what is credible and the real original source, it will take us to the original source which then we need to look at. 

ACOG, right? We pay attention to ACOG. Midwifery groups and things like this, we want to look. Who wrote it? 

I think one of the things is what is the full purpose? 

Julie: Yes. 

Meagan: One of those articles that I was reading actually wasn’t in relation to what the post was about. 

Julie: Exactly. 

Meagan: I don’t know if you saw that. 

Julie: Three of them. 

Meagan: The purpose of this article and the goal of why they are one writing it in general and what’s their ultimate goal in giving you the information. 

Julie: Right. 

Meagan: I mean, when I was reading one of them, I was like, Wait, what? 

Julie: And when she shared these four links and I called her out, I said, “These three are about this, that, and the other thing. They are not related to the other things that you posted,” she deleted all of the other information that she shared and just kept the one outdated German study up. I felt really salty then. I still feel a teeny bit salty about that. 

But yeah, I feel like asking the author and the poster. I know that at The VBAC Link, when I was there, I tried to really make sure that we did this and I feel like you still do but whenever we post anything with stats or numbers or anything like that, we try to post a source with that every time. 

Meagan: Yeah, for sure. Exactly. 

Julie: It’s in the course like that. Sorry. I feel like we are going in different directions there so circle back. 

Meagan: Yes. I think you really need to break it down and look at the ultimate study. If it is saying that you have a whatever success chance of having a VBAC in the hospital or having a VBAC in general and you’re looking at the stats, if you’re looking at a review that has 9,000 people and then there is another one that has 400,000 people involved in that study, to me, automatically I’m going to be looking at the difference there because to me, 9,000 is a lot but this one was less than 2,000 specifically. 

Julie: Right. 

Meagan: So when we’re looking at big studies, if you have a very small control group, it’s just not as credible as some other sources. 

Julie: Right. 

18:37 Cochrane reviews

Julie: What I really love is when I can find a Cochrane review of something. Cochrane reviews in my opinion is the most credible place because what Cochrane reviews are is they are a meta-analyses of a bunch of different studies. What they do is they find a whole bunch of different studies or research papers or evidence or just huge collections of data. They go through and pick them all apart and find out which ones are credible or which ones are not credible and then they compile the results in those studies to have a bigger meta-analysis which is a collection of a whole bunch of credible studies pulled apart and data presented. 

I love if I can find a solid Cochrane review because I know that is just about as credible as you can get. Also realize that most studies have flaws and limitations like Meagan:: was talking about. Who is behind the study? Who funded the study? Who contributed to the study? What were the study controls? How many variables were there? Because if you have a study with more than one variable, then your numbers are going to be skewed anyway because these different variables may influence each other. 

If you have, for example, the ARRIVE trial. The ARRIVE trial we know had flaws. I’m not going to go over all of them but they were funded by a doctor at a hospital whose goal was to show that induction provides the same or better outcomes than waiting for spontaneous labor. That was the intention of the study. When you go in trying to prove something, you’re already introducing bias into the study and you could bring protocols or procedures into the study that might not be realistic in the real world that could influence the results of the study which is one of the things that actually happened in the ARRIVE trial. 

A lot of studies I feel like could be picked apart and torn apart which is why I really love Cochrane reviews and meta-analyses is because you can compile all of these and get more accurate results and information. 

Also, here’s the thing with that study, that one study that she showed that had less than 2,000 people and is 20 years old and is based in Germany, that’s not going to be relevant in the current day in the United States. 

Meagan: That’s another thing that I wanted to bring up. 

19:06 Checking the dates of studies and emailing us for verification

Meagan: How long ago was the study? If the study was done in 1990 and we are now in 2024, there is a large chance that things have changed either way. Maybe in favor of that or the opposite. 

Julie: Right. 

Meagan: So we need to look also at the date. If you are looking at something and here at The VBAC Link, we know we have stuff that was even published in 2020 that there may be a new article out in 2022 or 2023 and we need to stay up to date on these things so it is so important to also look at that date because something 20 years ago or even 10 years ago, that might actually be the most recent study. 

Julie: Yeah, and if that is, that’s all you can use. 

Meagan: Right. Right. There’s that. But there may be a newer study. So again, before just clicking “share” or “create” or something like that, it just goes back to stepping back and looking at it. Let me tell you, Women of Strength, right now, if you find a study online and you are like, Wow. I am really, really curious about this post or about this study or whatever it may be, but you are unsure, email us at [email protected]. Email us. We will help you. We will help you make sure to break it down and tell you the efficacy. 

Julie: The corrected-ness. 

Meagan: How efficient and correct it is. 

Julie: I don’t think efficient is the correct word. Accurate. 

Meagan: Accuracy. 

Julie: Oh my gosh. You should listen to us. We know how to speak. 

Meagan: Email us, you guys. I don’t even know how to use my words but I can tell you how to break down a study. No, but really. Accuracy. That’s the right word. Thank goodness for Julie. 

Julie: I think that maybe a more appropriate thing for her to have said in that post would be like, “Your chances of having a VBAC are higher at home than in a hospital.” That is accurate, 100% because it is true. Out-of-hospital births, at least around here in Utah. I can’t speak to other parts of the country so maybe I should say that. Around here in Utah where we are, I can confidently say probably in other parts of the country too, when you have a skilled home birth midwife and you are a low-risk pregnancy and VBAC does not make you high-risk P.S., you have a much higher chance. 

Now, there are no studies done here in Utah, but we have seen a lot. I mean, there is this Canadian home birth study that was just done that took a look at VBAC as well that showed some similar things but we know that the American Pregnancy Association says that women who attempt a VBAC have between 60-80% chance of getting a VBAC. 

Now, around here, we in our birth centers and out-of-hospital births and home births see over 90% of that success rate in all of the midwives and stuff like that who we have seen and talked to who have shared their data with us. That is good data. 

Meagan: It is pretty high here. We are lucky here. I have only seen out of 10 years of doing births two VBAC transfers and actually, the one was because she really just wanted an epidural. That’s the only reason why she left and the second one was because we did have quite a stall. I think it all was a mental thing. I think she actually needed to be at the hospital and then they still had VBACs so that’s great. 

Julie: For sure. I’ve seen one transfer, but that cord was wrapped around that baby’s neck four times and they had to cut the cord before they took the baby out via Cesarean. 

Meagan: Whoa. 

23:29 Nuchal cords

Julie: Nuchal cord, a cord wrapped around the neck most of the time is not a need for a Cesarean, but this mom pushed and pushed and pushed at home for hours. We transferred and got her an epidural. Baby’s heart rate started to not do good. They took her back for a C-section. The cord was wrapped around its neck four times and they couldn’t even take the baby out because it was wrapped so tightly. They had to cut the cord in four places before they could pull the baby out by C-section. 

Meagan: Wow, wow. 

Julie: Wild, right? That was an absolutely necessary Cesarean. That baby was not coming out. Absolutely necessary. And things like that are going to happen and it’s cases like that where we are so grateful for C-sections. This is one of those things where if it had been 300 years ago, mom and baby probably would have died because that baby was so wound up in there. This was one of those true cases. Most of the time when people say that, it’s not true in my opinion. Don’t cite me. 

Meagan: Okay, well the true takeaway from today’s episode is to check your facts and if you see something that doesn’t feel right, check it again but don’t just share it and ask for the source if there’s not a source. Check if it’s peer-reviewed. Check if it’s a Cochrane review and all of these things. Again, check the date. Check the amount of people who were in it. Really do your research and if you do have a question, please do not hesitate to email us at [email protected]. We’d be glad to help you decipher if that is a good and factual or not-so-factual article or stat or whatever it may be. 

Julie: Whatever it may be. 

25:21 Julie’s sleep training story

Julie: Do you know what is funny? Let me throw out another example really fast and then we will wrap this thing up. Years and years and years ago, nine years ago– my first VBAC baby just turned 9. After he was born, oh my gosh. All the things. I had all of the mental health things. One of my biggest things was that I thought, this is probably going to be a little controversial. I thought that in order to be a good mom, I had a checklist because I wasn’t going to have a NICU baby. I wasn’t going to have the same situation. I thought it had to be completely different. 

I had to breastfeed. I had to go and get him every single time he cried right away instantly and drop everything. I thought I had to do all of these X, Y, and Z things. What is that method called? It starts with a W I think. Anyway, it’s kind of a modified version of crying it out. You let them cry for a minute and then two minutes or whatever. It worked really well and he is still my best sleeper to be honest. 

I thought, Oh my gosh. I am so bad. I can’t believe I damaged my child. Yada, yada, yada and there are probably people listening right now who are like, Well, you did damage your child by doing that. But anyway, he’s damaged for other reasons but not that one. 

So with my second, I wasn’t going to do it because there was a study that showed that babies who were left alone to cry it out had the stress part of their brain remain activated up to an hour after they stopped crying and all of these things. I was like, Oh my gosh, I can’t believe I did that. I’m the most horrible mom ever.

Clearly, I think differently now, but I paid a postpartum doula to come in and help me learn how to gently encourage them to sleep. Well, it turned out my stinking baby would cry in his sleep. He would cry while he was sleeping. 

Meagan: Oh, no way. 

Julie: I would go in there and I would be like, Oh, super mom to the rescue. I would pick him up and wake my baby up who proceeded to cry for two hours because he couldn’t go back to sleep because I was waking him up. Anyway, it was this whole thing. I know, stupid right? Every baby is different. 

But my point is that this study which everybody was sharing about the damages of crying it out and how we are damaging our children and they are going to grow up to be people who feel unloved– that was the thing. Do you remember that? Do you remember that? It was 9 years ago or so, maybe a little bit more recently than that. 

The study had four babies in it. Four, Meagan::. Four babies. 

Meagan: Four? 

Julie: Four. And these babies were in a hospital environment in those little plastic bassinets so not only were there only four babies, but they were monitoring them in an environment that is unfamiliar and not letting their caretaker come in and soothe them at any time during this study. 

Meagan: What? 

Julie: Yes. Don’t let your baby cry until they throw up for sure. Go and soothe your baby, but four babies in an unfamiliar environment without their caretaker there at any part of it. 

Meagan: Wow. That was enough to say that that was– 

Julie: Yes. This is where all of these advocates for not letting your baby cry at all got their information from. Isn’t that ludicrous? That is insane, right? 

Meagan: That is insane. That just means that we need to take a steb back, look at what we are sharing, don’t just share it, and always look at the study. Always, always, always look at the study. 

Julie: Absolutely. And look at the damage that did to my mental health and not only me, everybody else’s. I know I’m not the only one. 

So seriously, dig in deep and trust your intuition and follow your instincts. You know what’s right. Going on the tangent for your baby, but also if you see something that feels a little strange or is showing numbers without information, ask for evidence. Ask for proof. Where did you get that information from? 

29:45 Information at your fingertips

Julie: Because we have, I will say this and then we will close it up. I promise. I hate it when people say, “Oh, don’t confuse your Google search for my medical degree.” Well, that’s B.S. because do you know how many times I’ve seen doctors Google something while I’ve been in their office? Yeah, for real. First of all, not saying that a Google search is the equivalent of a medical degree at all. I know way more goes into that. 

But, we have access to the largest database of information that was ever existed in the entire history of humanity. We have access to Google. There’s Google. There’s Google Scholar and if you know how to distinguish between credible versus non-credible information, there is so much power in a Google search that you can use to help you in anything you need to know. Anything in the entire world. 

Should you have a doctor? Sure. You absolutely should. But also, you know yourself and you have access to all of this information and it’s a very powerful tool that we have and we should be really grateful for it because we don’t have to rely 100% on other people with a different knowledge than us anymore. So don’t discount that. Don’t discount your ability to find out if something is credible or not because you have access to that power at your fingertips. It’s pretty freaking amazing. Okay, done.

Meagan: It is. Okay, done. All right, Women of Strength. We are going to let you go. We said it was going to be a quick one. It really was and hopefully, you got some information and will feel more confident in going out and looking at all of the many things that it said about VBAC. 

I honestly think that is another reason why we created our course, Julie, because we were so easily able to find so many things that were false out on the internet and we wanted to make sure that all of the real, credible sources were in one place. 

So find those places, you guys. Check out our blog. Check out the podcast. We have lots of links. Check out our course. So many amazing things. So many great stats. 

And hey, if you find a stat and find something within our blog and you are like, Oh my gosh, I’ve seen something new, let us know for sure. We want to make sure that the most up-to-date information is out there. So we do not hesitate to take any suggestions. If you see something, question us for sure. Please, please, please because like Julie said earlier, sometimes people misunderstand or misword or whatever and we want to give them credit but we really want to make sure that the right information is given to you. 

Julie: Absolutely. 

Meagan: Without further ado, I’m going to say goodbye and I love you. Bye. 

Julie: Without further ado, we will say adieu. 

Meagan: We will say goodbye. 

Julie: Bye. 

Closing

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

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“I did it. They said I couldn’t, but I did it.”

When planning for her VBA3C, Shannon got just about as much kickback as someone can get. She was ambushed. She was coerced. She was given the scariest information. 

Shannon joins us from England today and talks about how each of her four births brought her to where she is today. By the time she was pregnant with her fourth, she was ready to advocate. She was ready to fight for something she had never gotten to experience. 

Though none of her providers were supportive, Shannon stayed grounded. She made her desires known and stood by them. 

Shannon labored unmedicated for just over 14 hours. Then to everyone’s surprise, she pushed her fourth baby girl out vaginally in 14 minutes!

The VBAC Link Blog: Is VBA3C Right for You?

The VBAC Link Blog: VBAMC

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

04:04 First pregnancy and birth

08:31 Second pregnancy and scheduled repeat Cesarean

10:56 Third pregnancy

14:04 A heartbreaking third Cesarean

17:42 Postpartum during COVID

19:55 Fourth pregnancy

24:37 Getting ambushed

28:40 Shannon’s VBA3C birth

36:32 “We are all so proud.”

38:30 VBAC after three Cesareans

Meagan: Hello, hello. You are listening to The VBAC Link. We have our friend, Shannon. Are you from England? Where are you?

Shannon: England, yeah. New Cambridge. 

Meagan: Okay, see? I’m so glad my mind is remembering. You are in England and you guys, she is recording. It is quite late there. She is such a gem to stay up and record and share her VBAC after three C-sections. 

Shannon: Three. 

Meagan: Yes. Her fourth was a vaginal birth. Uno, dos, tres. I can’t even say. I can’t even pretend that I know Spanish. Let’s be honest. So three, you guys. After three Cesareans and we know in our community that this is definitely something that people want to hear. People want to hear these stories because it is harder to find the support. They want to hear what people are doing, how they are navigating through, where they are finding support, and what they are doing to have their vaginal birth after multiple Cesareans. 

We are excited, Shannon, for you to share your stories today. 

01:07 Review of the Week

Meagan: We do have a Review of the Week so we’re going to get into that and then we’ll dive right in. Okay, so this is from morgane and it says, “I’m Not Alone.” I love that title because Women of Strength, you are not alone. This community is so incredible and we’re all here for you. It says, “This podcast has provided so much comfort for me in coping with my unplanned Cesarean and now planning for VBAC in March. The transition to motherhood has been somewhat lonely for me since most of my friends are not mothers and hello? Pandemic.” So this is a little bit ago, right? 

It says, “I am also an aspiring doula and spurred on by these ladies and their work. So thankful I stumbled across this group.” 

Oh my gosh. It says, “Us women really are strong.” I love that. Us women really are strong. I could not agree more. You guys, you are strong. You are capable and you have options. If that is not anything and everything that we talk about on this podcast, then I’m doing it wrong and you need to let me know on your next review. 

As just a constant reminder, if you wouldn’t mind leaving us a review, that would be so great. You can leave it on Apple Podcasts, Google, or you can even email us. 

04:04 First pregnancy and birth

Meagan: Okay, Shannon. Uno, dos, tres– three. I’m saying it correctly now. After three Cesareans, you have had quite the different journey with each birth. 

Shannon: Yeah. I think each one taught me a little bit more and I probably wasn’t ready for a vaginal birth with my first three. I think that while looking back on my journey it’s difficult, I think it led me to where I am today. 

Meagan: Me too. I’m right there. Amen. Same. I love birth and I’ve always loved birth, but I do not think that I would be here right now with you today if it weren’t for my experiences. 

Shannon: Yeah. I think the same. I’ll get into where I am now when we’re after my fourth, but had it not happened the way it did, I wouldn’t be where I am now. 

Meagan: Who you are today. We grow and we learn and we inspire and here you are sharing your story. So let’s talk about baby numer one.

Shannon: Okay, so I was 19 when I had him. I just assumed that he was going to come out that way, that he was going to come out vaginally. It was going to go well. There were going to be no complications and it didn’t turn out like that. I was due in the end of May and I think I was about a week over due. I went into the day unit here. It would be just where you would go if you had concerns that were slightly more than you would go to your midwife for but not enough that you would need to go to the labor ward for. 

Meagan: Kind of in between? 

Shannon: Yeah. Here, you have a midwife who is assigned to your GP surgery, your doctors, and they are usually who you see throughout. It’s supposed to be a continous midwife, but it can chop and change. You don’t see that midwife usually in the hospital so you deliver with someone completely different. 

Meagan: Oh, okay. 

Shannon: Yeah, so you don’t get that continuity of care in labor. So I went to the day unit because I was having some hip pain. It was really difficult to walk and because I was overdue and I was already booked in for an induction purely because I was overdue, they brought my induction forward. I think I was 8 days overdue when I went in. I was induced. I had the pessary induction and it worked pretty quickly. It worked within about an hour, an hour and a half. 

Meagan: Oh wow. 

Shannon: They didn’t believe me. They told me that it couldn’t happen that quickly. 

Meagan: That’s not super normal but it can happen. 

Shannon: They sent my husband home and left me on my own for three hours before they summoned me. I was 5 centimeters which is when they take you over to labor ward. I was wheeled over. I called my mum and my husband. 

Then it’s kind of a bit fuzzy. I don’t remember a lot from his birth. I remember that they broke my waters and there was meconium. They put the monitoring clip on his head. 

Meagan: The FSC, the fetal scalp electrode? 

Shannon: Yes. They put that on him and I was managing fine on the gas and air. 

Meagan: Was it nitrious? 

Shannon: Yes, yeah. 

Meagan: Okay. 

Shannon: Yes, the gas and air. It was about 3:00 in the morning and they told me that the anesthetist was going home and if I wanted an epidural then that was my last chance. I felt pressured so I got the epidural. All stalled from there. I didn’t move off the bed. I think I got to 10 centimeters at 10:00 the next morning so I’m now 9 days overdue. 

I pushed. Nothing happened. They wheeled me to theatre. I think I started pushing at 11:00 and he was born at half 12:00 so lunchtime. He was a big baby. He was 9 pounds, 13. 

Meagan: Okay. 

08:31 Second pregnancy and scheduled repeat Cesarean

Shannon: That was that. I recovered and didn’t think anything of it. 18 months later, we decided to have our second. I fell pregnant I think within the first month. It happened quite quickly. I did my research. I wanted a VBAC. I actually got signed off for an HBAC.

Meagan: Home birth? 

Shannon: Yep. It was all going fine. Then I got to 32 weeks and I panicked because my mom is our only childcare and she lives about an hour. I didn’t know how quickly I would labor because I had never labored spontaneously. I didn’t know what was going to happen. So I booked a routine section. That was booked for 39 weeks. 

At 38 weeks and 3 days, I went into again, the day unit because I had reduced movements. They put me on the monitors and his heart rate was quite erratic. It wasn’t settling. It was either quite high or quite low. There was no middle ground. I think they put me on there for about 4 hours and they just weren’t happy so they brought my section forward to the next day. 

Meagan: When I read your note, I’m like, I don’t know why, but that got me. If baby’s heart rate is that erratic and they are that concerned, it would be that day and then. 

Shannon: Yep, but they were happy for me to go home and come back the next day. 

Meagan: Yeah. Yeah. It’s just convenience. It seems, I am not going to say, but it seems like it was more of like, Well, it’s already going to happen so we will make it for tomorrow. We’ll give you this as a good reason why to validate it. 

Shannon: Yeah, no I agree now. At the time, I don’t think I thought about it like that. 

Meagan: Of course not, no. 

Shannon: Yeah, because with my fourth, with my VBAC, I went through a lot of what happened before. I definitely think it was a case of they didn’t want me to come back with more reduced movements and just sit there so because the section was going to happen anyway, they just thought– 

Meagan: Mhmm, let’s do it. Let’s move it up. 

Shannon: Yes. He was born at 38 and 4. He was 10 days early and he weighed 8 pounds, 11 ounces. Again, he was quite a good size. 

Meagan: At 38 weeks, yeah. 

10:56 Third pregnancy

Shannon: So then we decided to have a third. It took us a long time to get pregnant with her. It took us 14 months which was our longest conception. Our first one was four months and then a month so it took a while. She was due the 11th of April, 2020. I got to, I think it was about 30 weeks when talk of the pandemic was rolling in. 

We were like, Oh, it’s fine. We don’t need to worry about it. And then it all blew up. I had to go to midwife appointments alone, the hospital scans alone because I had to have growth scans because my babies are big. 

Everything was fine. I did want a home birth again with her, but they kept me waiting. I wasn’t signed off until 37 weeks. They kept me waiting a long time to sign me off for that, but it was all signed off and we were good to go. I was feeling good despite the pandemic because we were in lockdown by the time she was due. I think the lockdown was called a month before she was born. Lockdown here for the first time was called on the 23rd of March and she was born on the 23rd of April. 

I remember I went into hospital and I had a growth scan at 40 weeks. She was absolutely fine, no issues. She was measuring fine. The water levels were fine. The placenta looked good. They gave me a sweep and sent me on my way and said, “I don’t think I’ll see you next week. You’ll have this baby by the weekend.” It didn’t happen. 

I got to 41 weeks and I went back for another routine growth scan. I remember going in the car on my own obviously and I felt good. I thought that they were going to say that everything was fine again and that they were quite happy for me to just carry on. It didn’t go like that. I should probably mention that my hospital’s policy is that if you haven’t had your baby by 41 and 4, so 41 weeks and 4 days, they either induce you or they give you a section. That’s their policy. 

I had this growth scan at 41+3. I went in, had this growth scan, and I was on my own. I didn’t have any support. It was about 3:00 in the afternoon. She scanned me. In a week, my placenta had aged. It calcified and it was failing. Those were the reasons she gave me that she needed to get my baby out the next day. She gave me the pre-op swabs. She took my blood and she basically told me to come back the next day at 11:00. 

I had no time to prepare. I had no time to research. I had no time to ask questions. It was, “This is what’s happening. You’re going to do it.” 

Meagan: See you tomorrow. 

Shannon: Yep, basically. 

Meagan: Was baby’s heart rate struggling? 

Shannon: No, she was fine. 

Meagan: She was fine. 

Shannon: She was fine. There was no reason at all. 

Meagan: That’s interesting. Okay. 

14:04 A heartbreaking third Cesarean

Shannon: Then it was a mad dash too because I am the only driver in my house. My husband doesn’t drive. Obviously, having a section means we can’t go anywhere. 

Meagan: Yeah, and during the pandemic on top of all of it. 

Shannon: Yeah. It was a mad dash that night to get enough food in. House deliveries were like unicorn dust so to get enough food in, I had to arrange childcare with my mom. Otherwise, I was delivering alone. Again, she still lives an hour away in a different county. We were sure what the rules were because here, you weren’t allowed to cross county lines. 

Meagan: Oh no way. 

Shannon: Yep. It was difficult. She did come up and she did look after the boys. I did see her before I went into delivery, but I didn’t see her again until baby was 6 weeks old. She had gone home by the time I came home so that was difficult. 

I went in. I think I got to the hospital at 11:00. I was pulled down to theatre at 2:00 and baby was born at 3 minutes past 3:00 in the afternoon. She weighed 9 pounds, 4 ounces, so again, she was a good size. 

I got back to the recovery ward. My husband stayed with us for an hour and then he left. He wasn’t allowed to come back. I still had my catheter in. I was still numb. My phone was dead and I was just left because I couldn’t get anything. Every time you had to call a midwife in, they had to put in new PPE on and it just took so much longer. 

I didn’t get wheeled around to the actual recovery ward until about 1:00 in the morning. They admitted to me that they had forgotten about me. I was just in this room on my own. 

Meagan: I’m so sorry. 

Shannon: Yeah. They wheeled me into recovery. I still had the catheter in. That didn’t come out until 7:00 the next morning so I was bed-bound with this new baby. They came around and took my observations. My temperature was raised which is normal after a section, but I was told that I might have COVID, that my baby might have COVID. I would need to be separated from my baby and we wouldn’t be able to leave the hospital for 3 days. 

Meagan: Stop it. 

Shannon: No, honestly. 

Meagan: I am feeling very frustrated for you right now and very saddened. Yeah. I feel a little enraged because this shouldn’t have happened. These things didn’t need to happen to people. 

Shannon: I know and the more that I talk to other people who have had babies during the pandemic, it’s not unusual either. 

Meagan: No, it’s not. It’s maddening. 

Shannon: It is. It’s strange now to talk about it without either filling up or actually crying because it has taken me a long time to get to this point. 

Meagan: To process. 

Shannon: Yeah. She said she would come back in an hour. I remember, obviously, I had my catheter in so I didn’t have to get up and go to the toilet. I was just downing water trying to get my temperature down. 

She came back at 4:00 and I did get my temperature down because I didn’t have COVID. 

It was a strange experience. There were six beds in this ward, but I was on the end bed and there was a woman diagonally to me and there was a woman two beds over and that was it. There was no one else there. It was eerie. It got to the point where I couldn’t do it anymore so 26 hours after my baby was born, I discharged myself and I went home. I was not staying in there any longer. 

17:42 Postpartum during COVID

Shannon: Even after that, I got home and I spent the first week in tears. Motherhood wasn’t new to me. She was my third baby, but giving birth during a pandemic was a completely different experience. I don’t know what it’s like over there, but here you have a midwife check in at day 3 and day 5 and then you get signed off at day 10 by the midwife then you get sent to a health visitor who then looks after you until your baby is about 5 then they go to school. 

Meagan: Wow, I like that. We do not have that. We are just told, “We’ll see you in 6-8 weeks. See ya.” 

Shannon: Oh. 

Meagan: Then you just go home. Yeah. It’s very different for a lot of home-birth people, but that’s how the hospital is. It’s like, “We’ll see you in 6-8 weeks and we’ll see you then.” That’s really it. 

Shannon: That’s interesting. I didn’t know that. 

Meagan: Yeah. It’s not great. 

Shannon: No. So on day 3 and day 5, I had to go to a clinic. They usually go to your house especially if you’ve had a section, but because of the pandemic, I had to go there, and being the only driver– my husband can drive. 

Meagan: You can’t even drive after a section, really. 

Shannon: My husband can drive but we had to stick the old plates on. We made it there but it wasn’t great. 

Yeah, we did that. We do have a 6-week check. It’s with a doctor. That was over the phone and then you get introduced to your health visitor. Normally, they come over to your house. That was on the phone. 

And then that was it. We were just left. No one met her until she was 6 weeks old. She was the first granddaughter because I’m the oldest and my husband is an only child. She was the first granddaughter after two boys. No one met her until she was 6 weeks old. I spent the first week in tears trying to process everything that happened. It was a difficult time. 

After that, we said we didn’t want another one so we locked it away somewhere and didn’t deal with it. 

19:55 Fourth pregnancy

Shannon: And then we decided to have a fourth. I had to come to terms with it. 

This is the reason why I’m here now. I found out I was pregnant in October 2022. It was a difficult journey to get my VBAC. It was the biggest fight that I’ve ever had to do. When you find out you’re pregnant, you contact your GP surgery and then you are assigned a midwife. 

The midwife I had this time was the same one I had with my third pregnancy, but the first appointment, she was actually off so I saw someone completely different and she was horrible. 

I only live 9 minutes from the hospital. 

Meagan: That’s really close. 

Shannon: Well, I know from listening to your podcast that women travel for hours. 

Meagan: Way far, yeah. Like to other countries sometimes even. 

Shannon: Yep, but 9 minutes was too far for them. She said that 9 minutes was too far. The paramedics might not get to me in time. If I bleed out, I’m going to die. If baby gets stuck, I’m going to die. I’m putting my birth experience over a live baby.

Obviously, they know I care about the safety of my baby but that’s obviously their job. I left that appointment in tears. It was a great start. It didn’t improve from there, really. 

I think spent the next, I think your booking-in appointment is about 8-10 weeks so I then spent the next 30 weeks listening to your podcast, and researching stats, risks, benefits, and percentages. I lived, breathed, and slept statistics for VBACs because she probably 99% is our last baby. We’ve now got two of each so we don’t need any more. 

I knew that this was my last chance to get the birth that I wanted. Off the back of my booking-in appointment, they referred me to the consulting midwife at the hospital. She is higher up than a community midwife or just a midwife on the ward but not quite the head of midwifery. She’s kind of somewhere in the middle. I had a few appointments with her and while it was beneficial, it still felt like I was banging my head against a brick wall because she wasn’t listening to what I wanted. 

Every time I would come back with a statistic or a risk that she had– like if I corrected her, then I’d just get a “Mhmm, yeah. Okay,” or a patronizing nod. 

Meagan: Like, Yeah, sure. You think you know what you’re talking about but you don’t. 

Shannon: Yeah, kind of. At this point, I was 28, a mother of three and I was about to have my fourth. They were treating me like a child or that’s what it felt like anyway. 

So I went to every appointment knowing that’s what I wanted. I read off my stats, my risks, my percentages and told them I wanted a home birth. They again weren’t for it. They tried everything they could to get me into the hospital. 

We have a midwife-led unit and we have the labor ward. The labor ward is more for ordinary births like if you are going for the epidural and you want the more hospitalized birth whereas the midwife-led unit is more of a hands-off. That’s usually where the birth pool is. 

Meagan: If you want more of a medicated versus unmedicated, those are the differences here. 

Shannon: As a VBAC after three sections, normally there would be no way on earth that they would have signed me off for the midwife-led unit. I was too high risk. However, to get me into the hospital, they signed me off for the midwife-led unit. 

Meagan: Nuh-uh. 

Shannon: Yeah. That’s the option they gave me because I was close enough if there was an emergency, but I wasn’t too far away. That was their trump card. 

Meagan: Okay, okay. 

24:37 Getting ambushed

Shannon: I still said no. I still wanted a home birth because that hospital was the one I had my daughter at during the pandemic and I did not trust any of them after being lied to by the consultant and coerced into having that third section. I just didn’t trust them to do what I wanted. 

Meagan: Yeah. It makes sense. 

Shannon: Pardon? 

Meagan: I said it makes sense that you didn’t feel that they were completely trustworthy. 

Shannon: So then I got to 36 weeks and I had a routine midwife appointment at 36 weeks. I walked into the room and my midwife was there but so was the head of community midwifery. I wasn’t told she was going to be there. I was ambushed. 

She basically said to me that– I have it written down because I made a post at the time. She said that basically, my baby would die if I carried on with my plans to home birth, that there was a risk of shoulder dystocia, and hemorrhage that would both result in death. A delay in the paramedics getting to me so that would be death. I didn’t want a cannula inserted as a routine at the hospital so that would be a risk factor. I have a high BMI so again, that goes against me and they said I had low iron because I was refusing blood tests so that again was something that went against me. 

I was told that if I hemorrhaged and lost around two pints of blood that I would die, that my veins would have shrunk so they wouldn’t be able to get a cannula in me. I was told that they wanted to send three midwives to my birth. They normally send two but for some reason, they wanted three. 

I was told that my previous experience should be put to one side because it happened during COVID and it’s not representative of how it is now. I was told that I was making the entire midwifery twitchy. 

Meagan: Oh my. 

Shannon: Oh, the midwife I saw at the first appointment, the one who made me cry, she was one of the ones who was on call and they told me if she was on call, would I go to hospital and I said, “Maybe.” In my mind, I’m thinking that they were trying to put her on rotation to get me into hospital. 

Meagan: Sneaky. 

Shannon: Yep. I was told that the head of community midwifery’s responsibility is to make sure I’m comfortable with the risks but it’s also her responsibility to make sure her midwifery team isn’t traumatized by my birth. I was also told– oh, they wanted my husband to be at the home birth assessment as it’s their responsibility to make sure he is aware of the risks of death so he is not traumatized like I hadn’t spoken to him about any of this. 

Meagan: Oh my gosh. Oh my gosh. 

Shannon: On my way out of that appointment, my midwife, the one who had supported me as best as she could said to me that she can’t wait until I give birth so that it’s all over. 

Thank you. 

Meagan: Oh my gosh. 

Shannon: Yeah. So that was that. 

Meagan: Wow. What a way to feel loved. 

Shannon: I know. Again, I had to go to these appointments alone because my husband was home with the three kids, and my mom, again, lives an hour away. I don’t have the support here so I had to go to these appointments on my own and to be faced with two midwives who are just coming at you with these scary statistics, it felt like I was ambushed.

I think I sent an email then and complained. I got this really lengthy email back but it was basically filler but it had happened already. 

28:40 Shannon’s VBA3C birth

Shannon: Yes. So, my birth. She was due on the 1st of July but I always thought she would be due somewhere between the 25th of June and the 28th of June. I remember the 27th of June, I needed to go and get new brake pads and discs put on my car. It was the last thing I needed to do. I sat in the mechanic’s feeling a little bit uncomfortable and a lot of pressure. I think I was about 39+3 at that point. 

I was just really uncomfortable. I sat there for about two hours and I was just like, Ugh, why is this taking so long? 

Meagan: You were ready to move on. 

Shannon: Yeah. The next day, my husband went into the office and I remember messaging him, I think you should have stayed at home today. Something just doesn’t feel right. I feel a bit off.

I woke up on the morning of the 29th of June and I had hip and leg pain which isn’t unusual for me. I’ve got hyper-mobility syndrome so my joints are extra bendy anyway so to wake up with pain is quite normal, especially in pregnancy. 

It was half-7:00 in the morning and my husband thought it would be a really good idea to cut his hair for him. It’s half-7:00 in the morning. I’m nearly 40 weeks pregnant and I was doing his hair. Then I felt a twinge. I was like, I don’t recognize that pain. I’ll keep an eye on it. 

They turned into contractions. I had my first contraction at half-7:00 in the morning and they got stronger. I said to my husband, “I think you need to sign off now. This is it. It’s happening. I’m going for a bath to see if they go away or if they stay.” 

We had a food delivery come in that day. We had an Amazon delivery come in and we had I think the carseat base was coming in as well that day. So in between my contractions, I was having to go to the door a deal with all of this stuff that was going on around me. 

The contractions stayed and they didn’t peter off. They just stayed. At this point, I was on all fours in the living room mooing like a cow which is bizarre because, with my first one who was my only experience of labor, my mum said that I was eerily quiet. It was different to make noise this time. 

My husband rang my mom and let her know what was happening and then he rang the hospital. They told me that the home birth service wasn’t available that day so I’d have to come into hospital. It was only after he told them my name that that happened. 

We’ll leave that just hanging there. 

Meagan: Yeah. 

Shannon: Then I burst into tears because I thought that as soon as I go into hospital, that’s it. I’m not going to get my vaginal birth. They’re going to find some reason to section me and that’s it. 

My mom came and drove us to the hospital. She was staying with the kids anyway. I think I got to the hospital at about 3:00 in the afternoon. They examined me and I was 4 centimeters so I was allowed to stay. 

They took me into the room and I stayed there until I had my baby. I just labored. I don’t remember a lot of it to be honest. When they say you go to another place, you go to another place. 

Meagan: You do. 

Shannon: The gas and air were amazing. I did try the birth pool but we had an issue here where they had to have air vents fitted in the rooms with the gas and air and they weren’t done in the birth pool. I was in the birth pool for about an hour, but I wasn’t allowed the gas and air. 

The pool was all right, but the gas and air were helping me more. 

I went back into the room with the bed and even though I said to my husband, “I don’t want to be on my back,” I was on my back for most of the time. That’s where I was comfortable. 

When I was in the pool, I said no to the continuous monitoring. I just wanted intermittent with the monitor. We didn’t know what she was. At this point, we had no idea what she was but they couldn’t find her with the Doppler. They asked me to get out of the pool and put me on the bed and they were going to scan to see where she was. 

I couldn’t roll onto my back at this point. I was on my side and I couldn’t roll on my back to get them to scan me to see where she was. Then I opened my eyes and the consultant that had lied and coerced me into my third section was in the room and I specifically said I don’t want to see her. 

She was standing at the end of the bed and she said to me, “How long are you going to push for?” I said, “As long as I need to. As long as me and my baby are safe,” and she left. That was the end of it. I didn’t see her again. 

Meagan: Oh my gosh. 

Shannon: Yeah. That was that. They managed to scan me and they found her. She was just really low. That’s the only reason they couldn’t find her. She was fine. She was happy. 

It went on again for about another couple of hours of moving from all fours on the bed to my back and I remember sitting up on my knees upright and I felt something go. I was like, “Okay, I think my waters have gone.” They had a look and they had gone on their own. I didn’t have to have them pop like last time. There was no meconium. It was all good.

I remember spacing out for a while going to that other place. I came to and it was burning. That ring of fire is real. It was real. I said, “Okay, it really stings. Something has changed.” The midwife lifted up the sheet and she said, “Oh, there is the head. Quick!” They had to scramble to get everything they needed. 

My husband was texting my mum so I got all the time stamps. They saw her head at 3 minutes past 10:00 at night and she was born at 14 minutes past 10:00. She slid out and we found out she was a girl which my husband told me which was what I wanted. 

I remember saying, “I did it. They said I couldn’t, but I did it.” They wanted to get her a yellow hat because we didn’t know what she was but because she came out so quickly, they only had a blue one so she’s got a little blue hat and yeah, she was here. It was amazing. 

I did have two second-degree tears. They did only repair one and I wish they had repaired both because going for a wee afterward with the open one was hell. 

Meagan: Yes, not fun. 

Shannon: But I would take that over a section recovery any day. I was going to the park with the kids 3 days post-birth. I was walking around the house. I was able to go up the stairs. It was amazing. 

Yeah, I did it. They told me I couldn’t and that I would die or she would die. 

Meagan: They really put up a fight and tried so hard. Let me tell you too, I don’t know the right word but to stand up to that type of pressure, oh my goodness. That is hard. That is very, very hard. The fact that you did and it’s not like it didn’t affect you. Of course, it affected you but you were able to go and you were like, “Listen, I know the research. It’s in my favor. I’m okay. I believe that it’s the best choice because I really have researched it and truly believe that it’s the best choice for me and my baby.” 

They just tried so hard to not let that happen. 

36:32 “We are all so proud.”

Shannon: They did. I think it was the next morning and I was just sitting in my room with my baby quite happy. The head of midwifery came into the room and I had met her once before. She said to me, “Well done, you did it. All of our phones were going off last night because it was flagged that you had gone into labor and we were all waiting to see what had happened. But you did it vaginally and we are all so proud. Well done.” 

I was like, “Well, you didn’t tell me that at the time, did you?” 

Meagan: You’re like, “I wish you had cheered for me in my pregnancy and not made me feel like I was crazy or scheming my husband,” or all of that. Oh my goodness. 

Shannon: Yeah. 

Meagan: You have gone through a lot on top of your birth and trauma there and recovering from all of that. You have grown so much and achieved so much. You should be really proud of yourself. 

Shannon: Thank you. I am. I think that like I said at the beginning, if it hadn’t happened the way that it happened, I’m going to train to be a doula in May and June. 

Meagan: Yay!

Shannon: Because I don’t want other women to go through what I went through. Like I said, if it hadn’t happened the way it happened then I wouldn’t be here today. I’m grateful for the experience, but I wish that I had more support at the time. 

Meagan: Right, totally. I mean, that’s definitely something that led me to the doula and obviously here where I’m at too. I think through these birth experiences, it’s hard to deny that fire inside of you when you feel it. Right? You’re like, I want to help people not have the experience that I had and have a better experience to the best of my ability. 

I’m sure that you will do it and you’re going to take this passion and you’re just going to flourish and touch so many lives. I’m so excited for you. 

Shannon: Thank you. 

38:30 VBAC after three Cesareans

Meagan: Okay, so let’s talk about VBAC after three C-sections. I think this is sometimes a hard one because we do have providers throwing out things and blank statements like, “If you hemorrhage, if this, if this, and if this, you and your baby will die.” When we hear those things, it is very scary and very overwhelming. 

When it comes to VBAC more than two after multiple Cesareans and more than two, the stats are harder to find. Did you find that it was really harder to find? There are not a lot of huge Cochrane studies at least that I know about where they have studied VBAC after three Cesareans specifically. 

Shannon: Yep. 

Meagan: We are often told by providers that the chances of uterine rupture are astronomically higher than our typical VBAC or VBAC after two Cesareans. For people in your area in England, what did you find local study-wise for your stats? I’m curious to see the difference. 

Shannon: I didn’t. There wasn’t anything, no. I remember I had to relay as much information as I could on VBAC after multiple Cesareans because I remember them saying to me that after two Cesareans, the risk of uterine rupture doubles and when they say that to you, you’re like, Oh my god, that sounds really scary. What they don’t tell you is that it only doubles from 1% to 2%. There’s not much here that is different because there really isn’t a lot. There was not support especially not from my hospital or anywhere like that for me. I just had to do it on my own. The internet is your best friend. 

Meagan: Yeah, I know. This darn internet can be your best friend and your enemy at the same time. That’s why we are here and why we have our blog and all of the things because we want people to be able to find that best friend side of the internet and really dive in. 

We do have a blog on vaginal birth after three Cesareans. It is titled, Is VBAC After Three C-sections the Right Choice For Me? We will have it here in the show notes so definitely check it out. In it, we talk about how uterine rupture makes the idea of VBAC very scary. The word itself, “rupture” makes it very, very scary. When I think of something rupturing, it doesn’t look pretty. It’s something that we want to talk about in its real form. 

Uterine rupture happens. When it does, it is typically an emergent situation. However, it doesn’t happen very often and when we’re talking about VBAC, the world feels like, and I’m talking about world as in other countries too, it is bigger than it is like you were saying. 

It happens in really less than 1% of people so they are showing that with VBAC after multiple Cesareans, it might be slightly higher around 1.2%. It’s just so hard. What I think is unfortunate is that it’s not being offered enough to show the real stats, but what this podcast and what Facebook and all of the groups out there, the VBAC groups are showing, is that VBAC after three Cesareans is possible. It is possible. 

Do your research. Find the support and you did it. I mean, I’m going to say that you did it without support. I mean, you had support from your husband and stuff, but to the fact that they were showing up at the end of your bed like, “How long are you going to push for?” That type of stuff is not combined with the definition of support for me by the way and ambushing you and those things. You got through it without that much support backing you up in this decision. 

That is where we are shy here. I think that we don’t offer the support. 

One, if you’re listening and you’re a provider and you offer VBAC after three Cesareans, please let us know so that we can chat with you and get you added to our list. If you’ve had a VBAC after three Cesareans and you are listening and had support, please message us so we can add your provider to the list because VBAC after three, four, and all of the Cesareans may not be the best choice for everyone, but for those who want it, let’s try to get the information out there. Read up. Get the information. Like I said, it’s going to be in the show notes and the blog. We have our course. 

There’s not a ton out there on vaginal birth after multiple Cesareans so find what you can. Read what you can. Find the stats and do what’s best for you. 

Closing

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

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Dr. Christina Pinnock is a Maternal Fetal Medicine Specialist/Perinatologist based in California and creator of the ZerotoFour Podcast. She is here to help us tackle topics like what constitutes a high-risk pregnancy, lupus, preeclampsia, HELLP syndrome, gestational diabetes, fibroids, and bicornuate uteruses and how they relate to VBAC. 

The overarching theme of this episode is that all pregnancies are individual experiences. If you are hoping to achieve a VBAC and you have pregnancy complications, find a provider whose goals align with yours. By ensuring that your comfort levels are a good match, you are on your way to a safe and empowering birth experience!

Dr. Pinnock’s Website and Podcast

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

00:58 Review of the Week

03:13 Dr. Christina Pinnock

03:56 Importance of a VBAC-supportive provider

06:36 High-risk pregnancies

11:02 Lupus and TOLAC

14:31 Preeclampsia 

17:19 Varying ranges of preeclampsia

20:46 HELLP Syndrome 

26:36 Other High-risk situations 

27:54 Gestational Diabetes

35:00 Inductions with gestational diabetes

42:25 Fibroids 

46:33 Do fibroids tend to grow during pregnancy? 

51:20 Bicornuate Uterus

Meagan: Have you ever been told that you were high risk, so you’ll be unable to TOLAC? Or maybe you can totally TOLAC assuming nothing high-risk comes into play? What does high risk mean? We often get questions in our inbox asking if having your previous cesarean makes them high risk. Or questions about topics like preeclampsiaclampsia, gestational diabetes, bicornuate uterus, fibroids, and more. 

I am so excited to have board-certified OB/GYN Dr. Christina Pinnock on the show today. She is a high-risk pregnancy doctor passionate about educating women along their pregnancy journeys so they can be more informed and comfortable during their pregnancy. She is located in California and has a podcast of her own called “ZerotoFour” where she talks about topics that will help first-time moms prepare for, thrive, and recover from pregnancy as well as shares evidence-based information and answers everyday questions like we are going to discuss today. 

00:58 Review of the Week

Meagan: We do have a Review of the Week, so I'm going to jump into that and then we can dive in to get into these fantastic questions from Dr. Christina Pinnock. 

Today’s reviewer's name is Obsessed!!!! It says, “The best VBAC and birth podcast. I am grateful to have discovered Meagan and this podcast. I definitely believe listening to stories of these amazing women and their parent’s course helped me achieve my two VBACs. Thank you for all you do The VBAC Link.”

Oh, thank you so much Obsessed!!!!!  And as always if you wouldn’t mind, drop us a review leave us a comment and you never know, it may be read on the next podcast. 

03:13 Dr. Christina Pinnock

Meagan: Okay, Women of Strength. I am seriously so, so excited to have our guest here with us today! Dr. Christina, is it Pinnock? How do you say it?

 Dr. Pinnock: Yes that’s perfect.

Meagan: Ok, just wanted to make sure I was saying it correctly. Welcome to the show! You guys, she is amazing and has been so gracious to accept our invitation here to today to talk about high-risk pregnancy and what it means. Hopefully, we’ll talk a little bit about gestational diabetes because that's a big one when it comes to VBAC. And if we have time, so much more. So welcome to the show and thank you again for being here.

Dr. Pinnock: Thank you so much for having me, I'm excited to be here and chat with you and your audience about these great topics, so thank you.

03:56 Importance of a VBAC-supportive provider

Meagan: Yes! Okay well, this isn’t a question we had talked about, but I’m curious. Being in California, do you find it hard to find support for VBAC or do you find it easy? I mean, California is so big and you’re in Mountain View. So I don’t know exactly where that is. You said the Bay Area, right? So how is it in your area? How is VBAC viewed in the provider world in your area?

Dr. Pinnock: Yeah, that’s a good question. I actually did most of my training on the East Coast, so it’s been a good experience seeing the differences in coastal practices. I think where I did my training we were pretty open to VBACs and supported them. In California, I’ve had a similar experience and I think it really depends on where you are.  I’m in the San Francisco Bay Area and I work at an institution where we support TOLACs and want our moms to VBAC as long as it’s safe and it’s what they desire. But I really think the opportunity to TOLAC depends on your individual OB provider that you have and their comfort in offering that. And importantly, the hospital resources that you have available in your area. 

California’s huge and depending on where you live it can be a very, very different infrastructure both geographically and specifically within the hospital. And so I really think that differences in that offering is based around those resources rather than maybe patient desire or even sometimes provider desire. So it really just depends on those things. 

Meagan: That’s so good to know. I mean, we tell our community all the time that provider is a really, really big key when it comes to being supported. But also I love that you were talking about the actual hospital because for me with my second– I had a VBAC after 2 C-sections and with my second, my provider was 100% gung-ho and super supportive. But in the end, I ended up switching because the hospital was going to end up restricting my provider in supporting me in the way he wanted to support me, right? So it’s also really important to vet your location and your hospital.

Dr. Pinnock: Yes, absolutely. Sometimes, someone may live in a location where they don’t have that choice, unfortunately. If you do have that choice and you can choose hospitals and providers that can support it, by all means if you have that ability. 

06:36 High-risk pregnancies

Meagan: Absolutely. Ok well, let's dive in more to high-risk. So a lot of the time, I'd love to see what you think about this. A lot of the time, providers will tell moms because they’ve had a previous Cesarean, not even a special scar or anything like that, that they are automatically grouped into the high-risk category. 

So I don’t know what your thoughts are on that in general, but let’s talk more about high-risk pregnancy. What does it mean? What does it look like for TOLAC? How is it usually treated? And are there often restrictions given for those moms? 

Dr. Pinnock: Yeah, no. That’s a really good question. One thing about pregnancy, there’s some level of risk in all pregnancies. No matter if you're completely healthy, no medical problems, or you're trying to TOLAC, or you have other medical conditions that exist before pregnancy, all pregnancies carry some level of risk but not all the risks are equal. 

There are some conditions that the mother can have before pregnancy that can put her pregnancy at a higher risk of developing some complications. There are some conditions that can actually develop during pregnancy that can cause the pregnancy to be at a higher risk of developing complications. Lastly, there are some conditions specific to the placenta, the baby, how the baby developed, or even the genetic makeup of the baby that can contribute to a high risk of having complications. All of these three categories can impact the status of your pregnancy being considered high-risk. 

So typically, if you have a condition that falls in one of those three boats, then your pregnancy could be considered a higher risk. Usually having a previous C-section or even two previous C-sections by itself is not really something that I would use to classify someone as having a high-risk pregnancy. I do think that definitely talking with your provider about your desire for delivery earlier on can help both people to be on the same page, but if you otherwise have nothing else going on in the pregnancy and you have one previous C-section or even two previous C-sections, I think the pregnancy itself, I wouldn’t consider it a high-risk pregnancy. 

Meagan: That’s good to know. 

Dr. Pinnock: Yeah no, absolutely. And when you think about the delivery, I think about it a little bit differently than the pregnancy. I think for the delivery if you are interested in having a TOLAC and you have a previous C-Section or two, then the management of your delivery and the risk of your delivery isn’t the same as someone who hasn’t had a C-section. I think about them as like two different boats. 

But overall, conditions that are related to maternal health can be high blood pressure, diabetes, and autoimmune conditions like lupus. Those things can cause your pregnancy to be considered high-risk. A good example of a few things that can develop in pregnancy that can make your pregnancy high-risk include things like preeclampsia which is high blood pressures of pregnancy. Having twins or having triplets can make your pregnancy a higher risk. In some instances, even gestational diabetes depending on what’s going on and where you are can be considered a pregnancy with some high-risk features. 

And then genetic conditions for baby whether that’s a difference in how one of your babies’ organs developed, or a genetic condition that’s discovered from testing; any of those things can really impact that high-risk status and how your pregnancy will be monitored and managed after that. 

Meagan: Ah these are all such great topics and actually things that we get in our inbox. Like, “Hey, I have lupus,” or we’ll have one of our VBAC doulas say, “Hey, I have a client who has lupus. She really wants to TOLAC and have a VBAC. What does that mean for her?” 

Obviously, all of these conditions are going to be treated differently throughout the pregnancy and probably even during the labor and delivery portion. 

11:02 Lupus and TOLAC 

Meagan: I don't know if we can touch on a couple of those like lupus. What does that look like for someone? If I have lupus coming in, I’m doing okay right now. I have it. What does that look like for someone wanting to TOLAC and to have a VBAC?

Dr Pinnock: Yeah. I think it’s similar to your first question about whether a C-section would make your pregnancy considered high-risk. So the lupus diagnosis would increase the risk of certain medical conditions happening in pregnancy relating to both mom and baby. Your doctor may get some extra blood work to monitor how your lupus is progressing in pregnancy. Your doctor may get some extra ultrasounds to make sure that baby isn’t too small and add some extra monitoring to make sure that baby is staying safe and that if there is a risk for baby to be in distress that that is picked up. 

And so the actual monitoring and management of the pregnancy is usually done with the help of a high-risk pregnancy doctor like myself with an OB provider. That is really specific to what is going on with that person. If everything goes smoothly and lupus stays under control and we get to the moment where we’re thinking about how we’re going to deliver baby, that’s sort of a separate boat. In an ideal world, everything goes well in terms of the lupus and pregnancy and if you’re interested in having a TOLAC, having a diagnosis of lupus should not restrict you from that option. You can still have that as an option but it really just depends on the specifics of how your pregnancy has unfolded. 

Have you developed any other conditions like high blood pressures in pregnancy or preeclampsiaclampsia where your doctor is maybe thinking you may need to deliver earlier? Are there things going on with your baby where we think baby is under more stress where we would really need to be very intentional about how we deliver baby? It’s a really nuanced thing and it’s based on the specifics on that person’s condition. I think an overarching theme is whatever is going on with the pregnancy that impacts the delivery if things are not going as smoothly. But if things are going smoothly and you want to try for a TOLAC, that’s not necessarily a reason to say, “No, you absolutely can’t do this,” unless there are specific conditions that came up in your pregnancy that make it less safe for either you or baby as the mom. 

Meagan: Yeah. Something that I’m just hearing you say so much that’s standing out is that really is individual, depending on that individual and depending on that individual’s case. I think that’s something important for listeners to hear because someone who may have lupus that’s going really, really fine, TOLACs going to be a really great option for them. But someone who may have active symptoms and it’s going and it’s really hard, that may be a different suggestion in the end. But I like that you’re like, We’re in this boat and then we travel over to this boat into this time, and then it’s a matter of how we float that boat and how we get to our destination.

Dr. Pinnock: Exactly.

14:31 Preeclampsia 

Meagan: Would you say that the same thing goes for preeclampsia? Preeclampsia can develop at any stage of pregnancy. I mean, we've had clients in weeks 18-20 develop it and then have to be really closely watched and all of these things. Is that someone also where you would say the same thing? Where it’s like, We’re in this boat doing these things and these tests and monitoring, and then again we get into this next boat and we have to decide what the best route is?

Dr. Pinnock: Yeah, no. That’s a good question. I think it’s similar but a little different with preeclampsia. It depends on the type of preeclampsia that’s going on. Preeclampsia is a spectrum and with the part of the spectrum that’s more on the severe side, we still try for a vaginal birth. It really depends on, as you’ve mentioned, how far along you are in the pregnancy.

Maybe you are 28 weeks and you have such a severe form of preeclampsia that your doctor is like, “I don’t think we can get any more time with the pregnancy,” that’s a very different situation than someone who has a very non-severe form of preeclampsia at 39 weeks who wants to TOLAC and have all of those options available. 

It really does depend but the overall theme with preeclampsia if you do want to try for a vaginal birth and your health and baby’s health are stable in the moment, then usually we do try as much as possible to have a vaginal birth. But things like very early gestational age and really severe complications of preeclampsia make the possibility of having a vaginal birth less likely. It makes the possibility of someone who wants to TOLAC in that setting less likely. It really depends on the severity of that spectrum of preeclampsia, but we always try for a vaginal birth if we can. 

Meagan: Yeah. This may be too hard of a question to answer, but can we talk about that range and the severity? What does a low to moderate to severe case of preeclampsia look like in a person? What would be considered that severe, “Hey, we might need to reconsider our birth desire here,” to “Hey, you have it. It’s really low right now,” or to “We’re in choppy waters right now.”

17:19 Varying ranges of preeclampsia

Dr. Pinnock: That’s a good question. Pre-e is defined as elevated blood pressure in pregnancy after 20 weeks. So once you hit 20 weeks, if your blood pressures are elevated, 140/90 times multiple times and we see any evidence of preeclampsia’s impact in some organs in your body.

One of the most common things that we used to use to diagnose is the presence of protein in the urine. Once we see that, we’re like, “Oh, man. I think you may have preeclampsia,” then we do an evaluation of the rest of the body to understand how severe it is. Preeclampsia is a disease that’s thought to develop from the placenta when it implanted. It can cause dysfunction or impact on the organs. It can cause severe headaches. It can cause changes in your vision and problems with your blood cells, your liver, your lungs, and your kidneys. 

We go from head to toe and take a look at how those organs are being impacted by preeclampsia and then we ask you how you’re doing. If you’re having a headache, if you’re having changes in your vision, pain in the belly, and all of that, it helps us to understand the severity. So depending on your symptoms, your blood work, and your blood pressures, those things together help us say, “Is this a severe form of preeclampsia?” and if it is, then we usually have some specific things that we have to do. 

Generally, you likely are monitored in the hospital. We keep a close eye on your blood pressure and your organs. That pregnancy is considered to be very high risk. Very high risk for a harm for mom, so risk of seizures, impact on the organs that can sometimes be lifelong and risk to baby. The highest risk to baby is that risk of being born early, so pre-term delivery. And usually if you have severe preeclampsia, we usually recommend delivery no later than 34 weeks. So once we do develop that severe form, we keep a close eye on things. 

If you have the non-severe form, so if your organs look oay and your blood pressures are stable but you have some protein in your urine and we do think you have preeclampsia but it’s not severe, then we give you some more time. We still monitor you and baby very closely, but we can maybe try to get the pregnancy up until 37 weeks and after that, the risk of continuing the pregnancy and harm to maybe the mom and baby are a bit higher than some of the risks of being born at 37 weeks. So at that time is when we would say, “Let’s have a birthday.” It really depends on those things. 

Meagan: Okay, that’s so good to know. I think sometimes that also can vary like, I’ve got high blood pressure, but I don’t have protein. Or I’ve got a trace of protein but I’m doing okay, I don’t have any symptoms. But we also know with preeclampsia it is important to watch really closely no matter whether severe or not because it can turn quickly. Where you have zero signs and the next morning and you wake up with a headache and crazy swelling and you have that blurred vision with really high numbers. So it’s just really important to watch.

Dr. Pinnock: Exactly.

20:46 HELLP Syndrome

Meagan: I really do like to ask that question because a lot of people ask, do I have to have a C-section? Do I have to be induced? What does that mean? Am I severe or not severe? And we also note, we weren’t even talking about this, but HELLP syndrome. So we can develop more, right? Preeclampsia affects more the mom, but then alsothe  baby timewise. HELLP syndrome is another really high-risk complication. What would you suggest for that when it comes to TOLAC because we have platelets being affected there? That one is a tricky, tricky one. 

Dr. Pinnock: I think HELLP syndrome is on that same spectrum of hypertensive disorders in pregnancy. But HELLP syndrome can be pretty life-threatening and dangerous for mom and by extension baby. So HELLP syndrome is when we find that your body’s sort of hemolyzing so there are some things in your blood that’s causing your blood vessels to sort of open red blood cells. We find also that you have elevated liver enzymes so your liver’s being impacted pretty severely and then the platelets or the blood cells that help with clotting get really, really low. And so the combination of that with or without elevated blood pressures make us very concerned about HELLP. So the worry is if we don’t deliver the baby pretty expeditiously and deliver the placenta which is thought to be really the source of the diagnosis, mom can get really ill and we really try to deliver as soon as possible. 

The exact way we deliver is really dependent on the specifics of what is going on. So maybe if your liver enzymes are very, very elevated and there's a high concern for mom’s health and safety, your doctor may say, “I don't think we have time to try for a TOLAC, especially if you're not in labor. I think it would be too unsafe. I think I would recommend a C-section at this time because of that,” then that would be that recommendation. 

Sometimes we do try for a vaginal birth with HELLP, but it would be a case where we would want to limit how long we try but overall we try to deliver as fast as possible either vaginally or with a C-section. And if you do want to try for a TOLAC in that setting, I think my recommendation is to really, really be open to whatever is best for your health and your babys health. That’s my advice for all women who are in labor. 

It’s such an unpredictable experience and you can come in with your desires and your doctor can come in with their desires for you, and your baby or your health just dictates something else. And so with HELLP, that’s an even more significant moment where if your body’s telling us one thing, we have to listen. You may not be eligible for a TOLAC at that point. I think in more cases than not, many providers may not have that bandwidth or think it’s safe to try for TOLAC in that setting. 

Meagan: Yeah. I’ve had very few clients as a doula who have had HELLP, but one of the clients– they actually both ended up having a Cesarean, but one of the clients’ providers was even uncomfortable with even having an epidural and actually suggested general anesthesia. Is that a common thing if HELLP is super severe that could possibly be what’s suggested or best?

Dr. Pinnock: Yeah, no as I mentioned with that kind of diagnosis, you can have pretty low platelets. And so when we think about a procedure like an epidural or even a spinal, so any sort of neuraxial anesthesia where we’re not putting mom to sleep, we’re just numbing mom from the waist down, that requires insertion of a needle or a catheter in the back. That’s near a lot of important structures so once you have that puncture, you’re going to have some bleeding. And if those platelets aren’t enough to sort of prevent that bleeding from extending, then our anesthesia team may not be comfortable doing that procedure safely because it’s not safe. 

They may offer to give some platelets etc but often with HELLP, it may not be as fast acting and sometimes you may just hemolyze again. Those platelets may go back to being very low and if we are thinking about having a delivery urgently, delaying for that reason may not be safe for mom and baby. Oftentimes, if the platelets are too low, then our anesthesia colleagues, who are a very important part of the team, may recommend against trying for an epidural or even a spinal and recommend general anestheia.

In my experience, I don’t do C-sections under general anesthesia often, but when I do, it’s usually recommended for a very, very significant reason and it’s always with the safety of mom and baby in mind. It’s never something that we want to do. It’s only something that we do if we have to do for mom’s safety or for baby’s safety. 

Meagan: Yeah. So good to know. And they actually ended up doing a platelet transfusion as well specifically for the Cesarean. Obviously, we know blood loss is a thing that’s a big surgery so they were trying to help her there. 

26:36 Other High-risk situations

Meagan: Okay, well are there any other high-risk scenarios where you feel like truly impact the ability to have a TOLAC offered?

Dr. Pinnock: Yeah. I think the highest risk conditions that could prevent mom from having a TOLAC are probably conditions related to the heart or lungs where the physiology or the changes that happen in labor can make it so that a vaginal birth is not safe or recommended for mom or baby. 

A TOLAC in those high-risk settings is often not recommended. There are a lot of cardiac and lung conditions that we take care of. There are not that many that we would say you can’t have a vaginal birth, but sometimes there are blood vessels in the heart that can be dilated or blood vessels near the heart that can be dilated that we may say, “No, you definitely need a C-section,” so if you wanted to TOLAC we wouldn’t recommend that. Those are probably the highest-risk conditions that I take care of and where a TOLAC is not recommended or even offered because it’s just not considered to be safe. 

27:54 Gestational Diabetes

Meagan: Okay that’s so good to know. Okay, let’s jump in a little bit to gestational diabetes. We can have both managed and not managed. Do you have any advice for listeners who may have gestational diabetes or maybe had gestational diabetes last time and they’re preparing to become pregnant or wanting to learn more about how to avoid it if possible or anything like that? Do you have any suggestions to the listeners?

Dr. Pinnock: Yeah, that is one of my favorite things. I really believe that just paying close attention to your health and taking steps before pregnancy can make a world of a difference in your risk of developing certain conditions. Gestational diabetes is one of those conditions that can be definitely most susceptible to things that we can do before pregnancy. 

And so I know that this is going to maybe sound like a broken record to those who had gestational diabetes before, but just look at your lifestyle factors. I think that the most undervalued or underestimated intervention is really exercise. It doesn’t have to be your training for an Iron Man or a marathon. It could just be like a 20-minute walk every day or a ten-minute job every day and work your way up. We definitely found that aerobic exercise more days of the week than not, and resistance training, it could be with resistant bands, if you have any sort of light weights or even body weight. Any resistance training to help build up that muscle mass can help to reduce your risk of getting gestational diabetes. 

If you couple that with adjusting your diet, and diet is such a big topic but essentially no matter what your background is, focusing on the whole foods of your cultural background is best. So low processed foods, more homecooked meals with whole grains, fruits, vegetables, fish, and limitations of red meat and processed foods. All of those things can go a long way with preventing gestational diabetes and also reducing the recurrence of gestational diabetes. I’m really passionate about that. 

Meagan: Yeah, us too. I didn’t have gestational diabetes, I had kidney stones weirdly enough because my body metabolizes nutrients differently during pregnancy and anyway, it’s totally not gestational diabetes but I had to look at my pregnancies and before as something like that. Really dialing in on nutrition. Really dialing in on my exercise. And I couldn’t agree more with you that it doesn’t have to be this big overwhelming Iron Man training or running a marathon. 

It really can be a casual 20, 30-minute stroll around the neighborhood walking the dog or whatever and dialing in on those whole foods. We love the book Real Food for Gestational Diabetes by Lily Nichols. If you haven’t ever heard of that, it’s amazing. It’s a really great one. You might love it. And I definitely suggest that to all of my clients. She even has one for Real Food During Pregnancy. Just eating good food and then we love Needed because we know that getting our protein and getting the nutrients that wer eally need can really help like you said recurring and current and just avoiding hopefully. So we really love that topic, too. 

But gestational diabetes doesn’t just nix the opportunity to TOLAC, correct?

Dr. Pinnock: No, it doesn’t. Gestational diabetes can be a really tough diagnosis for a lot of women to get in pregnancy. It can be really disappointing especially if you may be a relatively healthy, active person and you don’t have a lot of risk factors for developing gestational diabetes. It can kind of feel like a gut punch almost. 

Meagan: Yeah! And it’s very overwhelming because you’re like, What? No! 

Dr. Pinnock: It is! And it happens fast. You’re diagnosed and then you have a flurry of things that you have to now do and change and think about. It can be very stressful. But I always tell my patients that there are things that put some people at risk of developing gestational diabetes more than others, but all women because of those placenta hormones can have insulin resistance or your body’s just not responding as well to the insulin that you’re making. 

Depending on those risk factors, some women develop it. Some women don’t. And once you do develop gestational diabetes, it’s something that we really pay attention to because it can increase the risk of things for moms so particularly it can increase the risk of mom developing preeclampsia and it can increase the risk of things for baby. Babies can be on the bigger side or have macrosomia if the blood sugars are too high. 

They can actually have a higher risk of having a birth injury if we’re having a vaginal birth or mom may actually have a higher risk of needing a C-section if you’re trying to TOLAC and baby’s on the bigger side. Rarely, and this is sort of the thing we worry about the most, is that if those blood sugars are too high for too long, baby can be in distress on the inside and it can increase the risk of having a stillbirth or having baby pass away. 

So because of those things, once we diagnose it, we do pay attention to it and we try our best to sort of make those changes hopefully with diet and exercise to sort of manage the blood sugars. If we’re having perfect blood sugars with those changes, then wonderful. If we’re not, and it happens and you need some additional support then your doctor provider may recommend some other management options like medications to help to bring the blood sugars down. 

But I think, when we think about TOLAC, we want to think about separately managing the pregnancy, keeping mom and baby safe, and then thinking about the safety of delivery. So as long as the baby’s size isn’t too big, as long as mom and baby are healthy and safe, you can definitely try for TOLAC with gestational diabetes. But those two things are big “buts”. You really want to try your best to manage your blood sugars so baby’s size doesn’t work against your efforts of trying to have a TOLAC.

35:00 Inductions with gestational diabetes

Meagan: Yeah, we know that the size can definitely impact providers’ suggestions or comfortablity to offer TOLAC. And we know big babies come out all of the time, but we know sometimes there’s some more risk like you were saying. So can we talk to the point of inductions?

So a lot of providers will, and you kind of touched on it. There can be an increased risk of stillbirth. But a lot of providers seem to be suggesting that induction happens at 39 weeks. Some of the evidence shows that in a controlled situation, meaning all of the sugars are controlled, but what do you see and what do you suggest when someone is wanting a TOLAC, has gestational diabetes, may have a baby measuring larger or may have a provider who is uncomfortable with induction which we see all the time? Any suggestion there and what do you guys do over in your place of work?

Dr. Pinnock: Yeah, that’s a great question and it’s something that I individualize to every patient. So let’s think about it in two different buckets or three different buckets. Say you have gestational diabetes that’s pretty well controlled with just diet. So with diet and exercise, your numbers are pristine. Baby is a good size, we’re not over that 4500-gram mark where we start to say, “Is it really safe to try for a vaginal birth?” and that’s okay. If we are in that boat, then I think it’s reasonable to allow for mom to go into labor and try for TOLAC if that’s their desire. 

The exact gestational age at which someone goes into labor varies. We don’t have a crystal ball. We don’t know. 

Meagan: Nope.

Dr. Pinnock: We do have to balance waiting for that labor process with the inherent risk of babies being less happy and distressed and the risk for a stillbirth as the pregnancy progresses. Now, if you have gestational diabetes that’s well controlled with diet, we think from the studies that we have that our risk of stillbirth is similar to someone who does not have gestational diabetes which is good. And so for those pregnancies, depending on your specific location and provider, we may do some monitoring with non-stress tests or something like that later in the pregnancy until you deliver. Usually, we start at around 36 weeks or so if you’re well-controlled with just the diet and allow you time for your body to go into labor and have a vaginal birth. 

Now, if we get to your due date and nothing, baby is still comfortable inside. They’re like, Oh no. I’m just hanging out, we start to think, How long are we going to allow this to go on? At that length of time, we start thinking about, Okay. We’re at 40 weeks. What are the risks to mom and baby? And so at 40 weeks, we’re about a week past 39, and we know that the risk of– if things are perfect for anyone, the risk of having babies be in distress, maybe the placenta’s just been working for a long time and isn’t just working as well and the risk of stillbirth goes up, we don’t want to go to 42 weeks. 

So I think at that moment, it’s a good time to think of an exit strategy. If your baby is just so comfy on the inside, think about, when I would say is an upper limit of reasonablility to wait for labor? That varies depending on the person and provider. But I think reasonably, up until 41 weeks. I wouldn’t go past that. If we’re allowing our body to go into labor up until 41 weeks, then we have to think about, How does that impact my risk of having a successful TOLAC? After 40 weeks, some of our studies suggest that you may be at a higher risk of having a failed TOLAC or needing a C-section and that’s regardless of whether you're induced or whether you go into labor. TOLAC-ing does carry that inherent risk so it’s really just dependent on your doctor, you,  your provider, and balancing all of those things. I think going until 41 weeks is probably the maximum limit for a well-controlled gestational diabetes with perfect sugars, no medications, and we’re still doing monitoring to make sure that baby is doing well.

Now, if you’re in the camp where you’re either gestational diabetes, or even controlled with diet, or if your gestational diabetes is controlled with medication or if you’re diet-controlled, but those sugars aren’t great, any scenario where the sugars aren’t perfect and we need either medications or your sugars aren’t perfect, I don’t generally go past 39 weeks.

The reason being at 39 weeks, baby is fully developed and after that, the risk of having a  pregnancy loss goes up because of that uncontrolled or not optimally controlled gestational diabetes. I think at that gestational age you would want to think about maybe an induction or maybe a repeat C-section depending on how you’re feeling if your body isn’t going into labor. And that’s a personal decision. 

Now, if you have gestational diabetes managed with medication and your baby is big and maybe let’s say over 4500 grams which is sort of that range where we worry about the safety of a vaginal birth. And you’re now going into labor, then that becomes a little bit more of a shared decision-making where you want to think of, My baby’s big. I would need to be induced. Is this going to be something I want to commit to or is it something I don’t want to commit to? That’s a personal choice but I think at that gestational age I would say I wouldn’t want anymore. 

ACOG though does recommend or does allow for moms who do have gestational diabetes well controlled with medication, like if your blood sugars are perfect with the medication to go until 39 weeks and 6 days. So technically you can use those extra few days, according to our governing board or the American College of OBGYN. But it’s going to really come down to you and the relationship you have with your doctor and what you both are comfortable with. Maybe you have a provider that is open to that recommendation or a provider whose more open or comfortable to a 39-week delivery regardless of how well your blood sugars are controlled once you’re on medication. But ACOG does give us that wiggle room to say we can go further. 

42:25 Fibroids

Meagan: So good to know. Okay, let’s see. Is there anything else we would like to talk about high-risk-wise? I know I had mentioned one time about fibroids and heart-shaped uterus. Do you have anything to share on those two topics, because those are also common questions? Can I TOLAC with fibroids? Can I TOLAC if I have a heart-shaped uterus? Where does that land as VBAC-hopeful moms?

Dr. Pinnock: Yeah, no. I think those are some great things to consider. So I think we can open with the fibroids. I think if you’ve have had fibroids and you’ve had that fibroid removed, so you’ve had a myomectomy, there are a handful of things where we usually say, “No, we don’t want you to TOLAC.” One of them is if you've had a previous uterine rupture or that previous Cesarean scar opened in a previous delivery, that’s an absolute no. The risk is too high. We don’t think it’s safe. The other is if you’ve had a previous surgery where that surgery included the fundus or the top of the uterus where those contractile muscles are. Usually, with a myomectomy or fibroid removal, that involves that area. If you’ve had a fibroid removed in that area or you’ve had a myomectomy, a TOLAC is not recommended. So those are sort of one of the few things or few times where we say, “Absolutely, no.” 

If you have a fibroid and maybe you just discovered you had it during pregnancy, most of the time fibroids don’t cause any problems. They’re benign growths of the muscle of the uterus that can vary in size. So generally if they’re small to medium size and depending on their location they may not cause any problems. If they do cause a problem, the most common thing women experience is pain. But usually if they’re not too big and they’re not in a location where we’re concerned about, it should not really your ability to TOLAC. 

Now if the fibroid is like 10 centimeters and located near the lower uterine segment or the part of the uterus where the baby transports through to come out through the vagina, then we’re going to take a pause and say, “Is this going to be a successful TOLAC?” Is the fibroid going to compete too much with the baby’s head for baby to come down safely and should we just think about doing a C-section? And a C-section in that event is also not straightforward or a walk in the park because either way, the fibroid is present near where we would use to deliver the baby.

 So short answer is that yes, you can TOLAC with a fibroid. But the long answer is that it really depends on how big the fibroid is, where it’s located and whether we think it’s going to obstruct that area where baby’s going to come from. If it’s not, then it’s reasonable to try and many women have TOLAC’d with fibroids all the time. So it’s definitely not a reason to say, “No, you definitely can’t.” If you’ve had the fibroid removed though, then it’s a no. That’s just one thing to talk about if you’re considering that procedure and you have an opportunity to talk with the provider who is offering that procedure, just knowing that after that for most surgeries that remove the fibroids you won’t be able to try for a vaginal birth. 

46:33 Do fibroids tend to grow during pregnancy? 

Meagan: Good to know. Good to know. And is it common for fibroids to grow during pregnancy? Does pregnancy stem them to grow? Or does that impede them because you’ve got a baby growing in there and the focus is on growing a human and not growing a fibroid?

Dr. Pinnock: No, that’s a good question. Interestingly enough, we see about a split group so about a third of them stay the same. They don’t change in size. A third of them shrink and a third of them grow. 

Meagan: Oh wow.

Dr. Pinnock: We don’t know which third it will be. Two-thirds of them either get smaller or stay the same size. But there are women who experience growth of the fibroid and it’s actually due to those hormones estrogen, progesterone, and all of those hormones being released by the placenta. It stimulates the fibroid to grow and that’s actually when some women experience pain. 

The fibroid grows. It outgrows its blood supply and then it degenerates or dies off a little bit and it causes this pretty significant pain for some women, but interestingly it’s not 100%. A lot of people don’t have many symptoms and don’t have any pain. When I monitor fibroids, a lot of them don’t change in size. Some of them get smaller and sometimes I’m not able to see them later on because they’re so small. But there is that percentage who experience the growth of their fibroid and that’s usually when pain is experienced from them. 

Meagan: Okay. And you mentioned that they could. I mean, 10 centimeters is a pretty large fibroid but it can happen, right?

Dr. Pinnock: I’ve seen it. 

Meagan: Yeah, so it can happen. You said it can compete with baby coming down. Can fibroids also inhibit dilation at all? Can it impact dilation at all?

Dr. Pinnock: Absolutely. Some of the things that we see or that we worry about if there’s a large fibroid present is other than impacting the area where baby can come through, it can cause dysfunctional labors. So those muscles that are contracting in a uniform way aren’t going to be able to contract as uniformly as they would have if the fibroid wasn’t there. So sometimes the labor can stall. The cervix isn’t dilated as much. Even sometimes we see that fibroid causing babies to actually present head down and so that’s also something that we can see with very large fibroids. It can actually increase the risk of baby being breech or transverse or malpresenting in general. 

Meagan: interesting. And you said that sometimes there aren’t even any symptoms at all, so how would one find out if they do? Is that just usually found at 20-week ultrasound? Or is it possible that at 20 weeks you had it but it’s so minute and it’s so small, that you can’t even see it? And then in labor we have some of these symptoms or whatever and it’s there but we don’t know?

Dr. Pinnock: Not usually. Most women, if they didn’t know they had a fibroid before pregnancy, get diagnosed in pregnancy at an ultrasound. Either a first trimester or 20-week ultrasound, we look at the uterus in detail and we can pick up fibroids. We are hopefully not going to have a 10-centimeter fibroid present at 10 weeks that’s missed that’s just going to magically present at 39 weeks and be a surprise. Usually the fibroid, if it’s there, is picked up on an ultrasound. That’s the most common way it’s picked up. Depending on the size, it may be a reason why your doctor or provider recommends for you to have ultrasounds in the pregnancy. 

Sometimes we monitor the fibroids. We monitor their locations, the size of them, and we make sure that they’re not too big to be causing a problem. Rarely if they grow, they don’t usually grow from like 3 centimeters to 10 centimeters. They may grow a centimeter or two. It’s very unusual to have that big change. And so for the most part, it’s picked up on ultrasound. We know the size of it. If it grows, it grows a small amount. It’s not going to grow from 5 to 10, and we’re going to know the location of it from that first time we evaluate it. It’s not going to be a surprise moment at delivery where we’re like, Oh my goodness, this wasn’t picked up.

51:20 Bicornuate Uterus

Meagan: Okay, good to know. Good to know. Okay and last but not least, I know we’re running short on time and I want to make sure we respect that. Any information you have on a heart-shaped uterus? Is TOLAC possible with heart shaped uterus? Have you seen it? Have you done it?

Dr. Pinnock: I have not seen it or done it to be honest. I do think a heart-shaped uterus just so we’re using the same language that’s considered a bicornuate uterus, is that–?

Meagan: Yes, a bicornuate uterus.

Dr. Pinnock: So for a bicornuate uterus or any kind of situations where the uterus developed differently, interestingly the uterus develops from two different stuctures. It develops from something called the Mullerian Duct and early in development when you are a tiny, tiny baby, those two structures fuse and when they fuse, they come side by side first, and then they fuse. When they fuse there, is a little wall in the middle that gets removed and so when all of that is done you have uterus that is shaped as we know it and we have that cavity on the inside where the baby would come in and grow. 

Now with a heart-shaped uterus, or a bicornuate uterus, there is an error when those structures come together side-by-side. So sometimes they just stay side-by-side and they don’t fuse as well or sometimes they fuse but only fuse partially. So you have the uterus that as we know it, but sometimes you can have two separate structures. So two separate cavities where the prgenancy can grow, or you can have one cavity where there is still some tissue right in the middle there. It can vary depending on the suffix of how that fusion happened. 

Essentially, if there’s less space in the cavity either from that tissue or having two separate but smaller cavities, there’s presumably less space there for baby to grow. There’s less contractile strength on that one side and so it can theoretically increase the risk of certain things happening in labor. I think the things that we see most commonly with bicornuate uteruses, it can have a higher risk of having a pregnancy loss, so a miscarriage. High risk of baby being born early because that area is just smaller so it’s not as strong in holding the pregnancy. And similarly, baby can also be malpresented more commonly because the are is much smaller than a full uterine cavity.

Meagan: That’s what we see a lot is breech. 

Dr. Pinnock: Exactly. I haven’t seen too many cases. It’s a rare thing to see. I haven’t seen too many cases where baby’s head-down and we’re at full-term and wanting a TOLAC. A lot of cases I’ve had, baby is breech or malpresenting so we end up doing a C-section. The shape of the uterus is not going to change for the next pregnancy so chances are the baby’s usually malpresenting. 

I don’t think we have any big databases or big data to say is it safe? Is it not safe to TOLAC? I think the main thing you’d be concerned about it that spontaneous uterine rupture if there is labor going on even if you haven’t had a C-section and also if you’ve had a C-section before. So I think a TOLAC would be a little bit of an unknown for this situation. I would think on it pretty heavily and talk with your doctor about the specifics of your situation. If your previous C-section because baby was breech, chances are baby’s not going to be presenting head down because of the shape of the uterus. It tends to have things that recur as to reasons for having a C-section. So we don’t have any large databases where we have women who have TOLAC’d with this condition, so hard to say. So maybe give it a try, but maybe thing long on this one. 

Meagan: Case by case, it all comes down to case by case.

Dr. Pinnock: Yes. That’s pretty much what I do. Anything in pregnancy that’s a little bit more nuanced and any high-risk condition, it’s very individualized. And we have to really have that approach with high-risk pregnancies or anything that comes up that makes your pregnancy higher risk of having anything happen to mom and baby for sure. 

Meagan: Right. Oh my goodness. Well, I love this episode so much and cannot wait to hear what people think about it. I’m sure they’re going to love it just like I do. I know I mentioned at the beginning of your podcast and things like that, but can you tell us more? Tell us more about the ZerotoFour podcast and where people can find you. I know you have YouTube and all the things, so tell us where listeners can follow you.

Dr. Pinnock: Yeah. You can find me on Instagram @drchristinapinnock, the ZerotoFour Podcast so the zerotofourpodcast.com where I share the episodes with new moms about pregnancy. I really started the podcast with the goal of helping moms to be more informed and comfortable about everything along their pregnancy journey. I share topics from the whole spectrum of that journey to help you feel more prepared and informed and empowered about your pregnancy experience. You can find episodes there, on Apple Podcasts, Spotify, or anywhere that you listen to podcasts.

Meagan: Awesome. So important. This is a VBAC-specific topic, but I mean those first-time moms, we have to learn. We have to learn all the things because there is really so much. We just talked about a little nugget of a couple of high-risk situations and there’s just so much out there that can happen. It’s so good to know as much as you can. Get informed. Learn all the things. Follow your podcast. I definitely suggest it. We’ll have all the links in the show notes and thank you for joining us today. 

Dr. Pinnock: Thank you so much for having me. It’s been a pleasure. 

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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Our friend, Kelsey, shares with us today what giving birth is like in Canada. From moving and traveling between provinces, Kelsey had experienced different models of care and when it came time to prepare for her VBAC, she was very proactive about choosing a birth environment where she felt safest. 

From a scary Cesarean under general anesthesia to an empowering unmedicated VBAC in a birth center, Kelsey’s journey is entertaining, beautiful, and powerful. We love hearing the unique details of her story including giving birth at the same time as her doula just in the next room over! 

The personalized care she was given during her VBAC is so endearing and heartwarming. As her husband mentioned, it should be the gold standard of care and we agree! 

The VBAC Link Blog: Assisted Delivery

Fetal Tachycardia in the Delivery Room

Is There Still a Place for Forceps in Modern Obstetrics?

Forceps Delivery Complications

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

07:36 Review of the Week

09:27 Kelsey’s stories

11:47 Logistics of giving birth in Canada

14:38 A normal pregnancy

17:50 Arriving at the hospital

21:37 Stalling at 7 centimeters

26:22 Asynclitic and OP positioning

29:31 Kelsey’s Cesarean under general anesthesia

34:50 Second pregnancy and VBAC prep

41:07 Switching to midwives

46:14 Beginning of labor

51:07 Driving to the birth center

54:49 Pushing baby out in two pushes

1:00:24 Differences in care

1:02:11 Enterovirus

1:08:02 Risk factors for forceps and vacuum deliveries

Meagan: Hello, Women of Strength. We have our friend, Kelsey, from Canada. Is that correct? 

Kelsey: Yes. Yeah. 

Meagan: She’s sharing her story with you guys today. Something about her first story of her C-section that stood out to me was that she had a forceps attempt that didn’t work out. Sometimes that happens. I want to talk a little bit about forceps here in just a minute before we get into her story. Kelsey, I wanted to ask you that this is something that in our doula practice we will ask our clients. If it comes down to an assisted birth with forceps or a vacuum, what would you prefer? It’s a weird thing because you’re like, Well, I’m not planning on that, but a lot of people actually answer, “I would rather not do those and go straight to a C-section.” Some people are like, “I would rather do every last-ditch effort before I go to a C-section.” 

Did you ever think about that before? Had it ever been discussed before as their style? That’s another thing. Some providers are really vacuum-happy. Some are really forceps-happy. I know it’s a random question, but I was just wondering, had you ever thought of that before going into birth? 

Kelsey: So no. I didn’t think about whether I wanted a C-section or a forceps delivery. However, I was really staunchly against having a C-section. That was primarily nothing against it, it was just that I have a really huge fear of awake surgery so with my forceps attempt, the OB who was there because it wasn’t my provider. That’s not the way Canada works. The OB who was there who was called in said, “Are you sure you want to do forceps? You could tear.” 

I told her, “I would rather tear than have a C-section.” That was just a personal preference for me because I was so terrified of having a C-section. 

Meagan: Yeah. I think that is very common and very valid to be like, “No, I would rather try this.” 

Kelsey: Yeah. 

Meagan: So I did. I wanted to go over just a little bit. I mean, I have seen a couple of forceps and they are not happening as often these days, but there was an article that said, “Is there still a place for forceps delivery in modern obstetrics?” I’m trying to say obstetricians and obstetrics. We’re just going to stop. 

Kelsey: We know what you mean. 

Meagan: You know what I mean. There was an article and I was like, That’s a really good question, because I think a lot of people think they shouldn’t be done anymore or a vacuum shouldn’t be done anymore either. It talked a little bit about the background. it says, that nowadays we are seeing a decrease in instrumental deliveries and a continuous increase of Cesarean rates. That makes me wonder if we were to increase vaginal and help instrumentally if that would decrease, but one of the things that I thought was interesting is that it says, “The prevalence of forceps delivery was 2.2% and the most common indication for a forcep delivery was fetal distress.” It is very common where it’s really, really close, baby is struggling. Baby is so low and let’s get baby out. 

That’s 81.6% which is crazy. It says, “Among mothers, the most frequent complication is vaginal laceration,” which means we have tearing at 41% and third and fourth-degree perineal tears were noted. It says, “Regarding neonatal APGAR scores, around 8 around the first and the fifth minute,” which is around 91.2% and 98% of newborns which is pretty great. An 8 APGAR is pretty great. 

I think a lot of people worry about that. It says, “8.8% experience severe birth injuries like hematomas and clavicle fractures.” Those are probably shoulder dystocias. That’s probably why they were having. It says, “Although fetal distress is the most common indication for forceps delivery, the vast majority of newborns were actually in good condition and didn’t require NICU care.” 

That’s something that was kind of cool. Obviously, there are a ton of more studies and deeper studies on that. This was just one, but it was kind of interesting. It was like, all right. That is a good question to ask as we are preparing for VBAC is hey, if for some reason a forceps or a vacuum is necessary, that’s something to think about. What do we want to do at that point? 

I love how you were like, “Yeah, I didn’t want a C-section. I feared that more than I did that.” Anyway, getting off that topic now so we can get this review and get on to your story but I think it’s a topic we don’t talk about and it’s not something that we are thinking about so as you are preparing, Women of Strength, for your VBAC, it might be something that you want to discuss and learn more about both vacuum and forceps and discuss with your provider what their tool of choice is and just have that in the back of your mind. 

07:36 Review of the Week

Meagan: Okay, so onto today’s review. It is from laurenswat and it was back in 2023. It says, “Thank You.” It says, “I listened to as many episodes as possible when preparing for my VBAC. The stories on here were so encouraging to me and Meagan is so knowledgeable and reassuring. I am happy to say that I had my unmedicated hospital VBAC last week and I caught my own baby before the doctor even got in the room.” 

Oh my gosh, that is awesome. Seriously, catching your own baby is so amazing. I loved it personally myself as well and highly encourage it to anyone that is sort of interested because it is a really cool feeling. Thank you for your review and as always, we are looking for reviews. It is what helps people find this podcast. It helps us grow as a community. You can leave it on Apple, Google, email us, or whatever but we are so grateful for your reviews. 

09:27 Kelsey’s stories

Meagan: Okay, Kelsey. 

Kelsey: Yeah? Hi. 

Meagan: Hello. Welcome to the show. 

Kelsey: Thank you. I’m super, super excited. 

Meagan: Me too. Me too. I would love to turn the time over to you. Both of your babies were born in Canada. That’s correct, right? 

Kelsey: Yes. Yeah. 

Meagan: Tell us the story. 

Kelsey: Yeah, so basically my husband and I got married in November 2019. Just prior to that, we had actually been living in New Brunswick. Just prior to getting married, we decided to move back because we are from Ottowa. We moved to Ottowa. We were living with his parents, his dad, at the time. 

We went to Mexico for our honeymoon and on our honeymoon, we decided to start trying to have a baby. We decided to start trying but not preventing it because we weren’t sure how long it was going to take and there was no indication that it could take a while but my husband is actually an IVF baby. It had taken 7 years for his parents to conceive him. 

Meagan: 7 years, wow. They are amazing. That’s a long time. 

Kelsey: He was actually their last attempt. When his mom got up to say our wedding speech, she was like my 1 in 7 or something like that and I was just bawling. 

So because of that, we decided to start trying and not preventing but there was nothing indicating it would take us a while. We started trying in December of 2019 and it just wasn’t happening for us so around the year mark, we had a lot of friends who started trying around the same time as us and were getting pregnant really, really quickly. I was going to so many baby showers and crocheting baby blankets that just weren’t for my baby. 

Actually, the year mark rolled around and I got my period the day of. My best friend gave birth the day of. I was trying so hard to be happy and stay positive and whatnot, but it was devastating. 

11:47 Logistics of giving birth in Canada

Kelsey: We ended up being referred to a fertility clinic. They did a full work-up on both of us and there was nothing. They didn’t come up with anything. So they said, “You could keep trying or we could start IUI.” My husband and I said, “Let’s do 3 more months of trying on our own, and then we will try for IUI.” Our fertility clinic was in Ontario and we ended up moving to Gatineau, Quebec in July 2020.

The way it works in Canada is you have your healthcare which covers. You can go inter-provincially and give your card unless you are from Quebec. If you are from Quebec, it’s kind of like living in another country. If you have a RAMQ card, you actually have to pay for your care in Ontario. 

The Quebec government will reimburse you but only for 30%. It’s super weird. If you are from Ontario and go to Quebec, the Ontario government will cover you in Quebec. 

Meagan: What? So weird. This world is so weird. 

Kelsey: I know. It’s super bizarre. So essentially we moved to Gatineau because the housing market was a little less expensive. I was working in Gatineau at the time as a teacher. I was extremely stressed out in my job especially once COVID hit. We were sent back to the classroom before any of the other provinces were. 

Anyway, I was extremely stressed out in my job and I decided to switch to the Ontario side because you can go between the two. Where I lived, you cross a bridge and you can get to Ottawa so you are in Ontario. 

Essentially, we went through the fertility clinic. They said that nothing was going on but because the Gatineau government will cover you for IVF and any fertility treatments up to a certain price so we had to be referred back to Quebec for IUI. The month that we were referred back to Quebec for IUI, it was the day before my appointment that I found out I was pregnant. 

Meagan: Oh my gosh, yay! 

Kelsey: Yeah, on our own. It super just happened and some weird funny things happened. The day before, my husband and I went for a walk around our neighborhood. I found a quarter and was like If pennies are lucky, then quarters must be super lucky. I picked up the quarter and put it in my pocket and the day after, I found out I was pregnant. 

These weird things kept happening. My pregnancy made me oddly psychic too which I’ll get into after. 

14:38 A normal pregnancy

Kelsey: I got pregnant in March. I was due November 28th. I had a super easy pregnancy. I was nauseous for the first little bit. I was working for a virtual school in Ontario so I didn’t have to go into the school which was really nice. I just got to hang out in my basement and yeah. I mainly had nausea as a symptom but I was also extremely anxious because it had taken us so long to get pregnant. It felt like it was so long. It was about 15 months. 

I was super anxious. I had heard so many stories of miscarriage and whatnot, but luckily, we were followed by the fertility clinic because we were with them so we had a scan at 5 weeks and we had a scan at 8 weeks and then at 12 weeks once we graduated which was really nice. 

It was a really, really normal pregnancy. I ended up going back into the school in September and I was working as a French teacher. I went off work at 36 weeks. It was pretty normal. The reason I say that I was psychic during my pregnancy is that I kept saying all of these things about my baby. 

I had this gut instinct that he was a boy and sure enough, it was a boy. Mind you, it’s because my husband’s family only really has boys but then with certain things, people would say, “When do you think he will be born?” I’d be like, “Oh, I think December 4th.” I would make off-hand comments like, “Oh, he’s going to have really dark hair.” My husband and I were both born at 5:00. I was born at 5:00 at night. He was born at 5:00 in the morning. I said, “Wouldn’t it be funny if he was born at 5:00?” 

I said, “He’s going to be over 9 pounds. I can just feel it. He’s going to be 9 pounds.” Then the other weird thing is that I said he would be born December 4th, but someone told me, “No, you don’t want him to be born on December 4th. He will share a birthday with your cousin.” I was like, “Okay, December 3rd.” 

December 3rd rolls around and I am 5 days past my due date. I wake up in the morning to go to the washroom and my water breaks. I had not been well-informed about birth. I was just going into it like, Yeah. Everything is going to be fine. I had a bunch of friends who just had babies and everything was smooth sailing. 

The only time I had heard of a C-section was when my aunt had two C-sections because she had a breech baby and a special scar and then they didn’t give her an option for a C-section. I was like, Oh yeah. It’s going to be fine. 

My provider told me, “If your water breaks, go straight to labor and delivery.” 

Meagan: Many do, by the way. 

Kelsey: Yes, I do know that. 

Meagan: It’s a very normal thing for people to say, but we don’t have to do that. 

Kelsey: Exactly. 

Meagan: I did the same thing, the same exact thing. 

17:50 Arriving at the hospital

Kelsey: Yeah, so we went into labor and delivery. Actually, we went slowly. My husband was like, “I’m going to take a shower.” I was under the impression that baby was going to be born in a couple of hours. I was like, “We’ve got to go.” He was like, “No, no. I’ve got to take a shower. First impressions are important.” I was like, “All right.” 

Then we went and we got Tim Horton’s because I was super hungry. I figured This will be the last time I eat.

We got to labor and delivery. They monitored me for two hours and I didn’t have a contraction until 6:00 right as I was leaving and I was only a centimeter dilated. She was like, “Come back in 12 hours or sooner if your contractions get intense.” 

So I went home. I decided to go to sleep but I was having irregular contractions. I woke up probably around noon and I was starting to get uncomfortable. My contractions were starting to get closer together and they were more intense. I could feel them in my back and in my bum. I learned a lesson. Anyway, I’ll get into that after. 

I could feel them mostly in my back and in my bum. My husband was like, “You look like you’re really uncomfortable. We need to go to the hospital now.” He was afraid of getting stuck in traffic because I ended up giving birth in Ontario even though we lived in Quebec. The reason is the hospital I gave birth at actually takes your RAMQ card, the Quebec healthcare card so we weren’t going to be charged for it or anything. The Gatineau hospitals are not known for being super well-equipped for much so we preferred to give birth in Ontario. 

We drove to Ontario which was a 30-minute drive so not super terrible, but traffic can be bad going across the bridge sometimes. The whole way there, I had really uncomfortable contractions. 

We got to the hospital and the doctor had me in the waiting room for 30 minutes, not terrible. The doctor meets with us and immediately, I just was not into him. He just put me off. He made an off-hand comment about nurses. He was like, “I see pain. Do you want pain medication? Do you want Advil or Tylenol?” I was like, “Whatever you can give me, I don’t know.” I told him, “One of the things going into it is that my husband would really like to catch the baby. Can we do that?” 

He was like, “Well, do you think you can handle it?” I’m like, “Well, he was a firefighter so he’s pretty okay with that kind of stuff.” Yeah. I can’t even remember the comment now, but he made an offhand comment like, “Well, that’s what nurses are for,” or something like that. I just was super put off by him. 

We went into our room and I didn’t know at the time that maybe I could have asked for someone different or whatever. We go into our room and we get set up and they were like, “We have to monitor you for a little bit.” I was like, “I’d really like to labor in the tub. Can I get in the tub?” They said, “We need the monitor on you for an hour.” I’m like, “Okay.” 

They monitor me for an hour. They give me a shot of Demerol or whatever. I was under the impression and my mindset going into it was that when you give birth, you use pain medication as pain management. I hadn’t researched anything else. I was just like, “I want the epidural as soon as I can get it and whatever you can give me for the pain is great.” 

21:37 Stalling at 7 centimeters

Kelsey: I was monitored for about an hour and they let me get in the tub. For two hours, I laid in the tub and that’s my best memory of my birth with my first. I laid in the tub and listened to music. My husband and I were in the dark. It was very calm, soothing, and relaxing. When I got out, the doctor was like, “We need to check you.” He checked me and I was at a 1 but he could stretch me to a 3. He said, “If you want your epidural, you can have it now.”

I didn’t know any better so I said, “Yeah, okay. Give me the epidural.” Overnight, I was progressing 2 centimeters every 2 hours. We got to 3:00 in the morning. I told a nurse, “I feel a lot of pressure in my bum.” I said, “I feel like I have to push.” She checked me and she was like, “No, no. You’re only at a 7.” 5:00 AM rolls around. My nurse comes in again and she checks me and she’s like, “Oh, you’re at a 9.” Another nurse comes in right after and she says, “She’s not at a 9. She’s at a 7.”

The two of them were like, “We need to get a doctor in here to confirm.” It’s 5:00 AM. The doctor didn’t show up until close to 7:45. He’s like, “I’m not going to check you because the changeover will happen in 15 minutes and the new doctor is going to check you. I don’t want to introduce any more bacteria.” 

The new doctor came in at 8:30. She checked me and she goes, “No, you’re still at a 7. You’ve been stuck at a 7 for a few hours. We really need to start talking about a C-section.” It was the first time she had seen me. I had been lying in a bed now for almost 12 hours. They gave me the peanut ball for 2 hours and then they took it away I think because my son’s heart rate had started to go funny or they lost it or something like that but he was doing fine. 

They lost it because he moved or whatever. They took the peanut ball away and nothing showed that he was under any distress at all but she was like, “You’ve been stuck at 7 for a while so I want you to talk about it with your husband.” I was in tears because again, the whole time, all I said to my own provider was, “I don’t want a C-section. I don’t care what happens. I don’t want a C-section.” 

So I’m in tears. She’s like, “Talk about it with your husband.” She comes back an hour later and we were like, “We want to wait a little bit longer.” She goes, “Okay, what we’re going to do is put you on the highest dose of Pitocin.” She was like, “We’re going to start you on Pitocin and every 5 minutes, we’re going to increase it until you’re at the highest dose. Then we’ll wait 2 hours, check you again, and if you haven’t gone anywhere, you’ll have to have a C-section.” 

I didn’t know any better so I was like, “Okay.” They started me on the Pitocin but I’m having intense pain and pressure in my bum. I’m like, “I feel like I have to push. My body feels like it is pushing.” I knew that if you pushed too soon, your cervix would swell. That’s one of the few things I did know. 

They put me on Pitocin and I was crying because I was panicking. My husband was having to push my bolus every 15 minutes when it came on because I could feel everything through the epidural. The nurse was not super kind about it. She was like, “You need to stop pushing. If I check you now and you’re not an 8, then you’re going to have a C-section.” 

She just was not overly compassionate or anything. Well, finally, she suggests, “Why don’t we put you on your hands and knees?” She put me on my hands and knees and I felt immediate relief. Something changed in baby’s position. I sat there and I was able to talk. I was comfortable and I was fine. I think we got to an hour and a half and then they checked me because what happened was they put me on my hands and knees and my feet lost circulation and turned purple and went numb. 

Yeah, so then they put me on my back again. They checked me and they were like, “Oh, you’re at a 9.5.” I’m like, “Yes.” I progressed. 

26:22 Asynclitic and OP positioning

Kelsey: Finally, we got to 10 centimeters and I was a typical you push on your back type of thing. The doctor said, “We cannot wait to let baby descend. Your water has been broken too long.” Then she checks me and she’s like, “Oh yeah, and baby’s OP.” I should have learned. Had I done my research, I would have known all that pressure was my OP baby. 

So she said, “Baby is OP. We’re going to start pushing.” I was so frustrated by her because she would leave the room and then she’d come back and she’d sit there just with her hand inside of me and checking her watch and stuff. She was just waiting for the hours to pass. I’m doing everything I can. 

Once they told me that I could push, I was like, “Yes. Let’s get this baby out.” I pushed for 3.5 hours and then they said, “We’ll give you 30 more minutes and if you cannot get baby out in 30 minutes, we’ll try forceps but we’ll need an OB to come in because if forceps fail, you will have a C-section.” 

I decided to push for 30 more minutes and the nurse came in and said, “Let’s flip you.” They flipped me again and I lost all of my progress. They had also told me that not only was baby OP but he was asynclitic so his head was tilted to the side. They said, “That’s probably what’s happening.” But when I flipped, I lost my progress. There was a new nurse who couldn’t figure out how to get the monitor on me so I couldn’t push in that time. They were like, “Well, we’re going to stop pushing because whatever.” 

30 minutes passed and I had lost all of my progress. They’re like, “Okay, we’re going to get the OB in.” She comes in and she says, “You could tear.” I said, “I would rather tear than have a C-section. I don’t want to have a C-section.” 

Then I said, “What are the chances that this will work?” She said, “I wouldn’t do it if I didn’t think it would work.” As she tried to get the forceps on, I could feel my body pushing. I’m like, “Can I push? Can I push?” She’s like, “No, don’t push right now.” 

My body is doing it for me and she can’t get the forceps on so she’s like, “I can’t do it.” As she was trying to put the forceps on, baby started getting tachycardic so they said, “Things are going to get really scary for a minute because this is an emergency C-section. A lot of people are coming in here and we have to turn on alarms in the hallway because we have to get you to the OR really quickly.” 

Meagan: Wait, so baby’s heart rate is high not low, and just because baby’s heart rate went a little high, they treated it as a true emergency. 

Kelsey: Yes. 

Meagan: Okay. 

29:31 Kelsey’s Cesarean under general anesthesia

Kelsey: They start throwing clothes at my husband. There were people piling in. I’m in a hospital that is French-speaking. I can speak French but not medical terminology. Nobody is talking to me. They’re all just talking around me and they’re rushing me down the hallway. I’m bawling and I’m like, “I don’t want this.” I have no idea where my husband is. They’re trying to push my legs together but baby is so low that it hurts to do that. I’m telling them to stop and whatnot. 

We get into the OR and I was inconsolable because I was terrified. They gave me my spinal which didn’t take. They gave me the pinch test and I was like, “I can feel it. I can feel it.” I’m crying, “Please just put me out. I don’t want to be awake for this. I’m scared.” They’re not talking to me and that’s the last thing I remember is saying, “I can feel that,” and they put me out. 

I was under general anesthesia and I woke up 2 hours later in recovery by myself. It was COVID. It was in December 2021. My husband couldn’t be there. I asked where he was and they said, “Oh, he’s in your room with your baby. Everything is fine.” I was sobbing. The first thing she said to me was, “Everything went great. You are a great candidate for a VBAC.” That stuck with me. 

The whole way back to my room, I was staring at the ceiling. I couldn’t look at anyone. I was just devastated by how everything had gone. I didn’t think I could ever look at my husband or my baby ever again. I was just like, What happened?

I hear my husband. He is like, “You need to see. Our baby is here. You should see him. He is so beautiful. He has the most beautiful eyes.” He came around to my bed and he passed me my son and nothing mattered. None of it mattered. He was 9 pounds, 8 ounces so I was right. He was born on December 4th which I had said at 5:11 PM. 

Meagan: Oh my gosh. 

Kelsey: Yeah. He had a full head of dark hair. He was born in a snowstorm. That was the other thing. I said, “He’s going to be born in a snowstorm,” because my husband and I were both born during a snowstorm and he was born during a snowstorm. 

Yeah, he was perfect. He was huge and he was chunky and he looked exactly like me. Normally, they look like their dads is what I’ve heard but he looked exactly like me and was so beautiful. 

Throughout my pregnancy, I don’t like being pregnant because I don’t like sharing my body I’ve learned. Throughout my pregnancy, I said, “I don’t want another. I don’t think I want another.” When he was born and I held him, I was like, “I will do this again in a heartbeat.” 

34:50 Second pregnancy and VBAC prep

Kelsey: Postpartum was good. I ended up starting therapy 5 days after my C-section. He latched and he did not have breastmilk for his first feed which makes me really sad. I was devastated from the C-section because I didn’t get to see my baby be born. I didn’t get to hear his first cry. I didn’t get to touch him first and my husband wasn’t there. He wasn’t allowed to be in the room. 

Postpartum was fine. I was seriously anemic. I was incredibly swollen. I had no knees because I was on fluids for so long and getting around was awful, but I just focused on our baby. He was perfect. He was so easy and 6 weeks rolled around and I was like, “Let’s have another.” But we waited. 

We decided around 9 months to start trying again and loosely trying because again, we were wondering how long it would take. 

Meagan: Right. 

Kelsey: We ended up trying got 6 months and I got pregnant in April of 2023. My due date was December 29th. Again, super, super easy pregnancy throughout. Immediately after my C-section, I decided to look into VBAC because that stuck in my head. I had been listening to a different birth story podcast. I searched for VBACs and there weren’t many and then I searched VBAC in general on Spotify and came across you guys.

I started listening to VBACs before getting pregnant and I started doing lots of research about it. I learned about the cascade of interventions and how my case was really typical. I started learning about OP babies and how the pain I was feeling correlated with that. I wanted to try for a birth in a birthing center. 

Now, when I got pregnant with my second baby, I was living in Gatineau but we had a bunch of stuff happen. My mother-in-law ended up splitting up with her husband. We said, Hey, let’s buy a house in Ontario together and we’ll move in. 

I found out I was pregnant about 2 weeks before we put in an offer on a house and we moved in in July when I was 15 weeks pregnant. At the time, my GP was my provider for my first and I started off with her with my second as well. The thing was when I found out I was pregnant, I went to her. Sorry, I should have said. 

After my C-section, I went to her and said, “I was told I was a good candidate for a VBAC.” She said, “Yes, but you cannot go over your due date. We’re going to monitor your baby to see how big it is because you had a big baby before. You cannot be induced. You need to have 18 months between pregnancies.” Typical. 

Meagan: All of the red flags. 

Kelsey: Yeah. This was before I started listening to your podcast. Then I started listening to your podcast and when I went in to see her when I found out I was pregnant before I had gone into a birthing center, I said to her– and I’m not an outspoken person. I struggle to advocate for myself. I said, “I want to try for a VBAC, but I do not want you to put limitations on me.” I said, “I know that I can safely have a VBAC even if there is less than 18 months between my pregnancies. 

From birth to birth, it was 2 years and a bit so it didn’t matter. I said, “I know that big babies are 10 pounds+. That is macrosomia. I know that.” I said, “I know that I can’t be induced.” In Canada, they generally don’t do Pitocin for VBACs at all. They don’t generally induce for VBACs at all. I said, “I do know that there are safe ways to induce though and I do know that I can safely go past my due date.” She said, “I believe in informed consent and if you understand all of this, I think that you are well prepared and we can move forward with a VBAC.”

I said, “Great.” I had applied for birthing centers prior to this but it is really hard to get into them here. I ended up being able to get into one in Gatineau. I was concerned about moving over cross-provinces again. It ended up working out. I did stick with my GP until I was about 20 weeks pregnant just in case. 

It didn’t work out with the birthing center after my move. What happened was, she was super, super supportive, but she would say things like, “Do you want me to book you an appointment with an OB just in case?” or “Do you want me to book you a C-section at 40 weeks just in case?” I was like, “No, I don’t want you to.” She said, “Okay,” but around 20 weeks, my midwife was like, “We can keep you on even though you live in Ontario. It’s no problem.” I said to my GP, “My midwife will keep me on.” My GP said, “You sound like a really good candidate so go ahead. I really hope it works for you. I hope that it’s everything that you want.”

Meagan: That’s good. 

Kelsey: She was very supportive of it so I felt really good about it. 

41:07 Switching to midwives

Kelsey: I switched to the midwives full-time. My pregnancy was super smooth again, but there were little hiccups. I didn’t pass my one-hour gestational diabetes test. They said, “If you have gestational diabetes and it can’t be managed, we will have to transfer care.” Around 37 weeks, I started measuring large and they said, “We think we want to send you for an ultrasound just to be sure of how big baby is.”

I said, “I know that those ultrasounds aren’t super accurate so I’m not sure that’s what I want.”

I ended up getting a doula through The VBAC Link. I found a doula. 

Meagan: Yay!

Kelsey: Yeah, what was funny about the doula is she was pregnant too and her due date was a week after mine and we found out that we were giving birth at the same place. 

Meagan: Oh my gosh. 

Kelsey: So she was like, “I’ll keep you on and I’ll do your prenatal appointments, but I probably won’t be at your birth. I have a partner who is a nutritionist.” She ended up being amazing. My son was in daycare. I got sick a lot and I couldn’t take anything for it so she would help me find natural ways of dealing with a cough. I think I had pregnancy rhinitis for the last trimester. I was constantly congested. I had terrible acid reflux. She originally had prescribed chest openers, but my midwife ended up putting me on medication for it because of the trigger to cough. She was afraid that my cough could trigger my water breaking too early. 

I couldn’t give birth at the birth center if baby came before 37 weeks. I had to make it past 37 weeks. 

Yeah, so pregnancy was smooth. I was extremely nauseous in the beginning. It was really hard with a less-than-two-year-old. I kept him home because I’m a teacher. I’m home over the summer. I kept him home over the summer and it was rough because he just is needy and my 9.5-pound baby continued to stay in the 99th percentile for height and weight. He wanted to be carried everywhere but he is so heavy and he is still so heavy. 

I was a lot more active during this pregnancy than I had been prior. I tried really hard to walk and whatnot and do lots of stretches. Around 30 weeks, baby was still breech and I started to panic a little bit. I started doing Spinning Babies exercises and lots of inversions and whatnot.

When I first met with my doula, I talked with her about everything. I was able to just spit out facts that I had learned from you guys. She was like, “I’ve never met someone who is this prepared or who knows this much.” She was like, “I have all of this stuff to go over with you, but you already know it.” 

She ended up as well becoming certified in HypnoBirthing so I took a HypnoBirthing class. I was really concerned about doing an unmedicated VBAC because I didn’t know if I could handle the pain of it. I had originally wanted to VBAC in the hospital, but I watched– what is that documentary with Ricki Lake? 

Meagan: Um, okay, hold on. 

Kelsey: The Business of Being Born. 

Meagan: Yes, that’s all I could think of was Born. The Business of Being Born. 

Kelsey: My entire perspective on birth completely changed. My husband watched it with me and he was blown away by it. He was just like, “I want that. I want that for us. I want to be a huge part of this. I want to help you through it and be an active participant. Let’s do this.”

We did the prenatal classes with my doula. He learned all of the pain management techniques. He was so excited for counterpressure and he wanted to be active. He was fully supportive and he wanted to catch our baby. 

This time around, we didn’t find out the sex of our baby. We wanted it to be a surprise. I was 100% sure it would be a girl. I didn’t even pick out a boy name. 

Anyway, we get to December 21st. I get checked and she can’t even reach my cervix. It was so posterior. I was super discouraged, in tears discouraged because I was afraid of going past my due date and they were afraid that this baby was going to be so big because I was measuring large. 

46:14 Beginning of labor

Kelsey: Overnight, I started to have contractions. They were kind of regular, but they were manageable. December 22nd rolls around and I’m still having contractions on and off and I start feeling sick. I had pulled my son out of daycare to prevent getting sick. 

I started to get a cough and I was really congested. I wasn’t feeling well at all. I was supposed to go to Costco with my mom that day. I texted her in the morning, “I’m having contractions. Not feeling great. Let’s cancel,” but because my son was home, things started to slow down with the contractions. I said, “You know what? Never mind. I need something to do today.” 

My mom picks me up and my husband and her are joking that I’m going to go into labor at Costco. We walked the entirety of Costco as I was having contractions. My 18-year-old brother is in the back of the car. I’m breathing through them and he’s like, “What is happening right now?”

I get home. I started timing them and they were 6 minutes apart. My husband decides that he is going to take our son. He was kind of off work so he took over care of our 2-year-old. I ended up going and taking a bath and all of the contractions stopped. 

That night, they started again and then on the 24th of December, they were still pretty inconsistent but my doula was suggesting things like, “Oh, if you’re comfortable, have sex, then take a shower. Sit on the toilet and do nipple stimulation for 15 minutes on each side and see if that gets things going.” 

We had sex and then it all stopped. We kept trying things and then my doula was like, “I just think that maybe your body needs to rest and relax so let’s try resting and relaxing.” Well then, the 25th is Christmas Day and I decided to host Christmas. 

Meagan: Because that would be a really good distraction. 

Kelsey: Yeah, I was like, “It’s going to be fine.” My mother-in-law was like, “I’ll cook Christmas dinner.” Prior to that, I had all of these ideas. I’m going to make bread by myself. I’m going to make all of these desserts. I’m going to make puppy chow. I’m going to wrap all of my kid’s Christmas gifts. I’m going to put together his Pikler Triangel we got for him and wrap that. 

Just all of these things that I wanted to do for Christmas. By the 24th, I was so exhausted from the contractions that I didn’t bake anything. There was no way. But I did host Christmas dinner and everyone told me, “Why? Why are you doing that?” I was like, “Well, it will be easy,” because my husband and I are both from divorced families. We’ll just have everyone over for Christmas, and then we won’t have to worry about going to anyone else. 

We had my mom and my brothers came over and his step-mom came over and my step-dad came over. It just was not great. 

Meagan: Like Christmas Vacation where the door keeps opening and all of the family members keep showing up. 

Kelsey: I know. I was still having contractions. I couldn’t stand up or sit down without having a contraction. 

I was just exhausted and uncomfortable and felt huge. People are like, “How are you doing?” I’m like, “I’m surviving. Right now, I’m just surviving.” 

So anyway, finally Christmas Day is over and Boxing Day, I wake up at 7:30. I had a weird contraction. I went to the washroom and I had my bloody show. I was like, “I’m just going to try to go back to bed,” because my son and my husband weren’t up but my back started to hurt. I was like, “Okay, I’m actually just going to get my son up and go downstairs.” 

My husband got up with me. We go downstairs. We started getting my son ready. I’m like, “I’m going to get in the bath and see if my contractions stop because I’m really uncomfortable.” I called my midwife from the bathtub and I said, “They are 5 minutes apart and they haven’t stopped, but I’m scared to come in because what if this isn’t real?” She said, “If you’re in the bathtub and they are still going, this is real labor. You need to get here now.” 

51:07 Driving to the birth center

Kelsey: We get all of our stuff in the car. It was a 50-minute drive to the birthing center. 

Meagan: 50? 5-0?

Kelsey: 5-0. 

Meagan: Okay. 

Kelsey: The good part was that they were regularly 4 minutes so I could look at the clock and know that I was going to have a contraction and I could breathe through it. I was managing pretty well at that point, but before we had left, my mother-in-law decided to stop me at the door. She was like, “So where are you feeling them?” I’m like, “I just need to go. Please just let me go. I can’t talk to you right now.” My husband is trying to get me out the door too because he knows. 

We get to the birthing center. It was nice because I could choose the color of my room. They had options for the color of your room so I chose purple. I get into my room. It’s now 10:00. I could hear in the next room a woman screaming, literally screaming. I start panicking. I can hear her yelling, “Get out of me already!” 

Meagan: Aww. 

Kelsey: My vagina is on fire! I’m panicking. My midwife says, “I need to monitor you for a little bit, so can you get on the bed? I’m going to monitor your baby’s heart rate and then I’m going to monitor your contractions.” She could get baby’s heartbeat and she couldn’t get my contractions on the monitor. 

At this point, I’m starting to panic because I can still hear the woman screaming. My husband’s like, “I’m going to get you your headphones.” He gets me my headphones. 

Meagan: Very good call. 

Kelsey: He gets me my headphones and puts on my birth playlist. I’m laying there and things start getting really intense really fast. I was panicking that the same thing that had happened with my son was happening again. But I started getting irate and my midwife still couldn’t get the contractions on the monitor. I remember flinging my headphones off and just being like, “I need to go to the bathroom. Let me up. I can’t lay here anymore.”

She’s like, “Okay. If you need to go to the bathroom, go to the bathroom.” I’m sitting there on the toilet. I’m crying and I’m telling my husband that I can’t do this. In the back of my head, I know what that means, but I couldn’t ration with myself at that point. My midwife hadn’t checked me yet at all so she goes, “I really want to check you because we haven’t done that.” 

I had to get off the toilet. I didn’t want to and as I was getting off the toilet, I was so hot. I’m flinging my clothes off. I get to the edge of my bed and I’m like, “It’s not me. It’s my body. I’m pushing.” I saw my stomach contort. It was just like my whole body was not me at all. It was so wild to me. 

My midwife gets me on the bed finally and she checks me and she goes, “You’re at the 7th centimeter.” She said, “You’re a second-time mom so if your body feels like it, it remembers. You can start pushing whenever you want.” It was such a different experience from being told in the hospital, “Do not push,” when I’m at 10 centimeters to my midwife being like, “If your body is pushing, it’s fine.” 

54:49 Pushing baby out in two pushes

Kelsey: So she put me over a ball and then she called in the assistant midwife because she was like, “This is happening very soon.” 

The assistant midwife comes in and that was funny because she goes, “My name is Gabrielle.” I had a friend who had gone to the birth center who had Gabrielle. I turned to her and said, “You know my friend, Kelly.” She was just like, “Yeah.” I’m like, “I heard you’re really good.” She’s like, “Okay, let’s–.”

So over the ball, my husband tried to do counterpressure on me and I was like, “Don’t. Don’t do it.” But he pressed my tailbone down and that made a huge difference and I just kind of let my body do its thing. They had to flip me a couple of times and I ended up being put on my back to push for the final little bit because they needed to keep monitoring baby’s heart rate. It kept going down every time I had a contraction so they were a little concerned. 

At one point, they said, “Don’t panic, but we are going to call an ambulance just in case just because we keep seeing this. We’re going to call an ambulance just so that they are here.” Yeah, so I pushed on my back for a while and I remember at one point, she said, “The head’s right there. If you reach down, you can touch it.” I was like, “I’m going to have my baby vaginally.” My husband was like, “Yeah, you are.” I was just so excited. 

In one push, his head came out and she goes, “Ope, he’s OP.” He was sunny-side up. My husband was like, “He’s looking at me.” Well, sorry. That’s a spoiler. “They’re looking at me. I can see the baby. Their eyes are open. Their mouth is going.” And then she said, “Okay, next time, one really big push,” and he came out on the second push. 

My husband caught him and put him right on my chest. I was like, “What is it? What is it?” It was another boy, so spoiler alert. We didn’t have a name. I got to hold him on my chest for 2 hours. We did delayed cord clamping. My doula made it in the last 15 minutes and she said to me, “I think Victoria is in the next room having her baby.” 

Meagan: Nuh-uh. I wondered when you were saying that. I was like, I wondered if that was her doula. Oh my gosh. 

Kelsey: Literally, our babies were born 2 hours apart. 

Meagan: Oh, that’s so cool. 

Kelsey: We were in the birthing center at the same time which was wild. I got to see her on my way out which was really nice. 

Meagan: That’s so special. 

Kelsey: Neither of us knew what we were having and we both had little boys. They weighed him and my super big baby was 8 pounds, 3 ounces. 

Meagan: Perfect. 

Kelsey: Perfect. Yeah. People were like, “That’s a good-sized baby.” I’m like, “My first was 9.5 pounds. He’s tiny.” My husband got to tell me the sex of the baby which was another thing I really, really wanted. We did delayed cord clamping. We had the golden hour. We just got to sit there and compared to my prior experience, I just felt so cared for. I remember a midwife putting a cold cloth on my head and I thanked her. Her response was, “I know you are grateful. Save your strength.” She was just like, “You don’t need to tell me thank you at this moment. Just don’t talk at all. I know you are thankful.”

Meagan: Enjoy. 

Kelsey: Yeah, I was given water in between pushing. My doula sat there and rubbed my eyebrows so I wasn’t tense because I learned about the fear/tension/pain cycle. My husband got to be a huge part of it and he got to cut the cord. He didn’t get to do that with our first. He got to hold our baby. He touched him before anyone. It was just– my husband and I talked about it for a while afterward and he was just like, “You know, why is this not the gold standard for birth? Why is this not what we do every time? This is the most incredible thing.” 

We recorded the entire thing. 

Meagan: Yay. If you decide you want to share, post it in the community. 

Kelsey: There is a 30-minute video out there because my son was actually, so my first birth was 38 hours total. My second birth, I had my first real contraction at 7:30 AM. My son was born at 12:38 PM. There were 5 hours. 

Meagan: Another five, by the way. 

Kelsey: I know, so weird. I was not psychic for this birth because I had a boy. I was so convinced I was going to have a girl but he was a little boy and he was baby no-name for four days. We ended up naming him Oliver. 

1:00:24 Differences in care

Kelsey: Yeah, I just felt so cared about and looked after. There were differences like my husband had to go out and search for food after I gave birth after my first. He was so exhausted, he couldn’t get out of the parking lot so my mother-in-law had to drive in to bring us food. I ended up scarfing down Popeye’s but I had been intubated and my throat hurt so badly. I ate the world’s driest biscuit and thought I was going to choke and die. 

But with my second birth, they had a postpartum doula who was there. She offered me lentil soup and a grilled cheese so that was my first meal. 

Meagan: So much better. 

Kelsey: Yeah, lovely lentil soup and grilled cheese. My son had been placed on my chest but I still had my bra so they washed it for me before I left. Just small things like that, I felt like I was cared for. 

Meagan: Yeah, absolutely. 

Kelsey: We ended up leaving at 5:00 PM. We were home in time to eat dinner at home. 

Meagan: Yeah. Yeah. 

Kelsey: That postpartum experience was incredible. We literally, I was able to get up and walk and I wasn’t dizzy or anything. I barely felt like I had a baby. I did have a second-degree tear but for some reason was just completely unbothered by it. My midwife came to me postpartum which was really lovely. 

1:02:11 Enterovirus

Kelsey: However, one thing I did want to touch on was I had a cold during labor and this is something I wanted to mention because it is not something I knew about. I had a cough and five days postpartum, on New Year’s Eve, my doula came. Not my doula, my midwife. As they do, she temped my baby and he was measuring a little hot. She temped him a second time and he was normal. 

Around 4:00 AM on New Year’s Day, I realized he was very warm. I temped him and he had a fever. I only know Celsius but it was 39.9 which is really high. I temped him a second time and he was 39.2. Anything over 38 is a fever. I ended up having to take him to the hospital and I didn’t know what the protocol was if your baby gets a fever below two months. 

We were pretty much admitted on the spot. He had the full workup. He had bloodwork done. He had a lumbar puncture done. He didn’t have a birth certificate and had to have a lumbar puncture done because the problem was that they were looking for infections. When they did his lumbar puncture, they did find something. He had a virus called an enterovirus. In adults, it’s just a common cold, but if you get it while you are pregnant, you can pass it through your placenta to your baby just before you deliver and your baby can be born with the virus. 

It can just present as a fever, but it can also progress to viral meningitis. 

Meagan: Oh, scary. 

Kelsey: My son was kept in the hospital for two nights. Because of the fever, he stopped nursing. He was super sleepy and they make you stay for two nights even if they perk up and are nursing and everything seems fine. They will keep you for two nights because they are looking for things to grow on the lumbar puncture. If a fever indicates an infection and because the blood/brain barrier is so thin, infections can spread super quickly to the brain. 

Meagan: Scary. 

Kelsey: He ended up being okay. He didn’t have viral meningitis and I had the most incredible angel nurse while I was there. I was so grateful for her. I forgot my Peri bottle at home and she made me one. She did everything she could to prevent my son from being put on an NG tube while still getting the fluids he needed. She managed to get him nursing enough that we didn’t have to switch to an NG tube. We didn’t have to switch to bottle feeding. He continued to nurse. 

She stuck up for me when a resident came in and was like, “Well, what’s his urine output like?” I was like, “I don’t know. I have no idea.” She was like, “All of that is in his chart if you just check it. She’s obviously very tired. Leave her alone.” I had a lovely angel nurse but it is something I wanted to touch on because I had never heard of enterovirus. I did know what to do if your baby got a fever, but it definitely is that you take them right to the emergency room. Generally, they will admit you for two days. 

But yeah, otherwise, my postpartum experience was night and day compared with my C-section. I was up and moving and I did experience baby blues with my first. I cried for weeks. With my second, I was just so over the moon. But yeah, that’s my VBAC. 

Meagan: I love it. Thank you so much for sharing that. I had actually never heard of enterovirus.

Kelsey: Enterovirus.

Meagan: Enterovirus. I was like, What the heck? That’s actually with an E. I didn’t know that. I just Googled that so it’s really, really good to know that’s a thing. It does look like it’s pretty rare but it’s something to take seriously. Sorry, my dog was barking in the background. He’s got something to say too.

I’m so happy for you and I’m so happy that you could see that it was a very similar situation with an OP baby and things like that and you were still able to deliver vaginally. Maybe it was a little bit of that asynclitic position that maybe made it a little harder to get under that pubic bone. It sounds like in ways they were willing to help you, but they also didn’t help you too much either. 

Kelsey: No. 

Meagan: Yeah. I just love that you were able to prove to yourself too. Not that we have to prove anything to ourselves or anybody, but it is definitely nice when you are like, This is the same situation and look, I did it. Yes, my baby was a little smaller, but it probably wasn’t the size more than it was just a slight bit of position and probably the cascade. 

I love that.

1:08:02 Risk factors for forceps and vacuum deliveries

Meagan: Okay, so before I let you go, I wanted to touch a little bit more on those risk factors for forceps and vacuum because we talked about that in the beginning and tearing. Tearing is definitely a risk. You even said with your VBAC baby that you tore a little bit which is really common with a posterior baby coming out vaginally too just to let listeners know. 

Tearing can happen. It can happen with any baby. We can get rectal pain. Posterior babies, oh my gosh. Amazing to not only labor with one but push one out. It is hard work. You did an amazing job. Yeah. It may have a lower chance or a higher chance of coming out vaginally just in general. 

For baby, that bruising to the head or even nerve damage. It’s really rare but it is a thing. Temporary swelling, skull fractures– again, it’s rare but it is a thing so these are all things to take into consideration. 

For vacuum, we’ve got weakened pelvic floor, tears as well, possible even larger tears weirdly enough so that’s a thing and then yeah, for baby, the suction can pop off and need to be replaced or cause hematomas there. 

Just all things to take into consideration. In the show notes, I know this wasn’t a complete forceps delivery, but because it was something within your story, I wanted to touch on that today and make sure we included links. If you guys want to learn more, check out the show notes. Also, I just think it’s so fun that you and your doula were at the birth center at the same time giving birth at the same time. There are so many fun things about this story. Amazing support it sounds like from your husband, from your family, and from all of the things. I just loved your story and appreciate you so much. 

Kelsey: Thank you. Thank you so much for having me. 

Meagan: Absolutely. It’s been such an honor. 

Closing

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

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The amazing Gina Conley from MamasteFit joins Meagan today to answer your questions all about perinatal fitness! Gina is a birth doula, perinatal fitness trainer, and founder of MamasteFit. ​​In partnership with her sister, Roxanne, who is a labor and delivery nurse and student-midwife, MamasteFit is a place for women to find education courses and fitness programs to be their strongest selves during each stage of motherhood. 

Gina shares her expertise on how exercise affects babies during pregnancy, labor, birth, and postpartum. She also touches on topics like when to start prenatal exercise, what to do if you didn’t exercise before pregnancy, how late into pregnancy you can exercise, weightlifting, and which movements to incorporate to create more space in the pelvis. 

Gina’s comprehensive prenatal fitness book, Training for Two, will be released in September 2024. It is a fantastic resource for all pregnant women!

Link to Gina's Book: Training for Two

MamasteFit Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

01:00 Review of the Week

03:59 Is it bad to exercise during pregnancy? 

09:00 How will exercise affect my baby’s development? 

13:40 Better pregnancies, better birth outcomes

16:23 What do I do if I wasn’t active before pregnancy?

19:30 Movements to incorporate

20:59 Three pelvic levels 

23:19 The mid-pelvis and outlet

25:56 Being told that your pelvis is too small

30:36 How late in pregnancy is okay to work out?

32:31 When is it too late to start exercising during pregnancy?

34:43 Postpartum fitness

39:20 Weightlifting and pregnancy

45:51 Training for Two

Meagan: Hello, everyone. Welcome to the show. We are going to be talking about prenatal fitness today with the one and only Gina Conley. Gina is the founder of MamasteFit, a prenatal fitness training company based out in North Carolina. Gina is a fitness trainer specializing in pre and post-natal fitness and a birth doula. She combines her expertise in both to prepare her clients for a strong pregnancy and birth. 

Fitness in general is one of my all-time favorite things to do and talk about. I do notice a difference when I’m not moving my body, but when it comes to pregnancy, there are a lot of questions surrounding fitness. Is it safe? When is it okay to start? Is it really okay to start later on? How to start? And so much more. 

I can’t wait to dive in on all of the amazing information that Gina is going to share after the Review of the Week. 

01:00 Review of the Week

Meagan: Just a reminder, if you have not left a review, I would love for you to do so. You can leave a review on Apple Podcasts, Google, Spotify, Facebook, or wherever you listen to your podcasts. 

Today’s review is by Janae Rachelle. It says, “The Best There Is.” It says, “I am so happy I found this podcast. After having two prior C-sections, I was convinced I would have to have another C-section for my birth this November. I feel empowered and educated and hopeful I can do this. Thank you for all of the true facts and the safe space where we can all talk about our birth trauma and space where we don’t sound ‘crazy’ for wanting to do something God created our bodies to do.”

Thank you, Janae Rachelle, for leaving that review. You are right. This is that space. This is the space where we do talk about all of the crazy things, where we talk about the trauma, where we talk about the things where in the outside world if we were to discuss them, people would and sometimes do look at us like we may be crazy. But Women of Strength, if you are wanting to pursue a VBAC, if you are wanting to learn about the evidence about VBAC, this is definitely the place. 

All of these stories here are going to share so much information, guidance, facts, and all of the things, and definitely leave you feeling inspired. 

03:59 Is it bad to exercise during pregnancy? 

Meagan: Okay, it’s been so fun. We’ve actually had just a couple of returning guests from the show who have also been on 2-3 years down the road. Before we started recording, Gina was like, “I just had someone say that they listened to my episode that was on your podcast before”, which was 3 years ago. It’s fun to see that people one, are still listening all the way back to 3 years ago and then two, have you back on the show. So welcome. 

Gina: Absolutely. Thank you for having me. 

Meagan: Yes. It’s such an honor. You know that I just love you to pieces. I’m so excited to talk about fitness, prenatal, postpartum, and all of the things today because this really is a topic that as a first-time mom, I didn’t really know much about. When I was first pregnant with my daughter who is now 12, I was just determined. I was like, I’m going to run. I’m going to run a half marathon. This is going to be so great. I’m going to be one of those running through with a big belly. 

I was so excited to be fit and active. Let me tell you, I was the opposite of that. When I was training, I started having round ligament pains and pelvic pains. When I talked to my doctor, he actually told me to stop. He told me to stop which is kind of crazy to me looking back that it wasn’t even just like, “Maybe do less miles or don’t train for a half marathon right now, but do a 5k.” It was just like, “You should just stop. It’s too much.” 

I don’t know why I took that advice as, Okay, I should stop and I should eat Chinese food every day because orange chicken sounded amazing and I should really just not do anything besides be unhealthy.

That’s truly how I felt like I was in my first pregnancy. I don’t think providers all over the world are telling people not to work out necessarily like mine did 12 years ago, but I think that it’s a very daunting topic and we don’t know what to do. I think a lot of people who may not be very physically active before pregnancy are unsure what they can do during pregnancy, if it’s safe, and all of the things. 

We have a big list of questions today to ask you and really, number one is Is it bad to work out during pregnancy? My easy answer is no, but I think it’s a real answer. Can we talk about that? Working out during pregnancy– is it bad? Is it good? Tell me all of the things. 

Gina: There is a lot of fear-mongering and fear involved with exercise during pregnancy. There is this really long list of things that you shouldn’t do so it gets really overwhelming to know, Well, what can I do? when the majority of the things that you see are Don’t do sit-ups. Don’t do this. Don’t do that. If you lift weights, you’ll have a miscarriage. 

A lot of fear that comes with fitness during pregnancy is, Is it going to affect my baby’s development and growth? Am I harming my baby by exercising? And then the second is, Is it going to affect my pregnancy length? Am I going to have a miscarriage or go into pre-term labor because I was exercising during my pregnancy? 

The answer to both of those is generally no. Just as a disclaimer, there are absolutely complications in which the benefits of exercising do not outweigh the risks of exercising. These are usually folks who have preexisting heart and lung conditions, if you have uncontrolled diabetes, if you are actively in pre-term labor, if your placenta is detaching, or have severe preeclampsia. There are circumstances in which exercising is not safe and your provider should be very clear in communicating that to you. You will probably already have preexisting exercise recommendations if it is a preexisting health condition. 

But for the majority of us who are of a normal-risk pregnancy, even some high-risk pregnancies, exercise is typically very safe to do. So a lot of research supports that it does not cause miscarriage and it does not affect the length of your pregnancy which is one of the major concerns with exercising. The risk of miscarriage is highest in the first trimester and it doesn’t differ whether you exercise or you don’t. 

Exercise does not cause miscarriage. It’s just something else that folks like to be blamed for when they do have a pregnancy loss. It was because I went running. It was because I lifted weights. Typically, there is nothing that you could do do prevent that pregnancy loss and it just sucks to be mourning this and then to have this additional guilt put on you like it was because you were lifting weights. There are people who are sedentary and don’t exercise at all and have miscarriages. Are we blaming them that it’s because you didn’t exercise? No, because it’s one of those things that is out of our control. 

09:00 How will exercise affect my baby’s development? 

Gina:The second thing is, is it going to affect my baby's development? Like, is it going to make them too small? Is it going to make them too large? One of the things that can make your baby too small is the placenta. So if the placenta hasn't developed properly or there's an issue or complication with the placenta, it can make your baby too small. 

Well, exercise helps to improve the function of your placenta, especially if you exercise in the first half of your pregnancy, which is really cool. Your placenta will be more voluminous. It'll be larger and it'll have improved functional capacity. It's going to be able to transfer oxygen and nutrients to your baby much more effectively. It's going to help provide immune function to your baby. It's going to provide hormone function to your baby. It's also going to help remove metabolic waste more effectively. It's going to be a much more efficient organ, which is going to help to support your baby's growth. 

The second half is like, is it going to make my baby too big? I think most folks are not concerned about exercising and making their baby too big, but exercising could decrease the risk of developing gestational diabetes. Obviously, you can still exercise and eat super healthy and still develop gestational diabetes. It's not a foolproof method to avoid it. 

But exercising can help reduce your risk of developing gestational diabetes by 39% which is pretty substantial. And if you do develop it, continuing to exercise and eat well can also help to reduce the risk of you needing to get insulin or medication to manage your gestational diabetes. Those are the things that are contributing towards developing a baby that's too large. So having gestational diabetes that's controlled with insulin, uncontrolled gestational diabetes, and those two things can be mitigated with exercise. 

Exercise can actually help your baby grow more optimally, to have really good body composition, and be a really good size.

In addition, which is really cool– and this is stuff that I was researching when I was writing my new book, Training for Two, which comes out in September. I'm really excited about it. I guess it's like the twins in my current pregnancy. 

Meagan: It’s awesome. 

Gina: But one of the things that I was researching because our editor was like, “We really need to highlight why exercise is so beneficial for baby because this is something that's going to help motivate people to move their body.” Something for me that has been helping to motivate me during my current pregnancy to move when I'm kind of like, But I don't really feel up to it is one, it helps to improve your baby's nervous system development, which is really cool. It helps to increase their blood volume as well. They have more blood reserve to respond to the stresses of labor and to postpartum after they are infants. 

When they're in the world, it improves their brain development. They have more cognitive function. And these are all things that are probably in response to the stimulus of exercise. So we're introducing more stimulus to them during exercise because of this controlled stress that we're introducing which is helping to build all these new neural pathways and helping them just start doing things a little bit earlier. 

What that translates to in the first year of life, they have more motor skill development, so their fine and gross motor skills. They're crawling earlier, they're walking earlier, they're rolling and doing things earlier. They have more cognitive function. That's responding with higher levels of IQ and improved language skills. 

Meagan: Wow. 

Gina: So there's a lot of benefit to just being active. It doesn't have to be go and lift super heavy weights. It can just be going for walks every day, doing yoga every day, and doing intentional movement throughout the day is exercise. It doesn't have to be like how I exercise. Then what happens is that even though there are all of these benefits to exercising and fairly little risk unless you have like a complication which your provider will ideally walk you through. 

Even though there are all these benefits, there's still a lot of fear involved with working out during pregnancy. A lot of it's just outdated guidance and folks. I think it probably relates to the fear of women lifting weights and exercising, too. Maybe it's a little bit of that as well. And then make it somebody who's pregnant and it's just like a double whammy. So we have this mentality of like, Well, it's better to be safe than sorry. 

And it's like, Well, actually, you can be sorry. You can actually be sorry if you don't move your body intentionally during your pregnancy because one, not that your baby would be less developed, but we're going to say no thanks to those additional development things that they're having with the nervous system and their brain development. Those are two really big deals, I think. We're going to say no to a larger, more functional placenta which really helps to decrease the risk of developing certain complications during pregnancy. We're going to say like, I'm good with increasing my risk of developing like a prenatal complication, which again, exercising does not equal no complications, but it does reduce the risk to include preeclampsia, gestational hypertension, and gestational diabetes. 

13:40 Better pregnancies, better birth outcomes

Gina: And if we have a healthier pregnancy, it's going to serve us better during labor as well or in the preparation for labor. We develop complications. It increases the necessity of a medical induction. It increases the number of interventions that were being used during our birth. And yes, I am so thankful for medical intervention, for C-sections, and for these things that save lives. But if we can use less of them because we're healthier going into our birth, that's going to help improve birth outcomes as well. 

This is a VBAC podcast. So if you're wanting to have a vaginal birth after a C-section, being healthier during your pregnancy by moving your body intentionally is a really good way to help reduce the risk of needing these additional interventions. I'm thankful for them. But if you don't need them, let's go around that. Let's do that path. 

Meagan: Let’s avoid them if we can. Absolutely. And let me tell you, talking about my first pregnancy where I just kind of quit, I mean, I didn't even really walk. I mean, not even like a 30-minute stroll at night. I just stopped and I really didn't pay attention to my protein intake or what I was really eating. I mean, I was literally told this at the end that I was unrecognizable. Everything about my body was trying to just make a baby and it was showing in a negative way because I was struggling. I got super swollen. I gained a lot more weight. I really was not in shape. 

When labor came, it was harder. It was a lot harder. And then postpartum was really hard. And then having to catch up to all the things that I did to my body, but then not even to think about all the things that you just said about the baby. I mean, I was one of those people that signed up to the “no thanks”. I mean, essentially, right? It wasn't in my head that I was saying that. And then after my, that pregnancy, I was like, I will not do that again. 

I did. I started changing my ways and doing intentional movement. I became a Barre coach and really wanted to be active. It was a night and day difference, night and day difference. I don't think my baby's less smart or whatever, but I will say that like what you said, I can look back and be like, Oh, oh, I can recognize those things. So that's kind of interesting. 

Gina: So it's not like if you don't exercise, you're screwing up your baby’s life or anything. I don't know how to feel the differences between the two, but if you can do things to help improve your baby's growth and development, I think we would want to do that. Even if it's just going for a walk, just move your body. 

16:23 What do I do if I wasn’t active before pregnancy?

Gina: I think one of the things is the next question that's on the list is like, Well, what do I do if I wasn't active before pregnancy?

Meagan: Yes. 

Gina: Because I do have folks that'll either come to my gym– we're located in Aberdeen, North Carolina. We have an in-person training facility. And so we'll have folks that show up and be like, “I have never exercised before in my life, but I heard it's really good for me and I'm pregnant. Help me.” You can absolutely start an exercise program during pregnancy. This is hard to know because you get told, “Whatever you're doing before pregnancy, you could just continue during your pregnancy, just do a little bit less.” 

What if I was not doing anything? How do I do less than that? Like what does that even look like? 

Meagan: Right. 

Gina: You can absolutely start an exercise program during pregnancy. Yes, it will look different than pre-pregnancy workouts. If you were an active person before pregnancy, there will be some sort of modification that needs to happen because workouts can't look exactly the same when we're pregnant. But if you're like, Okay, how do I even begin? Just pick 20 minutes where you go for a walk. Pick 20 minutes where you choose a Peloton on-demand video. They have prenatal ones on there too where you just follow that. We have prenatal on-demand workout videos as well. We also have a prenatal app-based program, so we have some different options as well. 

Just choose a 20-minute option and just move. Just move your body. Use lighter weights. We're not trying to get super sore. You probably will be sore the first week or so. It's just part of getting used to the program.

Meagan: It’s not normal, yeah. 

Gina: It's normal, but don't be working out so hard that you're incapacitated the rest of your day, start for 20 minutes and do that three times a week, and then the next week do it four times and then increase it to 30 minutes. Then maybe it's 40 minutes and then you're walking more. We're just going to start really slow and manageable, and then we're going to just slowly increase during pregnancy. 

The main goal during pregnancy is 150 minutes of moderate-intensity activity per week. That's the minimum goal. So if you exceed that, that's totally fine. Research supports that even higher-intensity activity is perfectly safe during pregnancy. A higher volume of exercise is perfectly safe. But the bare minimum that we're trying to aim for is 150 minutes. That's five days a week for 30 minutes or whatever the math is for the other one. 

But you can also do more than that. I would start with 20 minutes of something that feels manageable for you and do that and if it's, “Hey, I need to follow a program,” we've got programs for you. We've developed them for pregnancy specifically. There's Peloton on-demand. There are so many workout programs out there for pregnancy too. They're going to have safe modifications for you. 

You can hire a personal trainer. You can join an in-person gym. We're just looking for you to move your body in a way that feels manageable for you and it's okay if it's not perfect pregnancy workouts either. Now if you're an active person or you're like, Okay, I have done my month of exercising. I'm feeling more confident, this is where we can start to really ensure that our workouts are not only keeping us active and moving us during our pregnancy but also helping us actually prepare for birth. 

19:30 Movements to incorporate

Gina: Common workout programs are really focused on front-to-back type movement patterns. This is the sagittal plane. This is like squats, deadlifts, cleans, clean-and-jerks, box jumps. Everything is very front-to-back because this is the way that we move our bodies. When we walk we typically walk in a front-to-back movement pattern. 

However, we also need to be moving laterally and rotationally as well which is another myth. Can I twist during pregnancy? Yes, you can twist. It’s necessary to twist. If you don't twist, your back will hurt. I promise you it's okay to twist. Now we don't want to do such deep twists that we’re compressing our belly because it would be really uncomfortable. Not because it would be harmful for you, but we want to we want to be comfortable during our pregnancy. 

We want to also be incorporating movement patterns that are in other planes of motion ot just front-to-back. We also want lateral movements like lateral band walks, side lunges, and movements where we're just we're going in this direction. And then we also want rotational movements. So like when I'm doing lunges, I'm adding an internal to an external rotation or I'm doing a rotation with a core exercise. 

We want to think about what type of movements are we incorporating or are included in our workout programs because that is really important to creating space in our pelvis which is not the point of this episode, but fitness can really relate to labor in that aspect as well. It's keeping you strong during your pregnancy. It's helping to support your baby's development. It's helping to decrease your risk of complication but we can also use it to help prepare for our birth. 

20:59 Three pelvic levels 

Gina: And so there are three pelvic levels and I'll go over this super quick. The top opens in one way, then we have the middle, and then we have the bottom. We have inlet, mid-pelvis, outlet, and they all open with different types of movement patterns which is where moving in different planes of motion is going to be really helpful. The top of the pelvis opens with wider knee movement patterns like an external hip rotation with an anterior tilt with abduction. Legs are moving out. Think knees out, ankles in so really deep squats for example. 

An anterior tilt or arching your back is going to be really helpful because this makes it easier for you to find external rotation. It also changes the pubic bone angle and makes it easier for baby to enter into the pelvis. The good news is we already do that during pregnancy. That's a common postural tendency that we have. We like to live in that position. It's comfortable for us. We have more weight on the front. We're just extending in our spine and just loving that spot. 

However, we also need to be able to find other types of movements such as a posterior pelvic tilt or rounding in the back. This one is really important to opening the top of the pelvis in addition to an anterior tilt. So with a posterior pelvic tilt, we have this big chunk of bone on the back of our pelvis called the sacral promontory that moves backward when we tuck our butt underneath or we round in our back. That anterior pelvic tilt creates a little bit more space in the front half of the inlet and then that posterior pelvic tilt creates more space in the back. 

We want to be able to shift between the two but because we always favor this extended position, it can be really hard to find that rounded position. If you had a prior labor where baby just never entered and they were like, “Your pelvis is just too small. Baby just can't fit in your pelvis,” it probably was more related to whether or not you can find– and I don't want to blame anybody for what happened with labors but just helpful tips. If you're having a hard time finding a round in your back or tucking your butt underneath, it's going to be harder to create that front-to-back space in the pelvic inlet and it can make it harder for baby to enter. 

So during our prenatal workouts, we want to think about, Okay, what can we do to help me find more of a rounded position? We can release tension in our lats or musculature. We can release tension in our hip flexors. We can incorporate pelvic tilts into our movement patterns. Those are some things that we can do to help us find this more rounded position. 

23:19 The mid-pelvis and outlet

Gina: The next pelvic level the mid pelvis is asymmetrical movements like side-to-side, hip shifting, and so we have a little bit of external rotation and a little bit of internal rotation. We're just going back and forth between the two. 

Then the bottom of the pelvis with the pelvic outlet is essentially like the opposite of the inlet where we have an internal rotation at the hip where knees in, ankles out is creating more space side-to-side. A slight posterior pelvic tilt can help to make internal rotation easier, but we're not necessarily rounding in our back as we're pushing because it's not really that comfortable. 

Anterior pelvic tilt or a little bit more lat tension can kind of pull that sacrum back so we're kind of back to that pelvic tilting a little bit in the outlet, but we're really focusing on that internal rotation to create space. But if we recall, our favorite positions during pregnancy are extension and external rotation. That rounded position is harder and internal rotation is harder. In addition, that prenatal posture tends to make the back half of the pelvic floor really tight so we need to one, be able to release tension in the posterior pelvic floor and help us find more internal rotation. We can do that with our prenatal workouts as well. 

This is where hip-shifted exercises can be really beneficial like finding internal-external rotation with our single leg movements. These are all things that we incorporate within our prenatal programming because we have been observing birth and people working out for a really long time and we want to help you move through your pregnancy and through your birth. We also have a free birth prep circuit that I'll give you the link for that you can put in the notes as well. It has six movements that help you release those common areas of tension. 

We also have our prenatal fitness program if anybody's interested in working out. We have lots of different options for that as well. But when we're looking at our prenatal workouts, we need to look beyond just one– we just want to be active and intentionally active and then two– we want to think, Okay. Well, how does my workout help to support my birth preparation? How is it helping to create more space in my pelvis? How is it helping me release tension in my pelvic floor? Those are things that are going to help us to support us during birth. Yeah, that was a really long answer to you. 

Meagan: No, it was an amazing answer. It's interesting because I never really thought when you were like, “Front-to-back”, we focus so much on front-to-back. There's that lateral movement that a lot of the time we skip and I didn't even think of that. I know in your book, we've got a couple of little teasers online within your book. You've been showing different ways to work those sides and move your body in different ways. That is amazing. 

25:56 Being told that your pelvis is too small

I love that you talked about the pelvis, the inlet, the middle, and the outlet because I'm pretty sure you probably have known this within the VBAC community. How many times are we told that our pelvis is too small? I mean, all of the time. 

Gina: It makes me so mad. Once you get told something really random or a fun fact about your pelvis like, “You have a really prominent sacrum or pubic bone.” What does that mean? 

Meagan: Yes. What does that mean? 

Gina: How can I take that information and do something with it? Instead of acknowledging that yes, each of us has different types of pelvises. Similarly, we're all from different ethnic backgrounds. Of course, we would have slightly different pelvises. We have different femur lengths. 

Meagan: Right. 

Gina: However, we can all still figure out how to squat and figure out how to do movement patterns that make us functional humans even with differing bone structures. It just blows my mind that we don't acknowledge the fact that the pelvis can change shape and diameter and displacement with movement. Our baby is also shape-shifting and wiggling their way through the pelvis as well. But the only person to blame is you. It’s because your pelvis is just too small. 

Meagan: Right. I know. 

Gina: Maybe you didn't know how to support me. 

Meagan: I know I have those same feelings. It's very frustrating. I think it's probably a little extra salt on the wound because I was told that. I was told that I would never get a baby out of my pelvis. Like you were saying, you're like, “Well, maybe I just wasn't supported well enough. Maybe I wasn't given the tools or the positions,” like what you're describing. 

I mean, with my first labor, I just sat there in the bed, clinging to the side, and then got an epidural and sat there. Really? Like, so I wasn't moving my pelvis. I wasn't doing those asymmetrical movements. I really wasn't working with my body to get my baby out. Okay. So a question that I know that we have received is the anterior placenta. So does fitness change if or what we're doing change if we have an anterior placenta? 

Gina: Really, if you have an anterior placenta, a posterior placenta, it closes out on the side, it doesn't really matter where it is unless it is covering the cervix. At that point, like, there will probably be some sort of modification, because we don't want to have any sort of cervical dilation or cramping or urinary irritability that can cause the cervix to begin to dilate which may cause the placenta to start to detach which would not be ideal. 

So typically, if you have any sort of placenta previa, potentially like a low-lying placenta in the third trimester, after 28 weeks, we probably want to modify it to where we're not doing super deep squats. We're not exercising at a high intensity. It's low to moderate. If you are experiencing any bleeding or cramping during your workouts, you’re stopping immediately. 

But in regards to the placenta being in the front or the back, there really is no difference when it comes to exercise. The baby is pretty snug as a bug in a rug. 

Meagan: Snug as a bug in a rug. They are pretty protected in there. They are pretty deep in there. 

Gina: They are. They are. Now when it comes to certain birth options, sometimes an anterior placenta– usually with an ECV if baby’s are breech, providers don’t want to do it if you have an anterior placenta. It may be harder for you to feel your babies. You should feel your baby but it may be muted. You would be like, I kind of feel you, when in comparison, if you had a posterior placenta, there’s a little alien rolling around in your belly.

Meagan: Right. Or you might not feel kicks until them later on in your pregnancy when someone with a posterior placenta is feeling those little butterfly kicks early one. 

Gina: Yeah. It will be more muted. But in regards to exercise, the only placenta position that would result in modifications is a low-lying or placenta previa where the placenta is covering the cervix. But usually for those, if you found out at your 18-week anatomy scan, they usually resolve within a few weeks so you can always ask for a repeat scan, but typically, we don’t need to modify until the 28-week mark. But again, if your provider has given you specific guidance on what they consider to be safe for you with exercise because again, they are looking at your medical records. They are looking at you as an individual and this is just a podcast. 

Definitely go with their guidance, but typically, they do move. There usually is not an issue into the third trimester with that either. 

Meagan: Yeah. Okay, so good. 

30:36 How late in pregnancy is okay to work out?

Meagan: Another question is, How “late in pregnancy” is okay for me to work out? We’re talking about early, what we’re doing. We may be started to feel really good. We may be increasing our physical activity. We might be more mindful. Now, it’s on top of intentional movement. It’s on birth prep and really getting ready for this birth journey. Is there a time when we should cut off physical activity or is it okay to be doing squats and lateral movements and yoga one day and go into labor the next day?

Gina: You can workout until the day that you give birth. Now, how intense your workouts are will probably decrease toward the end of the third trimester. For us, around the 36-37-week mark, we do certain tapering in the program which means we start decreasing overall volume and intensity of workouts because one, we are just more tired at the end of the pregnancy. We still want to move and be active, but we also need to be in the mind that, Tonight, I might go into labor so I don’t want to be super sore from my workout. 

Similar to if I was training for an athletic event, not that birth is a competition or anything, I wouldn’t want to be doing my hardest workout the morning of the competition. Again, birth is not a competition but with that type of fitness mentality, you’re like, Okay, well birth is probably going to be physically demanding even if it’s super fast. It’s still physically demanding. I probably don’t want to be super sore or super fatigued going into that. 

So around the 36-37-week mark, you can decrease overall volume. If you were working out at 200 minutes a week, maybe at week 37, we are only doing 150 minutes a week, and at week 38, we are doing 100 minutes a week and then maintaining that so whenever your baby decides to come. 

32:31 When is it too late to start exercising during pregnancy?

Gina: We also get folks who ask, When is it too late to start? I would say if you gave birth, it’s too late. It’s probably too late for prenatal fitness at this point. Kind of like, When is it too late to get an epidural? It’s when your baby is born. When your baby is born, it’s too late to start a prenatal fitness program. 

We will have folks who are 35 weeks. They are like, I’ll just wait for postpartum. I’m like, You might have 2 months left. That’s a long time. 8 weeks, that’s a whole fitness challenge or whatever. You know those ones where it’s like, “6 Weeks to a Bigger Booty”, it might be 6 weeks until a baby. That’s still a good period of time to move your body. It doesn’t have to be training for a PR, it’s just learning how to release tension, starting to build up some stamina, some endurance for the big day. 

Now, if you’re 38 weeks and you’re in that, I could go into labor anytime, I probably wouldn’t start a lifting program at that point. I would probably be focusing more on yoga and mobility-type things. Walking, just trying to release tension in my body. I wouldn’t be like, Let me go squat and deadlift for the first time in my whole pregnancy. I would do more breathing and stretching. That would be more reasonable to me. 

Once you hit the 36-37 mark and you’re like, Can I start something now? Absolutely. A prenatal yoga program would be my recommendation. Going for walks and things like that. If you’re 32, 33 or even to 35 weeks, I would say that you can start a lifting program. I would say to start our prenatal program at that point because we do have a monthly option. You can just grab the months that you need. We also have a just third-trimester program on demand. 

You can still intentionally move, but it’s just going to be a little bit more mindful to the fact that we are kind of at the end of this journey, but it’s definitely not too late to start unless you gave birth. At that point, it’s probably a little too late. But what can you do? 

Meagan: Now you’re going into postpartum after your baby is born. 

Gina: Yeah, then we can focus on postpartum stuff. 

34:43 Postpartum fitness

Meagan: Which is also a thing. There are postpartum programs. There’s a lot after birth that we can do. I know this wasn’t in the questions that we were talking about but it led into this where a lot of people don’t know when they can start working out after birth. For my second C-section, at that point, I was a Barre instructor and at 4 weeks, I went back before I was technically cleared. I was just following my body doing the very minimal. 

When is it appropriate to start a postpartum training program? 

Gina: It depends on the program. We have a free early postpartum recovery course that is intended to start within a few days after birth which is just breathing mobility and some stretches. It’s really, really gentle stuff just to reconnect with our body but it’s not like, go lift weights or anything. 

Usually, I would recommend doing a gentle program like that for 4-6 weeks. I’ll give you the link to that as well as another. It’s just a program that we offer. After the 10-week mark is when most folks can start to return to fitness. This will vary from person to person, whether you had a vaginal birth, whether you had a C-section, whether you had a hemorrhage, how much support do you have postpartum, and how your healing has been so far. It can really vary from person to person. I can’t even say 4 weeks for unmedicated vaginal birth, 10 weeks if you had a labored C-section because even within that is a whole realm of where you might be. 

Meagan: It is. 

Gina: So just giving yourself some grace and knowing that there is plenty of time to return to fitness. Obviously, we don’t want to wait 5 years, but it’s okay. 

Meagan: You don’t have to jump into it. 

Gina: Yeah, it’s okay if it’s 12 weeks before you start a program. It will be fine. Again, we don’t want to wait for 5 years. That’s a long time to live with whatever we are having postpartum. Usually 4-10 weeks is when I say if you feel ready and you want to start moving your body, that’s usually a good time to start. 

We’re looking for bleeding to pretty much be stopped. We’re not having any issues still lingering from birth so we are not having any infections from birth. We are not having post-birth surgeries or anything like that. That may delay things a little bit longer. If you’ve had a hemorrhage, that will delay you a little bit just because your blook is trying to replenish itself from all of that. 

Sometimes a C-section blood loss or hemorrhage can be a little bit higher, but you can also have severe hemorrhage from a vaginal birth as well. Just honor how you are feeling. 

Then when you do return to fitness, it is a gradual slow process of reconnecting with this new body. I know there sometimes is this mentality of, I want to bounce back. I want to get back to who I was, especially if postpartum is hard, which it is, or if birth wasn’t what you expected, which it can be for a lot of folks. There can be this, Let me get back to something that reminds me of myself and who I was before so I’ll do my workouts and get back to my workouts. 

Meagan: That was me. 

Gina: I love working out. That’s a part of my identity. I can sympathize with that desire, but if we rush that process, it’s going to delay you in the long run. You’ll be 4-6 months postpartum. You’ll be like, Why am I still leaking? Why do I still have a diastasis? I just feel unstable. But when we take the time in the beginning to really reconnect, really focus on the foundational core work, and really rebuild slowly which is painful to do sometimes. Not painful physically, but painful mentally, it really helps so, so much in the long run. 

So take your time. Again, we have a program to support you if you want it but there are so many programs out there too that suit everyone’s individual needs depending on the sport that you are trying to get back to as well. 

Meagan: Right, I love how you talked about mentally it can be so hard. It was for me. It just was so hard. I just needed to get out and move my body. I did follow my body, but so what you were saying, mentally it is hard and can hurt us but physically it was too much for me. I did have to take a step back. I went to this hour class. I cut it back, but it set me back 3 more weeks because I was like, Okay, I probably shouldn’t have done that. Noted. Thanks body. 

Gina: It happens. It happens to the best of us. 

Meagan: Thanks body for letting us know. I was able to return. I love how you talked about reconnecting with our pelvic floor and all of the things. Breathing in itself is so powerful, so I love that you are focusing on that. We’ll make sure to put in the show notes the link for your program. 

39:20 Weightlifting and pregnancy

Meagan: Okay, so last two questions. Weightlifting is a big one. I love weightlifting myself and I follow quite a few accounts who have gone through pregnancy like yourself and weight lifted. I am flabbergasted to see some of the negative comments on pregnant people lifting because it bugs me. It bugs me that people are so negative about it and judging them like, What are you doing? You kind of touched on that earlier. I don’t know why lifting sometimes with women in general, but then add pregnancy to that is really hard. You kind of mentioned that maybe at the end you’re not going to join a weightlifting program, but how can someone start with a very gentle approach to weightlifting? I do feel like especially if weightlifting is not something you are used to, it can be very, very intimidating. 

I know in your book, you have a section where you’re like, Instead of doing this, try this. Instead of doing deadlifts, try these, which is awesome because it can give us an idea. But can you guide someone who is like, I really want to weightlift but I’m so intimidated to start? What is a gentle way to start approaching that? 

Gina: If you live by us, you can just come to our gym and we will walk you through it which is usually the easiest way to learn how. If there is a lifting class somewhere or an intro to lifting or even a women’s fitness-type class, that could be a good way to get introduced to, How do I lift safely? 

Some CrossFit gyms will have Intro to CrossFit which can or cannot be great for starting during pregnancy, but they can at least teach you how to squat, how to deadlift, how to bench press, and there are barbell gyms out there that might have lifting classes. Even just box gyms like Planet Fitness or Gold’s Gym might have lifting classes. 

Hire a personal trainer to walk you through what to do. That can take some of the intimidation out because you don’t have to walk into this gym into this section that is male-dominated and be like, “Hello. I am pregnant. I am trying to squat. Can you hand me a dumbbell?” 

So it can be really scary to do that. You can also purchase some weights for your home. Dicks Sporting Goods has really good deals on gym equipment that is very inexpensive. It is cheaper quality so they won’t last you a long time, but if you’re like,  I just need to get started, that can be a great place to go. Amazon has really good sales pretty frequently to get cheap equipment that is still a moderate quality. Rep Fitness is one of our favorites for higher quality equipment that is still affordable then Rogue would be the super expensive brand. I would say them and Rep Fitness are the same quality. 

It depends on how much you want to invest. You can get the stuff and have it at your home as well. Usually, I would say to grab some dumbbells. If you want to explore barbell, buy a barbell and some bumper plates. They have sets that you can get for that. You can buy yourself a squat rack. That’s if you want to do barbell stuff. You can also do a ton of stuff with just kettlebells and dumbbells. 

I really like resistance bands. Those are huge in our programming. They are really un-intimidating. They are very easy to use. They are an attachment point for resistance bands. A box to step up on. You can also use a stool. It’s easy to get started, but you just have to figure out what type of environment you want to get started in. Do you want to start with a coach-type environment to guide you through it or do you want to try to figure it out on your own? 

With our programming, we walk you through how to do each movement especially with the on-demand one so you can see, Okay, this is how I’m supposed to do it, and then there will be some experimenting to figure out what feels good for you in your body to be like, Okay, when I squat, I have to spread my feet out a little bit more and that feels better for me, kind of thing. 

That can be a good way to get into it. Know that it is safe to do. I think that is probably the first fear that it is safe to do. I think that’s what you were saying. Folks love to comment some hateful things on people who are lifting weights during pregnancy. The comment the same shit on a female just lifting weights who is not pregnant. I don’t know if it’s dudes out there who are feeling very inadequate with themselves that they are like, I cannot stand that there is a strong woman out there so I’m just going to comment and critique her, then like I said before, you add on the additional layer that now she is pregnant and we have this overall belief that exercise is dangerous, people say some horrible things. 

I’m like, You do know you don’t have to comment on things, right? 

Meagan: I know. You can actually just swipe on. 

Gina: Those can be inside thoughts. 

Meagan: Yes. If you don’t have a nice comment to say, leave me alone. 

Gina: Yes, because you know what happens? You comment and then you get more pregnancy content on your feed then you’re like, Why is this pregnancy post popping up on my feed? It’s probably because you commented on this pregnant woman who was lifting weights and you said some nasty shit. That’s probably why it’s popping up on your feed, bro. 

Meagan: I love it. Oh my gosh. I know, but it actually makes me very angry and it’s not even just men. It’s women too. Why do we have to berate people for being active and choosing to lift weights during pregnancy or run marathons during pregnancy or do whatever they want? It is their body. Let them do it and honestly, we need people to share like what you guys do. We need these videos because it does offer us inspiration and also offers us a sense of, Oh, what they’re saying over here isn’t true. I want to learn more about this. 

It’s so frustrating, but it’s possible. So if you want to lift weights, Women of Strength, and you’re listening, go for it. Go for it. Check out their program. Get the book which we’re going to talk about right now I’m hoping and learn more. Learn more about fitness in pregnancy and the benefits for both mom and baby which we were just talking about in the beginning of this. 

45:51 Training for Two

Meagan: Let’s talk more about your book. You said earlier this is like the twin to your current pregnancy. I’m sure this is like another baby. I’m so excited for you. I’m so proud of you. I hope everybody in the world gets it. 

So tell us more about it and all of the things. You’ve got three parts, right? 

Gina: So right now, this is just one part to the book. Hopefully it turns into a three-part series so I need your pre-orders so that we can make a second part and a third part. 

Meagan: Pre-order everyone. 

Gina: That’s how we get the next two parts. 

The first part which will hopefully be a three-part series is all about how you can use prenatal fitness to support a strong pregnancy, a pain-free pregnancy and then also use that to prepare for birth because prenatal fitness is not just a list of pregnancy-safe “exercises”. It’s not just take out all of the sit-ups and crunches and all of the jumping and now it’s a pregnancy program which is what the majority of pregnancy programs are. It’s just a bunch of random exercises that just don’t involve crunches and sit-ups. Cool. That’s a great first step. 

But we can take it way further by ensuring that our workouts are also helping us to prepare for birth. We’re taking the pelvic floor into account. How are we integrating that in the overall system? How are we learning to release tension? How are we increasing mobility within our hips so we can find that internally and externally pelvic mobility. What movements are we incorporating to help increase the pelvic space so we can create more space for baby to navigate through? 

What kind of movements are we incorporating into our workout that helps us for our baby’s position? We’re not trying to force baby into any position, but we want to make it easy for them to find whatever their best position is. We can do that with our prenatal workouts. The book is going to break that down for you. It’s definitely a little bit heavier on the lifting side so it includes modifications for how to deadlift during pregnancy and how to bench press during pregnancy. 

All of these main lifts, we incorporate tons of accessory exercises such as core exercises that you can do during pregnancy, what signs and symptoms to be mindful of when doing core exercises, how to protect your core and pelvic floor during pregnancy. We incorporate exercises to help with pelvic stability because pelvic pain is super common but you don’t have to be in pain during pregnancy. 

Similar to you, my provider when I told him I had pelvic pain, they were like, “That sucks. When you give birth, it will go away.” I’m like, Well, that’s not true. There is a lot you can do during pregnancy to help resolve that as well. 

The book is a collection of all of the things I have learned through working with in-person prenatal clients and supporting in-person births. Hundreds of clients have helped me gain this information to write this book. My educational background and things that I’ve researched and studied have all been consolidated within this book specifically to prenatal fitness and using your prenatal fitness to stay strong and then also to help you prepare for birth. 

There is a little bit in there on labor. A bunch of that stuff got taken out because I write a lot. I have too much knowledge in this head of mine so that’s why I need a three-part series then there is one chapter on early postpartum recovery as well. We also include how to recover from a C-section in there. It’s just the first month postpartum so it’s just a taste of what book three will be. 

So help me get part two and three by pre-ordering the book. It’s on Amazon. I’ll give you the link as well. It’s $24-25. The book comes out September 14th so hopefully after my baby has been born. I will be very sad if I’m 43 weeks pregnant so I will be in the infancy of my postpartum with a newborn when this next baby, baby B has been born and would love your support with preordering it. 

We’re trying to figure out pre-order incentives right now. We may have a chapter that got cut, so if you pre-order, you get that chapter as a PDF which is all of the labor stuff- how to address labor stalls, laboring positions, what a contraction is. 

Meagan: So good. 

Gina: It was such a good chapter, but that will be in part two which is going to be birth. Part three is postpartum fitness so help me get the other parts by ordering the book. 

Meagan: Yes. 

Gina: It’s on right now. I am really excited about it. So yeah. 

Meagan: I am so excited for you. Yeah. it’s $24.99. That is amazing. We will make sure like she said to have the links to all of these things including this book pre-order link in the show notes. 

Right now, as soon as you are done listening and you’re like, Dang, that was an awesome episode, go down. Click the link and support her by buying her book. It is called Training for Two. She’s absolutely beautiful on that front cover holding her sweet baby bump. You guys, I’m so excited for this book. I’m so excited for you and I’m so grateful that you were with us today sharing all of this information. 

Gina: Thank you so much for having me. I really appreciate it. 

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

Aisha’s first baby was a scheduled Cesarean for a breech presentation during the height of the COVID-19 pandemic. Though she was symptom-free, Aisha tested positive for COVID and was not able to be with her husband or her baby right after birth. Her surgery was routine and uneventful, but the isolation left her devastated.

 

Aisha moved and was living in Oregon during her second pregnancy. She deeply desired a home birth and found a midwife to support her who also happened to be trained in vaginal breech delivery. Aisha went into labor sooner than expected but handled it beautifully. When it was time to push, surprisingly, feet started coming out first! Her team stayed calm and ultimately brought her baby earthside safely. Aisha is so proud of what she accomplished!

Evidence-Based Birth Article

The VBAC Link Blog: ECV Explained

The VBAC Link Blog: How to Turn a Breech Baby

The VBAC Link Podcast: Chelsey's 2VBA2C Breech Babies

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

03:31 Review of the Week

06:10 Aisha’s first birth

11:16 A COVID-positive Cesarean

14:38 Third pregnancy

20:02 Planning for a home birth

22:51 Breech workshop with Dr. Stu

24:57 Labor begins

31:25 Pushing out an unexpectedly breech baby

35:29 Reviving baby

40:53 Vaginal breech birth is possible

49:39 Adding to the supportive provider list

Meagan: Hey, hey everybody. Guess what? We have a breech VBAC, actually, it’s a breech HBAC coming your way today. We have our friend, Aisha, with us and she is going to be sharing her amazing journeys. We know that when it comes to breech, it is difficult to find support. It is difficult to find the evidence in that and this is one of the number one reasons for Cesareans in the first place. If you have gone through our podcast, we have over 300 episodes at this point, you will probably hear quite a bit that, “Oh, my baby was breech. We tried an ECV and it didn’t work so I had a C-section,” or “My provider didn’t even offer that and I had a C-section.” 

This is one of the number-one leading reasons for a C-section and it doesn’t always have to be that way. Aisha is living proof of that. Welcome to the show, love. How are you today? I’m so excited for you to be here. 

Aisha: Yeah, thanks. I’m so excited to be here. It’s like a dream come true. It’s wild. 

Meagan: It was so fun. Before we started recording, she said that not long after she had her baby, she was like, I’ve got to get my submission into The VBAC Link. 

Aisha: It was bathtime earlier this week when I saw the email and I was freaking out like, Oh my gosh. It was cool because my daughter is going to be a year old soon, so it was fun to think about her birth and I almost felt guilt because I was like, Oh my gosh, I haven’t listened to The VBAC Link in a minute, but how much this podcast blessed me and strengthened me to go on to have a VBAC, specifically a breech VBAC which was not planned for. It was wild and I’m just really grateful for my provider. 

Meagan: Yeah, absolutely. I cannot wait to dive into this story. 

03:31 Review of the Week

Meagan: We do have a Review of the Week and then we will turn the time over to our friend, Aisha. This is from larrr23 and it was left in March of 2023 so just over a year ago on Apple Podcasts. It says, “Hi, Meagan. I love your podcast so much. I always end up crying at the end of them. So happy for these moms who get this VBAC. Thank you for creating this podcast. It is so inspiring to hear these stories. I’m 38 weeks pregnant and hope and dream I get my VBAC here soon as well. Keep doing what you are doing here. You are helping so many women achieve their dream birth and knowing that they are not alone. Thank you for that.” 

Well, larrr23, if you are still listening with us, let us know how your birth went. I hope that you had an amazing birth no matter how it ended. Thank you so much for that sweet review. This is what I really am here for. I love this podcast so much myself. I listen and I record it and I hear these stories, but then I go back and I listen. I’m still hearing and still learning even knowing a lot about VBAC. I am still learning and growing myself and it’s just so fun to hear these incredible stories. I’m so grateful for all of you who are submitting your stories and sharing these stories both on Facebook, Instagram, and here on the podcast. 

So thank you for your review and as always, if you wouldn’t mind leaving us a review, they truly are what help other Women of Strength just like you find the podcast. You can leave that anywhere you are listening to the podcast or you can even email us at [email protected]. 

06:10 Aisha’s first birth

Meagan: Okay, are you ready to share your stories? 

Aisha: Yes. Yes. 

Meagan: I am so excited, so ready. I’d love to turn the time over to you. 

Aisha: Yeah, okay. So for my VBAC journey, I feel like it’s really important to understand how I got there. I got pregnant with my first in 2020. My husband was in the military so we were stationed in South Korea. It was right before we left Korea. We moved back to the States. We had already been going through COVID in Korea so it wasn’t as big of a deal because we had it first if that makes sense. 

We moved back and we are from Washington state so we went, spent time with family, and then we ended up in Texas. Here I am with my first baby, and I don’t feel like I’m a naive or ignorant person but I never really thought about the process of having a baby. I’m the oldest. My youngest brother is 13 years younger than me, but I just never really thought about what went into having a baby. 

Meagan: I agree. That’s how I was. I was like, Oh, cool. I’m so excited to have a baby. I’m pregnant. This is cool. All right, cool. What’s next? 

Aisha: Yeah. I got books. I read things. I joined groups. I watched YouTube videos. I listened to the podcast Birth Queens a lot just to understand more. I had a pretty normal pregnancy. There wasn’t anything too wild and because it was COVID, there was a lot of things over the phone. A lot of people thought it was weird, my friends and family, but my provider at the military hospital didn’t have a good bedside manner and it was known that she didn’t. It’s hard to explain. My husband was enlisted so he was just by the time he left, he was a Sergeant. He was one of the lower guys, so I don’t know if it was us or the culture, but you get nervous to speak out because of rank. 

He’d be like, “Don’t say anything. We don’t know if that will get back. You can’t be.” 

Meagan: Or disrespect them? 

Aisha: Yeah, because there are some military wives who are assertive. Assertive is a better word. I don’t like to use "aggressive" with women. She would just say things like, “You’re gaining too much weight.” I’m like, “I’m walking every day. What do you want me to do about this?” 

Meagan: You’re like, “I’m also growing a human.” 

Aisha: Yeah, I know that I’m gaining a lot. I’m seeing that, but what am I supposed to do about this? I just got stressed about the thought of her being near my vagina. I was kind of scared about it because I was like, I really hope it’s not you. 

We get to the 36-37 week appointment and they do a quick ultrasound. They’re like, “You’re baby’s breech.” I was like, “Oh, great. Cool.” They’re like, “You can talk to a doctor and talk about an ECV.” I know ECVs can be controversial. Some people are uneasy about them, but one thing I thought was interesting about my life is that I was a breech baby and my mom had an ECV with me. 

Meagan: Interesting. 

Aisha: Right? I was born in 1990, so I grew up hearing the story about them trying to flip me. When I heard people like, “Oh, ECVs are so risky,” I was like, “My mom did it. What’s so risky about this?” So we went in and the first provider we met with was like, “I like to put you in the operating room. I like to give you an epidural just in case something happens and we have to slice you open,” not like that, but it felt like that. I was like, Whoa. This is a lot.

So we get to the day of the hospital and luckily, I’m so glad it was a younger doctor. I was like, "Are you bringing me back to the operating room?” He was like, “No, I like to make you comfortable. You can watch TV.” He was really sweet. It was an interesting experience. Of course, you are wearing masks but I remember the nurse took my mask off to let me breathe because it was painful. But they were so nice. My husband wished we had taken a video of because he was like, “They were pushing so hard on you and they were shaking.” 

Meagan: Oh, yeah. 

Aisha: My baby didn’t flip. He’s going to be 3 in April and he is very stubborn. He does what he wants and I’m like, This is totally you. We ended up getting COVID right before having a baby. My husband did. I tested positive, but I didn’t show any signs. It didn’t really affect me a lot. I was just kind of crazy. I remember I cooked Easter dinner and he wouldn’t eat it. I’m like, “I cooked Easter dinner for you,” and he was really sick with COVID and I’m still doing things. 

11:16 A COVID-positive Cesarean

Aisha: We go to the hospital and we test positive again. They have this stupid COVID protocol where I’m like, “I already went through these 10 days,” but they just treated us like we were coming in throwing up on them. Does that make sense? 

Meagan: Oh yeah, I saw it as a doula. Yes. I had a client who wasn’t even sick. She had no idea and tested positive. We all got kicked out and they acted like she was going to kill them. It was really not good. 

Aisha: Yeah. It was just weird. Because mine wasn’t an emergency, I kept getting pushed back because they had emergency C-sections coming. The biggest thing that sticks out to me in my birth was when it was finally my turn, they came to me and they were like, “You’re next, but it’s going to take a little bit because we have to extra-clean because the last person was COVID.” I’m like, “Why do you have to extra clean? Shouldn’t you always clean an operating room? That doesn’t make sense to me.” 

Meagan: You should always extra clean, yeah. 

Aisha: Yeah, that’s gross. What were your protocols before? I don’t understand. 

Meagan: Interesting. 

Aisha: We didn’t go back until 3:00 or 4:00. I don’t know. It was late. You know, you’re not eating because they tell you not to eat so I’m starving. The doctor who delivered my baby was super nice. She came in and was like, “Let’s have a happy birthday today.” I don’t remember anything weird. I’ve listened to some episodes where they’re like, “Oh yeah, they were talking about their vacation.” I don’t remember that. 

Meagan: That was me. 

Aisha: Oh yeah. I felt like it was really respectful. The anesthesiologist, I wish I would have gotten his name. He was wonderful. He was so sweet and kept telling us what was happening. I was like, “Oh my gosh. You are our personal tour guide for this.” He was really kind. 

I have a nervous cough. I always have when I get nervous. I just cough. After they took my baby out, I coughed. That’s where I get emotional so they took my baby away because they were like, “Oh, COVID positive. You coughed.” I’m like, “I have a nervous cough. I always have my whole life.” They took my husband away so I was there for 30 minutes alone. Sorry, I get so emotional thinking about it. 

All of those sweet pictures that people have, I didn’t get that. Oh my gosh. My son is going to be 3 and it still brings me. 

Meagan: It’s still with you, yeah. 

Aisha: Whenever I talk, yeah. The C-section itself was fine, but it’s just the care that got me. I never know how to explain that to people. No, it’s the care. So then we finally were in the recovery room. I’m starving. My husband gave me fruit snacks. We didn’t realize I was not supposed to eat, but I was starving. 

We get to the mother’s room at 11:00 at night. The kitchen is closed. I’m like, “I’m starving. When can I eat?” The nurse laughs and says, “When you can walk.” I’m like, “But I’m hungry.” She’s like, “You’ve got to get up and walk first.” I’m like, “But I’m hungry.” What? 

Yeah, so that was him. That’s that part. 

14:38 Third pregnancy

Aisha: Everything else was fine. It was just the care. They lock you in a room when you are COVID-positive. It was just wild. 

When he was about 11 months old, almost a year old, I got pregnant again. We moved from Texas to Oregon because my husband was getting out of the military and sadly, 10 weeks later, I had a miscarriage. 

I had already picked out the midwives I was going to use in Oregon. I was like, I’m going to have a home birth because Oregon has really good laws when it comes to home birth and I am going to do this. 

There were a couple of driving factors to that. One, I did not want to go back to the hospital. I was like, I’m not being treated like that again, because I’m a pretty timid person and I don’t know if I’d be strong enough to advocate for myself. The other thing is we had a toddler. My mom lived in Seattle and my husband’s parents just moved to Idaho. My dad and my step-mom live in Atlanta, Georgia and I’m like, There’s no one to take care of my toddler so we’ll just have a home birth. 

My husband was like, “That sounds kind of weird,” but my husband’s mom actually had a home birth with her fifth. It wasn’t abnormal for my husband’s family, but he was kind of like, “Ew, gross.” We always joked right before I had my first if it was a scheduled C-section, my husband wouldn’t be there because he is really queasy when it comes to blood then finally when they were like, “It’s a C-section,” my husband was like, “Oh, you’ve got this.” I was like, “Nope, you’re going to be there. Sorry.” I know it was hard for him. I know how he gets. I don’t think it was him being weird or anything so I was totally fine with it. 

I had my miscarriage in April and then I got pregnant later that summer. It was cool– I guess not cool. I thought it was cool when I got pregnant with her daughter. Her due date was the same weekend I had my miscarriage. I was like, Wow. It was interesting. 

During my miscarriage, my providers were wonderful. My midwife was wonderful. The ER doctor was so great. It was a sad experience, but it was a peaceful experience. I definitely was at peace with it even though it was really sad. I definitely say the driving force with my daughter, there was a lot of panic and anxiety. I would say, I don’t know if it’s having another child and having a toddler, but I definitely didn’t feel as connected to that pregnancy. But again, I have a very active toddler. 

So one thing though, we didn’t find out the gender which was pretty fun. A lot of people thought it was weird and they were like, I like to prepare. I’m like, What do you have to prepare for? I just thought it would be really cool to not find out. 

I didn’t really post about my pregnancy a lot. I think I announced in January and she was born in April. I didn’t talk to people about having a home birth because I didn’t want to hear it. I didn’t want to hear people’s opinions about it. I remember I had some friends that I was like, I really don’t want to talk to you about it. They would ask, “Oh, how was your doctor’s appointment?” I was like, “Oh, it was great.” I didn’t say anything else because my midwife would come to me. It was so nice that she came to you and I didn’t have to worry about getting out the door and the whole family was involved. It was super nice. 

20:02 Planning for a home birth

Aisha: Oh, I remember I told my dad. I was like, “Yeah, I’m going to do a home birth.” He was like, “I don’t know. It sounds kind of sketchy. Are you sure?” I was like, “Yes.” He was like, “Don’t you want to go to a real doctor?” I don’t think my dad was being rude, but I was like, “Dad, it’s not a mountain man. It’s a real midwife. It’s a licensed business. It’s a real person. It’s not some woman off the street that I’m like, Come birth my baby. She went to midwifery school.” 

But no, my midwife was amazing. Her name is Liz and she was just so calming. Her voice was just very soft-spoken it felt like, but I was so worried about having a breech birth. Whenever I brought it up, she’d be like, “We’re not talking about that. We’re not talking about that.” I was like, “What if this baby is breech?” She’s like, “We’re not talking about that.” I’m like, “Okay, cool.” 

So when I was pregnant, like I had shared before, I just listened to The VBAC Link. I just listened to The VBAC Link. That’s all I listened to. I worked from home at the time just doing computer work and I would just listen to episodes. I would be sobbing. It was for a lawyer and I’d be doing these things and crying just thinking about all of these amazing things that these women went through and how they were able to bring their babies. 

One thing that I believe I learned from this podcast, so I failed my gestational diabetes test, my glucose test, but I had heard from an episode that it varies from state to state. I was like, Interesting. But my midwife was like, “You just did it by two points or whatever the thing is, so just watch what you eat. Keep a log and let’s talk about it.” So that’s what I did. She showed no other concerns. 

She was like, “Just eat more protein”, then I would log my food and at appointments, we’d go over it and she would go, “Oh, see? This is when your sugar goes high. It’s because you ate this. Let’s try to eat more of this,” and then I tried to stay as active as I could with my toddler. 

My husband was in school. He left the military and was in school finishing up his bachelor’s degree so we live right next to campus. We lived in a basement apartment and at first, I was like, Why? We rented this basement apartment and I was like, Can I legally have a baby here? I was like, Is this allowed? Do I have to tell my rental company? There were these 5 girls who lived above us and I was like, How am I going to do this? Aren’t they going to think this is weird if they hear me? 

But yeah, I just remember this basement apartment. It was pretty tiny. I would just sit in my living room and envision my birth there and be like, Okay, I can do this. 

22:51 Breech workshop with Dr. Stu

Aisha: April comes and my midwife had done a workshop with Dr. Stuart. 

Meagan: Oh, Fischbein. 

Aisha: Yeah, like 2 months before I gave birth. 

Meagan: That’s awesome. 

Aisha: I was like, “Oh, so is this a possibility?” We were on state insurance because my husband is a student. There were a couple of things. They covered my midwife, but we would have to pay for the birth because I was a VBAC but my midwives, they are really great where they accept payment plans because they were like, “We don’t believe people should tell you where to give birth. If you just pay us $5 a month, that’s fine.” 

We ended up paying it all off because we were like, “That’s fine too.” But she told me, she was like, “Well, because you’ve never given birth vaginally, you wouldn’t be able to.” I’m like, “Oh, that sucks,” which is the same thing they told me in Texas. I was like, People breech birth babies all the time.

I was like, “Can I transfer hospitals?” They were like, “No, no one will probably take you because you’ve never given birth vaginally.” I was like, “Okay, that’s weird. Whatever.” I was like, “Oh, dang.”

My baby was due at the end of April and on April 5th, I started getting contractions. With my son, I never had contractions. I never went into labor. I never had Braxton Hicks. I didn’t know how any of that felt so I was like, Oh, this is new. What is going on?

Oh, I did have a doula. In Oregon, when you are on state insurance, they do cover a doula so that was really nice. 

Meagan: Yeah, that’s really awesome. 

Aisha: Yeah. The doula that I had runs the doula program, but I contacted her directly because I was just looking through Facebook groups and she was like, “No, I’ll take you on.” She was actually training to become a birthing assistant with my midwife so it was pretty fun. She worked really well with them. 

24:57 Labor begins

Aisha: Okay, so on April 5th, I start getting contractions. They just tell me to rest. I remember I had a really bad headache so I was like, Oh, maybe I’m dehydrated and maybe that’s why this was happening. So I was drinking lots of water and coconut water and trying to eat protein. 

That night, I remember we were watching Ted Lasso and I was trying to hone in and focus while having contractions. I don’t remember anything else. All I remember is Ted Lasso. 

Then that night at 2:00 AM, my husband ended up calling the midwife because they were picking up. She came and he made this observation when she got there, they slowed down. She checked on me and she was like, “It looks like you’re just having false practice labor,” whatever you want to call it. “Just rest up.” I was like, “Okay.”

So the next morning, I wake up at about 7:00 AM. Through the night, while I go through contractions and my husband was timing them, I’m moaning through them. I took this course. Sorry, I’m jumping around. I took this course called Pain-free Birth so I just was trying to practice what she had taught in it. I was breathing through riding the wave and all of that. 

My husband would moan along with me during contractions while he was sleeping and I was like, “You’re not helping me.” He was like, “Oh, sorry. I didn’t realize what I was doing.” 

Okay, so then I wake up at 7:00 AM and I take a shower. I just remember I was like, I’m going to curl my hair, but then I was like, I can’t do that. 

It’s so interesting how in tune our bodies are and almost how in tune our family is because that week, my toddler slept in until 10:00 AM every day. That day, he slept in until 10:00. 

Meagan: That’s amazing. 

Aisha: He knew something was going on, right? That morning, I remember I ate. I listened to some Taylor Swift music and just swayed around my kitchen. I turned on Anastasia the movie and laid on my couch and went through my contractions. I labored a lot alone which is what I wanted. I didn’t want people at my birth. I didn’t want a mom or any relative and I think my mom would be great during a birth, but knowing me, I think if I wasn’t progressing, I think I would panic and from what I’ve learned, your body can shut down and not do it because I would feel the stress like, No one is comfortable. I’m doing this to people. 

I wanted to labor alone if that makes sense. 

Meagan: Yeah, it does. You didn’t want to be the host of your birth. 

Aisha: Yeah, and I feel like that’s what I would have been. I would have been like, “Does everyone have drinks? Does everyone have snacks? Is everyone comfortable? What does everyone want to watch on TV?” I know me and I was like, I don’t want that. 

So at about 10:00 AM, my husband and my toddler come out of bed. I put on the Peanuts movie for my toddler and I’m just kneeling on my couch which was really sweet. Every time I went through a contraction, my husband was timing them and they were still pretty inconsistent. That morning, I was texting with my doula and keeping her up to date with stuff. My toddler would come over and rub my back or bring me toys and I thought that was really sweet. 

My husband had a 12:00 class and was like, “Should I go?” I was like, “Do what you want, but probably not.” It was really funny because he was actually watching a video for his class. Have you ever seen– I always forget this actor’s name– have you ever seen the show Lost? You know the evil guy, the cult evil guy? 

Meagan: Yes. I don’t know the name. 

Aisha: He was narrating this video, this video on Marie Curie. 

Meagan: Curie? The X-ray lady? 

Aisha: Yes. 

Meagan: That’s so funny because my daughter did the wax. She was Marie Curie for her wax museum for her 2nd grade. 

Aisha: Yeah, so my husband is watching this video and it’s that guy narrating it. It’s about her. I’m going through my contractions, focusing, and asking him questions about it. I was like, “What did she do? How did that happen?” 

I had the Peanuts movie. I had that going on in the background. Yeah. So finally, I’m like, “I’m going to go lay down.” My husband was like, “Okay. I’m going to be there.” 

I go lie down and all of a sudden, I start getting hot flashes and get really cold. I’m like, “What is happening?” My doula finally called me. She heard me and she was like, “You are in transition.” We didn’t realize how far this was happening. I was like, “Maybe we’re not communicating,” but we were telling them about the contractions. We were keeping them up to date. 

I got back in the shower and she was like, “I’ll be right there, but you should probably call your midwife.” My husband was trying to figure out my phone. Something happened with my phone and he was like, “I can’t open it. I can’t open it.” I’m in the shower and he calls the midwives and the one that is not my midwife, the other one who I had met with before and I liked her too, she picked up and listened. She was like, “Okay, we’ll send Liz right over. It sounds like something is happening.” 

I’m in the shower. It just was so funny. I remember being like, I can’t do this. I can’t do this. I can do this. No, I can’t. Yes, I can. Then my husband was trying to talk to me. I keep referencing a lot of pop culture things. 

Meagan: I love it. 

Aisha: Do you know that TikTok sound? It’s from a movie with Will Ferrell where he’s like, “Shut up. Don’t talk right now. I’m so scared right now–”

Meagan: I don’t know if I’ve seen that. 

Aisha: Yeah, it must have been trending then, but that was running through my mind. I was like, Shut up. I’m so freaking scared right now. Will Ferrell was going through my mind. Then my husband is just standing at the bathroom door and he’s like, “I don’t know what to do.” Then I’m like, “I feel like I have to poop. That’s what I feel like right now.”

31:25 Pushing out an unexpectedly breech baby

aisha: I go over to the bathroom and go over to the toilet. I am like, “I can’t sit down. What’s happening?” I got scared and then all of a sudden, it must have been my water breaking because there was a pop and stuff went everywhere. Like I said, my husband is very sensitive to things so he was like, “Should I come in there and hold you up?” I was like, “No, because I don’t need you gagging in my ear because it stinks in here. Please stay right there.” 

Finally, I don’t know the times. I’ve been told they showed up pretty fast, but you know when it’s all happening. You lose the concept of time. My doula shows up. She says that my husband, his name is Logan, was standing there with a towel. He was ready to come in and catch a baby. She said he looked almost like a butler. He was just standing there. 

She comes in and rubs my back and I was like, “Heidi, I’m so stupid. This is so stupid. Why am I doing this?” Then comes my midwife with all of her stuff. You know what? It is so crazy. 

That morning, I don’t know if this is with all home births, but with my midwife, I had to buy certain things. I had to buy towels and hydrogen peroxide. I had to buy all of the stuff. It had come literally that morning. I wasn’t due for 3 weeks. 

They take me into my bedroom and all of a sudden, I hear them ripping things open, just moving stuff and ripping things open. I’m just over the bed and moaning. One of my biggest regrets is not having a birth photographer because they are all fuzzy and terrible pictures. 

Then they said I was pushing, but I don’t remember pushing at all. I just remember riding those contractions. Then at one point, they asked me. I think it was my doula. She was like, “Aisha, do you want to feel your baby? Do you want to put your hands down and feel your baby?” I said, “Absolutely not. No, I do not,” which I’m kind of glad about because I probably would have felt a foot or something and that would have scared me. 

I’m leaning over my bed and then like I said, my midwife is a very conservative, meek person, very soft-toned. All of a sudden, I heard her say, “Aisha, I don’t want you to panic, but your baby is coming out ass-first.” I was like, “Oh, that’s different.” She said afterward when we were talking, she said she saw it and she just leaned back and went, “Hmm.” She took a picture of it and then my husband’s perspective was funny because he said he comes and he sees feet and he was like, “What is happening? Why is my baby coming out this way?” 

She tells me to get on my hands and knees. She gets firm because I don’t know what is happening. I get on my hands and my knees beside my bed. She tells me to push and I’m like, “I don’t know what you’re talking about. I have not been pushing this entire time,” but I must have pushed. Then I heard a splat and I was like, Is that my baby? It was my placenta. It felt out of me.

Meagan: What? So baby was born, you turn over, and then the placenta? Or wait– 

Aisha: Yeah, so I’m on my hands and knees. The baby is born. I hear a splat and I get on my knees. I get up, lean back, look down, and there is a placenta. 

Meagan: Okay, I was like, Whoa, wait. That can’t… My mind was backward because I was like, Well, your husband saw the feet so I’m assuming baby’s out.

Aisha: Yeah, sorry. The baby was out. Yeah, but I thought it was my baby falling out of me but I’m kind of glad my placenta came out like that because I was more scared to birth my placenta than my actual baby. 

35:29 Reviving baby

Aisha: I turn around and she’s pretty limp. My midwife explained that it’s pretty common for breech babies to come out not breathing. She was talking to Heidi and she was like, “Get the–” what’s it called? An ambu bag? 

Meagan: For oxygen and stuff? Yeah. 

Aisha: She’s directing Heidi where it is. 

Right before I had her, we didn’t talk about names, but I had a strong impression it was a girl so I approached my husband. I was like, “Hey, I have these three names.” Her name is Margaret. I was like, “Margaret Sage, Margaret Alexis, or Margaret Alexandria. You pick.” He was like, “Margaret Sage.” I was like, “Okay cool. Let’s do it.” We don’t even know what we’re having. 

Anyway, so she was limp, limp and not breathing. I just look at her and I go, “Oh, it’s a boy.” My doula goes, “No, Aisha, it’s a girl.” I’m like, “No, it’s a boy.” I’m so dazed and then Liz was like, “Aisha, I need your help.” She had been doing mouth-to-mouth. She was like, “I need your help, Aisha. Talk to your baby. Help me with your baby.” So I just start stroking her and holding her head up. 

Later, Liz said that I don’t know if she said this to say this, but I was one of the best assistants that she had. She was shocked because I recently gave birth. She said she recently had a father and he kind of panicked. She said it was kind of cool. I didn’t know what was happening. 

Meagan: Your intuition kicked in. 

Aisha: Yes. I’m just like, “Hi, hi, hi. Hi, baby.” I’m just holding her head and then they got her breathing and gave her to me. There is a picture of me. You know those candid shots that you see where it’s ugly but beautiful? That’s what it is. It’s ugly, but beautiful. I’m crying and holding her. Blood is everywhere, but I love that picture so much because it represents something that I did. 

Oh, I skipped this part, but when she was coming out breech, I was like, Those midwives in Texas can suck it. I’m doing this. I was told I can’t and I did. That’s crazy, then they just put me in my bed and then by protocol, you have to call EMS and EMS came pretty quickly. They came. I remember they asked me, “Oh, do you want to be transferred?” I was like, “No.” They were like, “Baby looks good.” Then they asked my husband, “What’s the baby’s name?” 

My husband was like, “I don’t know.” I missed this. He had been running around doing things. When my midwife got there, we had street parking so she just parked in the middle of the street and asked my husband to go park her car. Keep in mind that I still have my toddler. I think he napped that day which is crazy. That’s wild. Oh my gosh. My baby was born at 12-something. My son woke up at 10:00 and he napped. He woke up to a baby. That’s crazy. I never connected that but he was awake for a very small amount. 

Yeah, that’s it. They hung around for a bit and then they left and that was that. 

Meagan: All was well. 

Aisha: Yeah, it was crazy. I can see the shock when I share it to people, but it’s probably one of the best things I have ever done, the coolest thing. I feel like I’m a pretty average person. When I was filling out my bio, I was like, I’m a stay-at-home mom and I watch a lot of TV. Yeah, then I did it. I had a breech birth. I guess I missed this thing. 

They weren’t tracking that she was breech. They think that maybe she flipped during labor. It’s not like I went in planning to have a breech birth. It just happened. 

Meagan: She obviously wasn’t aware when she was like, “Oh, I’m taking a picture of this. This is crazy.” 

Aisha: Yeah, they actually used the picture of Margot coming out of me. I think I shared it with you guys. She shared it. They actually share it for advertisement. She was like, “Can I use this?” I was like, “Yeah, that’s fine.” 

Meagan: Yeah, I mean, it’s amazing. Let me see what picture. I haven’t even seen your picture yet. Oh yeah, this is an awesome picture. 

Aisha: Yeah. 

Meagan: Yes. 

Aisha: It’s kind of crazy. 

Meagan: This will be posted on our social media so if you want to go see this really awesome picture, I definitely suggest it. One leg is still inside. 

Aisha: I think both of them, right? 

Meagan: One is out and then it looks like one is maybe coming out soon. 

Aisha: Maybe. Yeah, when I was trying to look for it last night, my husband was like, “I have lots of pictures. They are gross.” I was like, “I know which one I am looking for, you weirdo.” 

Meagan: Yes, I love it. Thank you for sharing it with us. 

40:53 Vaginal breech birth is possible

Meagan: Breech birth is possible. Rebecca Dekker over at Evidence-Based Birth did an episode actually just recently looking at this. It says January 2024 so just recently. We’ll make sure to add the link in there. It was with Sara Ailshire I think is how you say her name. They talk about breech birth and it’s a long transcript and it’s a great podcast so I would highly suggest it. They talked about how the study that was published in 2022 that included the studies from a 10-year period of 2010-2020 and they found that perinatal death rates were 0.6% in planned vaginal breech groups and 0.14% in planned Cesarean breech groups which is kind of crazy to think. 

It’s pretty low. When we talk about death, that’s a serious thing to talk about. Those are pretty low. They did find that Cesarean favored the rates, but there was not anywhere near as high as the breech trial. We just know that breech is starting to dissolve, these options. The providers in Texas were like, “No, we don’t do this.” 

I mean, ECVs aren’t even offered in a lot of places. 

Aisha: Oh wow. 

Meagan: Especially for VBAC. So for this instance, if you were a Cesarean going for a VBAC and having a breech baby to flip, a lot of providers are like, “No, that’s not okay.” We actually have a blog about that too showing that’s not necessarily true. You have options and we need more providers doing Stu’s training like yours going out and learning. 

I love how coincidental your training was to your birth. Really, really, really cool. 

Aisha: Yeah, it was crazy. It’s interesting that you say that. Now we live in Nebraska because my husband is in graduate school. Nebraska has some pretty weird laws about home birth. They are the ones, I don’t know the wording, but you can’t have a doctor or a midwife there. You have to have an undergrad– I don’t know how to explain it. I wonder if we had a third baby, what do I do? Do I have to tell a provider that I had a breech home birth after Cesarean? Obviously, my kids like to be breech. What do I do? 

Meagan: There’s something about your body that has breech babies. 

Aisha: And I’m not asking you, that’s just something that I think about a lot. I’m not comfortable being in a state that doesn’t support what I want when obviously I went through something. I’m obviously not going to do something that harms my child, but I feel like my mental health is important too. I think with my son’s birth, it just always makes me sad to think about. It’s really hard because right after I had Margot, I met two other women who are onto their second and they have had C-sections and they are like, “I’m just going to do it again. I’m just going to have a C-section. My doctor said that we can attempt but I might not progress.” I just want to shake them like, “You can. Don’t listen to that doctor!” But then I feel like it’s also important to respect a woman for how she wants to birth. If you want to have a C-section, that’s totally fine. 

I definitely see the benefits in both especially when you have young children. The women who I met who were like, I’m just going to have another repeat C-section, they are not around family. That’s hard to plan out. 

Meagan: It’s hard. I think that’s one of the things that we want to do at The VBAC Link is give all of the information so when a provider is like, “You could, but it probably wouldn’t really happen so we can just go do it easily and schedule it and have a C-section.” We just want you to know actually what the evidence says and that it’s actually not true. Here is an option over here. Whether you pick it or not, we here at The VBAC Link support you 150,000% percent, but in the end, we really just want you to know what your options are and not just be told something that’s really not true. 

Aisha: Yeah, whenever I meet women who have had C-sections and they are pregnant again, I always tell them, “The VBAC Link. Do you listen to podcasts? You need to listen to this one. It will help you so much.” I think we don’t realize. I was talking about this with my husband recently. We don’t realize that you can pick your provider. You don’t have to go with somebody that you don’t like. 

Here I was with my son and this midwife– and they just recently changed their base name but it was called Fort Hood, Texas. In the Fort Hood, Texas Spouse Facebook group, people were like, “This provider is terrible. I don’t like her.” You could just look up her name and see all of these negative things. You never saw a positive and you just feel like you are stuck with this person like, Oh, she’s been doing this for 20-something years. She must know what she is doing. 

Meagan: I love that you pointed that out. Dr. Fox and I talked about this on an episode. I think it was on our podcast, not his, where we talked about how we have the option to choose but then we also have to respect their option to choose because if they don’t feel comfortable supporting this type of birth, that’s okay. That’s their prerogative then it’s up to us to stay or to go and to find if that’s the right provider because we can fight for what we want, but we can’t make someone change their mind so that’s why you are doing your research and looking up those reviews, talking to your people in your community, really having an open discussion with your provider. 

Most of the time, your provider is going to give you pretty quickly if you are giving open-ended questions. You’re going to get the, Oh, that didn’t jive with me. That didn’t resonate with me, pretty early on. 

Then even then, even if you have a later situation where you have a provider who was supposedly supportive the whole time and they are changing their tune, again, like she said, you have the ability to choose. You do not have to stay with that person. You do not. You can leave, which is hard. That is very daunting. 

Aisha: It is. I feel like we are a people-pleasing culture. 

Meagan: We are. 

Aisha: We really are and we want to trust our medical professionals because they went to school. They know. I watch Grey’s Anatomy. I’m not a doctor. When they tell me my blood pressure, I’m like, Okay, cool. I don’t know what that means, but you told me it’s good. You want to trust them, especially with something so intimate about being near your private parts and having such a spiritual experience of having a baby. I don’t want those people in my birthing space. Yeah. It’s not something that I want. 

Meagan: And a lot of the time, they’re not going to want to be in yours either, right? That’s what is so important. If we are feeling that way, they might be feeling that way. It’s important to read those. I felt that way and I don’t like contention. I mean, sometimes you might disagree with that because sometimes on the podcast, we can get sassy but I don’t like it and that’s how I didn’t want to tell him I wanted to leave. I didn’t tell him that I didn’t like what he was saying or how I was feeling and I stayed then I had a repeat Cesarean instead of fighting for myself and standing up for myself. I stayed. 

49:39 Adding to the supportive provider list

Meagan: It’s not the biggest regret of my life because I feel like that birth specifically is truly what brought me here today in my doula career and in this career, but at the same time, it really wasn’t what I wanted and I do believe that I probably would have had a different experience if I would have followed my intuition and gone somewhere else even at 36 weeks. It was the very end. 

Don’t ever hesitate to change once, twice, or even in labor. Do whatever you need to do. Oh my gosh, know that breech is possible. Breech is 100% possible vaginally. 

Aisha: It is. 

Meagan: And if you are listening right now and you are like, Yeah, it is because I had a breech birth too, or whatever and you had a breech-supportive provider, will you please email us at [email protected]? We want to add these providers to the list. I’m trying to narrow this list down into specific things like vaginal birth after multiple Cesareans, ECVs, and breech birth because we have so many people looking. We have so many people looking and I know they are out there. They exist, but I am just one person here in Utah so we all need your help. If you have providers in and out of the hospital who will support breech, please email us at [email protected] so we can add to the list along with Aisha’s providers. 

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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Kristen joins us today to share her tough C-section and two beautiful VBAC stories! After a 41-week elective induction that turned into a C-section and a 2.5-week NICU stay due to meconium and heart decelerations, Kristen was very nervous about giving birth again. She found The VBAC Link Podcast and found hope. Through her VBAC research, she gained the determination and confidence she needed to try again. 

When she was showing symptoms of preeclampsia, Kristen accepted the reality of a medically necessary induction. She was nervous but knew things would be different. She labored well and had moments of discouragement, but she used the tools available and achieved her VBAC. 

Kristen also had some preeclampsia symptoms but was able to avoid induction, labored almost completely at home, and caught her baby in a wheelchair at the hospital waiting for the elevator!

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

01:11 Review of the Week

04:23 Kristen’s first pregnancy

06:20 Agreeing to induction

08:27 Emergency C-section and NICU stay

12:55 Gaining confidence to VBAC and getting pregnant again

17:28 39-week induction

21:18 Feeling discouraged

27:15 Getting the epidural and pushing for less than an hour

30:58 Third pregnancy

34:41 Forced to find a new provider at 36 weeks

40:45 Labor begins

46:11 Rushing to the hospital

48:06 Delivering her own baby in a wheelchair

51:27 Preeclampsia article and calibrating your blood pressure cuff

Meagan: Hey everybody, welcome to the show. We have our friend, Kristen with us today. Hello, Kristen. 

Kristen: Hi. 

Meagan: We have her and her little baby as well so you can hear those little cute coos in the background. You can just smile. I love when we have little babies on the podcast or kids. The other day, we had a little toddler. It was so fun. It makes my heart so happy. How old is your little baby now? 

Kristen: She is over a month. Just over a month. 

Meagan: Just little little. This is a VBAC baby. 

Kristen: Yes, she is. 

Meagan: We were just talking before we got recording. Kristen had a C-section and then a VBAC and with that VBAC, she had preeclampsia. We are going to talk a little bit more of what that looked like, but that has definitely been one of the themes that our listeners have been asking about. Is VBAC possible with lab-positive preeclampsia? The answer is yes. It is. We will talk a little bit more about that and then she has a surprise. 

01:11 Review of the Week

Meagan: We are going to read a review and then we are going to dive into her stories. 

This review was left in March 2023 by mcgrace and it says, “Must-listen For Every Mom”. It says, “This podcast is a must-listen not just for a mom preparing for a VBAC, but for anyone who gives birth and has given birth or plans to give birth in the U.S. Meagan wonderfully walks through personal stories while prepping for helping for helpful advocacy tips and a solid dose of empowerment in each episode. If you want to hear people discussing their plan to VBAC, if you are curious about what giving birth in the U.S. is like, and if you are wanting to have tips on how to mentally, emotionally, and physically prepare yourself for the best birth, this is the podcast to listen to.”

I love that. Thank you so much and I agree. This is such a great place for everybody, anyone preparing for birth to listen. I think with crazy-high Cesarean rates, we’ve talked about this before. We have to talk about why they are happening and this podcast literally shares a lot of why Cesareans are happening. It is such a great podcast for anyone including first-time moms or even fifth-time moms who haven’t had a Cesarean. 

As always, if you wouldn’t mind leaving us a review, you can head over to Apple Podcasts or Google or Spotify or wherever you are listening and drop us a review. You can even email us at [email protected].

04:23 Kristen’s first pregnancy

Meagan: Okay, Kristen. Welcome. Welcome, welcome and thank you so much for booking this. We are so excited that you were willing to come on. 

Kristen: I am so excited to be here. I have heard so many stories and been encouraged by so much so it is so awesome to share mine. 

Meagan: Yes. Well, I would love to turn the time over to you. 

Kristen: Okay, so I got pregnant pretty young. I was 20 at the time and I was in college so when I got pregnant, it was a little bit of a surprise. It was a little bit of a crazy pregnancy moving and figuring all of that out, but I got to move home to my big, crazy family. I had a lot of support. 

I had a really normal pregnancy. I was pretty young and a lot of my sisters had had babies, so I felt like I knew a little bit about birth and I really didn’t put any effort into looking any deeper into it. I felt like my mom had six kids naturally and I just thought, Okay. This is just what we do. 

I had midwives. I had a super normal pregnancy and then I got to the end and I was very done being pregnant. I was just ready to meet my little baby and have my baby. I was offered a 41-week induction. I think it was just offered to me and I was like, “Meet my baby on Friday? Sounds great.” 

I didn’t think anything of it. My mom had all of her babies naturally and she did seem a little wary to me, but I just was thinking I am huge. I get you are wary, but I want to do this. I want to meet my baby. 

06:20 Agreeing to induction

Kristen: I had a Foley placed the night before my induction date so I had a Foley placed and I was going to go home. When she placed the Foley, she told me— I can’t remember exactly when they fall out, but I was only a centimeter below. I think I was 3 centimeters. She was like, “Oh wow. You really stretched when I put this in. I might see you before your induction.” I was like, “Great.” 

I went home and then we got there in the morning. I wasn’t feeling anything. I was induced and it was just the natural cascade of things. I got Pitocin and then I had GBS so I had to get the antibiotics, but I thought I was allergic to them because I had a reaction as a kid so they had to give me something else. I don’t know whatever else antibiotic they had to give me, but it was something different. 

It made me feel super, super sick. I just wanted to lay in bed. I was like, I feel sick and I don’t want to stand up. I’m in labor and I don’t feel good. So I just laid there pretty much. 

Then I got an epidural and I got to a 10. I pushed for 3 hours but his head never came. He was having some decals so all of a sudden, I just heard the word “C-section” and I was so shocked. It didn’t come into my brain at all before they said it. I don’t know why. It was a long day. I had started at 5:00 AM and by the end of my pushing, it was 12:00 PM. I didn’t think of a C-section before that. 

Meagan: I think a lot of us don’t. It’s not really something that we plan for or even think about. 

Kristen: Yes. So it’s really jarring when you hear it. 

08:27 Emergency C-section and NICU stay

Kristen: Then we had to go down for the emergency C-section because my water had broken and there was meconium and he was deceling quite a bit all day. We went in for my C-section. I was pretty scared. My husband was really scared and we just went in. I was super shaky and I was terrified. I don’t do well with that kind of stuff, so I say the worst part of giving birth is the IVs. I was super nervous and then they needed to get him out so they told me, “You have to try to calm down and try to stop shaking so much” because they needed to get to him. 

I don’t remember exactly what happened. I just remember laying there and the anesthesiologist was just like, “She needs to calm down. Do you want me to give her something?” I just remember looking up at who was doing my C-section and who was somebody completely new because my midwife couldn’t do it. 

I remember them shaking their head and right after that, he must have put something in to try to calm me down. I calmed down, but all of a sudden, I felt like I couldn’t talk. I couldn’t speak. I was just lying there. I was so scared. 

I felt my son being pulled out. I felt them wiggling him out of my body and then I didn’t hear him cry. I just remember looking at my husband and I was mad at him almost. I was like, “He’s out and he’s not crying. I can’t say anything. You need to say something.” He didn’t know he was out, but I felt like he should know he was out. 

So then my son had to go to the NICU because he aspirated meconium. I just remember them lifting him up and the NICU nurses showing him over the drape as they were running out and they were like, “Here, mama,” and showed me him. I just remember feeling like such a bad mom. Everybody says, “Oh, when you see your baby and when you feel your baby, it’s just this overwhelming sense of something you’ll never feel again,” and I didn’t feel that. I felt nothing. 

I couldn’t talk. I just felt nothing and I was so scared and just numb at that point. 

My husband went with my son and everybody had told us all day that Dad gets to stay with baby if something bad were to happen so I was just assuming, Okay, at least my baby is not alone. My husband is with him. Then they started to sew me up, but I don’t know exactly what happened. I just remember them saying, “There’s blood where there shouldn’t be.” They said something about how they nicked my bladder. 

They were sewing me up and then they had to go back in and do something, but my poor husband at the time, there was a traveling NICU that didn’t know dads got to stay in there with baby so he kicked my husband out of the NICU at that point and then he said when he came out, he was in the hallway in between the OR and the NICU and he just said, “I just saw a bunch of people rushing back into your OR and rushing back in there,” and then he said somebody just put him in there like, “What are you doing?” 

He was like, “I don’t know,” so they put him in a maintenance closet. 

Meagan: Oh my goodness. 

Kristen: Yes, so he was like, “I just was in the closet thinking you guys were both not okay and I didn’t know what to do.” So that was a little crazy and then my baby was in the NICU for 2.5 weeks. That was a very long, very difficult process for us because I just wanted my baby to be home and my baby to be healthy. 

Kristen: We had some really amazing nurses and then we had some not amazing nurses and nurses are such a big thing. They really change your whole day. They change everything about your hospital experience when you have a good nurse and when you have one who is just not very supportive. 

That was a really difficult experience.

 

12:55 Gaining confidence to VBAC and getting pregnant again

Kristen: Then when we got home, I didn’t really think about another baby for a while because I was so scared. Once I did, I just remember saying, “You know what? If I go in and the doctor tells me I have to have another C-section because that’s what is best for my baby, then that’s okay. I’ll get through it and that will be okay. My baby will be healthy.” 

Then I started doing a little research and I found The VBAC Link. I think I binged for a full 24 hours. I don’t think I slept. After that, after 24 hours, I was like, Nobody can tell me that I can’t do this. I can do this. From then on, this was a couple of years before I was pregnant. I listened. I did research. I had called and met with doulas and home birth midwives and everyone before I was even pregnant. 

They would be like, “What is your due date?” I was always like, “Well, I don’t have one. I’m not pregnant yet.” They would always be like, “Okay.” But it was great and I felt a lot more prepared with my second. 

I did feel like I was going hands up a little bit. I felt like I was ready to fight when I needed to fight. 

I got pregnant again. She was born in 2022 so I got pregnant in 2021. I got pregnant again. It was an easy pregnancy. I was super sick at the beginning, but it was a pretty easy pregnancy. I started getting Braxton Hicks at 20 weeks which is very different than my previous pregnancy. I had them all my pregnancy every night for all of my pregnancy which was very crazy. 

Meagan: Whoa. 

Kristen: Yeah, but I had switched providers so I started with a provider because I wanted to go with a different hospital initially. When I went to this provider, he told me all about uterine rupture in the first appointment. I had statistics written in my phone because I knew when I went in there, he was going to scare me and I knew I just needed to look at my statistics to feel better. 

That’s kind of what happened, but he did push back a lot on things. He wanted me to get a test epidural. 

Meagan: Mhmm, the just-in-case. 

Kristen: Yes and to be honest, the best way I handled things was, I feel like it’s really difficult to talk to a provider in an appointment. I just feel like the power feels all theirs and when they are saying things, it really does sound scary whether or not. I knew so much information and it would still sound scary. 

They would be saying something and I felt like I was there and my baby was deckling and I did need the C-section. I would get scared in my appointments, then I would go home and I would do more research and I felt really secure in my decision. 

I went back to him and I told him that I would not be getting that. I told him, I just let him know that if it was that much of an emergency, I would be under anesthesia either way so I didn’t understand why I needed a needle in my back. 

He kind of giggled and he was like, “Well, you’re right. You’ve researched, so okay.” 

Meagan: Stop it. No way. Oh my gosh. 

Kristen: Yeah. I ended up switching providers at 20 weeks after I met my doula because I told her just a few things that I didn’t feel as supported with him and she let me know a midwife who I had never heard about. 

I met with this midwife around 20 weeks. I gave her a really long list. I gave her a very long list of papers to tell her exactly what I wanted and she was very, very apt to doing everything. She would say things before I even would talk about them.

I would ask her about an epidural and she would say, “No, you don’t need one and to be doing this, you need to be eating before.” I would ask about all of these things so I felt really secure going with her. 

17:28 39-week induction

Kristen: At 38 weeks, I got to my appointment and I had high blood pressure. It was pretty high and she just was like, “I’m going to do a urine test for preeclampsia.” I really had never heard of preeclampsia. I had heard of it. I just had never done any research on it. I didn’t understand what it was. 

I did the urine test and I really was thinking it was just going to come back fine. I felt absolutely fine. I had no symptoms. 

It seemed that it was going to be okay and then it wasn’t. She told me that I was going to need to be induced. I was very, very nervous. I really wanted to avoid an induction because my first was induced and I felt like that was leading up to my C-section so I was super nervous about a VBAC being induced. 

But she was very supportive of me. She really understood that I was very, very nervous and she was very respectful with that. 

So we ended up being induced at 39 weeks and I went in. I had a Foley bulb placed and then I just rested the rest of the night. You don’t sleep in the hospital, but I pretend-rested for the rest of the night. 

Then in the morning, I got up and they were like, “Yeah, you seem to be progressing.” They started me on a low dose of Pitocin. I just told them I wanted really low and slow so we did that. I had quite a bit of Braxton Hicks or prodromal labor. I don’t exactly know which. I had quite a bit of that beforehand. 

I was at a 5 and pretty actively contracting. They were like, “Honey, you don’t feel anything?” I was like, “No, I feel something. I just feel what I feel at home all of the time.” So I was like, “This is very similar.” I got pretty discouraged because I felt like nothing was happening. It was 2:00 or 3:00 PM the next day so I had been in the hospital for 20 hours at that point. I just felt really discouraged because I felt like nothing was happening and I just emotionally broke down to my husband and told him, “What if we do this and everything happens the same? I worked this hard and I fought this hard for this and I’m just going to go in and I’m going to have another C-section.”

I knew that having another emergency C-section was going to be worse for this baby than if I just had a regular C-section. I was so upset. I had my emotional breakdown, then after that, I kept going. I was doing everything. 

When they put me in that room before the nurses came in to even meet me, I was doing Spinning Babies. I was doing everything I possibly could to get this baby out. The nurses would even comment and say, “Wow. You just don’t stop moving, do you?” I just felt like a little geriatric patient with all of my little tubes attached to me and I was just walking around. 

21:18 Feeling discouraged

Kristen: Yeah, so then at that point, things started to progress a tiny bit. I was progressing, but nothing a ton was happening so my midwife came in and let me know that the only thing she could do besides Pitocin was break my water. 

I was really in my head at this point in labor. I felt like I really needed to advocate for myself. My doula was helping me and texting me the whole time telling me what I could do. She just let me know that once things really progressed, then she would come in. 

I at that point was really just trying to play the risk of what Pitocin I wanted. Do I want to stay low and slow? I just really didn’t want my cervix to tire out so I let them push it up a little bit more. I just was really in my head about trying to make the best decision which is silly because I couldn’t have control of everything but I felt like I needed to to have my VBAC. 

Things kept progressing and at 10:00, they asked me to break my water because that was the next step. I had been on Pitocin all day so I was a little bit worried about my cervix getting tired. I told them I was fine with that. 

The contraction after they broke my water, I was like, Oh my goodness. Here is the pain that everyone talks about. 

Meagan: And I feel it. I feel it. 

Kristen: Yes. I was like, Oh my goodness. Then it felt like I was actually in labor. My doula came at that point. She was doing some rebozo on me and shaking apples. 

Meagan: Yep, shaking the apples. 

Kristen: Yes. That was great. She brought out the TENS unit which was amazing. Oh my goodness. It helped so much. They put it on my back and it was just amazing. 

I was standing up moving my hips. I had the TENS unit on and I was really working through things and I started to feel like I was going to throw up. I started to get hot and cold. I would have a contraction then in the middle of a break for a second, I had told her in the middle of a contraction, “I think I’m going to throw up.” Then I looked at her after and I was like, “I think I’m going to throw up.” I was so excited because I was like—

Meagan: This is it. 

Kristen: Yes. I was like, “I think I might be in or nearing transition at this point.” I had amazing nurses the whole process. I just had amazing nurses. I had asked for nurses the whole time who agreed with HypnoBirthing or who were trained in HypnoBirthing. I had not done that, but I just wanted them who were a little more holistic and a little more natural. 

One of my nurses actually said, “You’re not doing HypnoBirthing.” I said, “I know.” She was like, “You just want somebody who’s going to let you do what you want, huh?” I said, “Yeah, absolutely.” She said, “Okay. I have the perfect nurse for you next time.”

I had amazing nurses the whole time. They were so encouraging. 

Meagan: Oh good. 

Kristen: But my nurse must have been doing something so another nurse came in to check me at this point and she was not as nice and amazing. She told me that she needed to check me. I was about to get on the bed and I had another contraction so I stopped right outside of the bed and put my hands on there. 

She told me, “Get on the bed. I need to check you.” I couldn’t speak because I was in a contraction, but I was thinking, Oh my goodness. I finally ended up getting on the bed. She looked at me and told me I was a 6. 

In my head, I was not a 6. The whole room changed for me at that moment. I was very discouraged. 

When she told me I was a 6, my doula’s face was right behind her shaking her head no. She just was looking at me shaking her head and she was like, “No you are not,” but I don’t know. I was exhausted and I just broke mentally in that moment when she told me I was a 6. I just heard I can’t do it. I can’t do this. This is too much. I can’t believe I’m at a 6, because at that point, when I got into bed, I felt pushy. I felt really pushy. During my contraction, I was bearing down a little bit. 

I just thought, Okay, if I’m pushing at 6, baby is in a bad position. I just was so nervous. 

I got up. I went to the bathroom. My doula actually told me, “You need to get up. We’re going to the bathroom,” so she just took me to the bathroom alone just her and I. She looked at me and she said, “Do you think you’re a 6?” I was crying at this point. I was like, “No, I don’t. I don’t think I am.” She was like, “I do not think you are a 6 at all. I think you know where you are.” I was like, “I know, but what if I really am? If she says I am, I am.”

I broke emotionally and I just was like, “I’m so tired.” I was so tired. I hadn’t slept in 24 hours at that point and I was just so exhausted and upset. I told her, “I want an epidural.” She knew that was not my plan so she really tried to encourage me against it and told me I was doing such a good job. I couldn’t hear it at that point. All I could hear was the doubt. 

27:15 Getting the epidural and pushing for less than an hour

Kristen: I just told her, “No, I want an epidural.” At that point, she shifted gears and was like, “Okay, then we’re getting an epidural and this is going to be great and you’re going to get some rest.” I was a little discouraged, but I ended up getting the epidural at 3:00 AM at this point. I got the epidural and I actually got an hour of rest which was really amazing because I was exhausted but when they had given me the epidural, they checked me at some point after this and I was a 9.5. 

She looked at me and gave me an eye like, Yes, you were not a 6. It was nice. I got an hour of rest and then they came in and told me that I was ready. This sweet, sweet nurse came in and told me that I was ready to start practice-pushing or something like that. I was like, “Okay.”

I was a little nervous about the pushing part just because I pushed with my son for so long and his head never showed so I was like, Once we get past a head, I will be there.

I pushed in one position on my side and then the nurse looked at me and she was like, “You know, we’re going to try tug-of-war.” She put the squat bar up and I did a tug-of-war push and right when I did that, her eyes got big and she ran over and got on the phone. I just remember her saying something like, “When she pushes in some position, I see something about baby’s head.” I just remember her saying, “Baby’s head.” I, in the bed, was like, “You said baby’s head?” I was so excited. I was like, “They saw baby’s head.” 

I pushed for a little less than an hour and she was there. It was everything. Everything went away for me at that point. I was just so happy and excited and it was the best feeling in the world. I just felt like all of my work, I actually did it. I did it. 

But I forgot to mention, my midwife got off shift during this so another OB was on and she came in. They actually were asking me to stop pushing to wait for her to come in. I giggled. I was not going to do that, but she was not as kind and helpful. 

She let me know right after, despite knowing my birth plan that delayed cord clamping wasn’t safe. 

Meagan: What?

Kristen: Yeah, and that I needed to cut the cord. To be honest, I was in complete baby land at that point. I was so happy that my baby was there that I didn’t fight it. Looking back, I’m honestly glad that I didn’t because I know that it would have taken me out of where I was able to be and the joy that I was in. 

I didn’t fight it. I just let her do it and it was silly, but it was okay. I got to have my sweet baby and it was an amazing postpartum experience. I remember being wheeled out with her because I didn’t get my little boy after my C-section so I remember being wheeled out with her. I was just holding her in my arms and I was so happy she was in my arms. 

I looked at a janitor while I was being wheeled to mother and baby. I lifted her up and I smiled so big at him. He just was like, “Okay.” 

Meagan: “Congratulations”. 

Kristen: I just was so happy. But yeah, that was my second and my VBAC which was amazing. 

30:58 Third pregnancy

Kristen: When my little girl was 6 months, I got pregnant again. It was an amazing pregnancy. I felt great the whole time. I totally thought she was a boy because I wasn’t sick, but it was a girl which I was super surprised by. 

I had no Braxton Hicks. I really didn’t have a ton until the end which was crazy to me because I had them so much with my previous. 

Meagan: Yeah, a lot. 

Kristen: Yes. That was pretty crazy. I went back to my provider who I had gone to with my second baby. I went back to her. 

Things felt a little different with her. She was still really supportive, but it just felt a little different, then at 16-17 weeks in my pregnancy, I did an initial test for preeclampsia and my numbers were already above. The protein in my urine was already above where it needed to be.

 

She just told me in an appointment very casually, but I was super nervous. I didn’t know a ton. During this pregnancy, I did a ton of research about preeclampsia, so the one thing I did to my diet was I ate so much protein. I ate. I tracked especially in that first trimester. I tried to eat 100g or more a day. I really focused more in that first trimester. That was the only thing I felt like I could do so that’s what I did. 

She told me my protein was already really high which I didn’t understand and it made me really nervous. I asked a few questions during the appointment, but I felt like I had a ton of questions after. I called and I felt very dismissed. I felt like she just kept trying to tell me, “Don’t get in your head. Everything will be okay.” 

She was being very sweet, but I just felt like I needed a doctor at that point. I didn’t need a friend. I needed her to give me information instead of trying to encourage me. It was really sweet, but we only had 5 minutes and I didn’t want encouragement. I needed information that I just felt like I wasn’t being given.

 

I actually ended up switching again to another OB. I just was interviewing them so I actually had appointments with my midwife and an OB. He actually came back into town. I had heard really good things about him but he moved and then he came back. I interviewed him initially and actually, I left my appointment and I kind of drilled him a little bit. I really asked him a lot of questions. I left my appointment. I called my sister and I said, “Yes. I don’t believe it.”

He said everything I wanted to hear and that feels too bait-and-switch to me. There’s no way he’s this good. Then I had a few friends through church who he was with and he followed through on everything. 

My doula told me, “I think he’s just that good.”

I was super surprised because I could not believe that he was that receptive of me, but I went to another appointment and talked about my initial labs with him and he sat there with me for a whole hour and explained what he knew about preeclampsia and explained what he could to me. 

It was really, really helpful and I felt very heard. So at that moment, I chose to go with him. 

34:41 Forced to find a new provider at 36 weeks

Kristen: I finished with him through the rest of my pregnancy. My sister was actually pregnant too and she was going with him. It was really cool. 

Meagan: How fun.

Kristen: She had her baby. I got to be there for some of her birth. She was due a month and a half before I was due so I got to be there with her and watch her amazing birth then she told me, “I’m having a lot of pressure. Can you just look down there?” She was crowning and I was like, “Oh, you’ve got to go to the hospital.”

Meagan: Oh my gosh. 

Kristen: She went to the hospital and we had that amazing experience and that was her first VBAC so it was really awesome.

Then my provider called me and told me that they were shutting down their office when I was 39 weeks pregnant. This was at 36 or 35 weeks. I was then scrambling to find another provider. It was very, very difficult. Everyone I talked to just told me that they didn’t take VBACs past 35 weeks and that I even would have my paperwork switched and then they were like, “Oh, you’re VBAC and preeclampsia. We won’t take you.” There were 3 weeks of me just honestly trying to find a provider who would take me, not even a supportive provider, just having a doctor take me was very difficult. 

I finally found a provider who would take me, but they told me there was another provider in the office who was very unsupportive. He actually was there during my sister’s birth when she came in and was totally crowning. He sat back with his arms and legs crossed and she was crowning, hopping on the bed ready to push and he sat there with his arms and legs crossed and told her how unsafe VBACs were. 

Meagan: Oh my gosh. 

Kristen: He told her that he didn’t know who approved her chart, but this was not okay. Thank goodness, the provider who was amazing came in and saved the day. But he was awful and he was actually one of the three providers in this office that would take me. I was really nervous about the on-call schedule and if he was going to end up being on-call when I was going into labor. 

There was a lot of back and forth there, but I ended up meeting with this provider and I met with him when I was 40 weeks and a day so I met with him the day after my due date and this was our first time meeting. I gave him my birth plan. He looked at how far I was and he was like, “Oh, awesome. You’re almost done.” 

I felt like he was perfect. “Let’s just get you out of here.” He was doing it as a favor to the other provider. I felt like a check in his box from the start of being there. I was really nervous about my blood pressure. I kept telling everyone, I had no symptoms with my previous preeclampsia. I had no symptoms and all of my labs are positive so I just want to be really on it. 

I didn’t have a provider for 2 weeks and at the end of my pregnancy so I just got a blood pressure cuff and I monitored myself as much as I could. It was stressful. I ended up going into triage once because my blood pressure was high and I didn’t have anyone to call. I didn’t know what to do, so I went into triage and they just were not very awesome with me. 

But that was okay and my blood pressure was fine so I ended up getting to go home. I was with my provider. He just was not, he really wanted to induce me. He told me all about my placenta dying at 41 weeks and he was so scared about me going past 41 weeks. 

I asked him if this was just something he did with just VBAC patients and he said, “No, I do this with everyone.” I was like, “Oh, okay.” I was like, “Perfect. I’m even less worried now. I was thinking you had more information about VBAC and my placenta, so I’m less worried now.”

Meagan: Less concerned. 

Kristen: I told him, “I don’t want to be induced at 41 weeks.”

He kept telling me, “Oh, I know. You do your research. You do your research.” He did not like that I was very informed on things. 

I ended up having to go into triage at the end of my pregnancy three separate times because of my blood pressure readings at home, but every time I went into triage, they were fine there so I kept telling people, “I don’t know what my blood pressure reading is doing at home, but is there something else I can do?” 

Everyone would look at my blood pressure cuff and say, “Yeah, that’s great. That’s the one I recommend.”

I was like, Well, why is my blood pressure so high at home? I need some help. This has to not be working. At one point, I brought my blood pressure cuff in with me and they were reading differently at the hospital versus the cuff. I was like, Mine is not working, so I don’t know how to check myself at home. 

It was really difficult. My husband started to be a nervous wreck about all of this anyway so everyone was pushing me to get induced and every time he heard the word “induction”, he was like, “Let’s just do it. It worked for us with the last VBAC. Let’s just do it.” Every time they told me I was okay, I just was like, “No. I’m going home. If I’m okay, I am going to have this baby naturally.” 

It was a really emotional experience because we were all very back and forth. it felt like everyone was going through it with me, but I was the one pregnant and fighting to stay pregnant if my baby was okay. It was really difficult, but I ended up getting through it. 

40:45 Labor begins

Kristen: I ended up having some prodromal labor at the end is what I felt like it was. 41 and a couple of days was my next appointment and I told everyone, my husband and my sister, I was like, “He’s just going to want to induce me and push it so much at my next appointment.” I was so worried so I told my doula that I was thinking about trying castor oil. 

She came over and she gave me electrolytes and she gave me a recipe with castor oil that was very, very small. I had gotten a few recipes and it was next to nothing. There was no castor oil in it basically. She told me, “It sounds like you are in early labor so I’m going to have you try this,” and I did one dose every 4 hours. 

She was like, “It sounds like you are in early labor, so I’m going to have you try this.” I honestly was even grumpy about that. I was like, “No, I want more. If I’m going to try this, I want it to do something.”

I tried that at 3:30 in the afternoon on a Friday. I did a couple of doses and then my mom called me and told me that she was in town and asked if I wanted her to come hang out with my kids. I had done two doses and I was like, “No. Nothing is happening. I’m never going into labor.” I was super grumpy. “I’m never going into labor.” 

I got off the phone with her. I started crying because I was super emotional and my husband told me to just go back in the room for a second. 

So I went back there and I don’t know. I must have known in my head that something was going on because I called my mom right back and I was like, “Yeah, maybe come over.” She was like, “Okay.” So she ended up coming over and hanging out with us and then we put the kids to sleep and I was feeling contractions and everything that I had normally felt throughout the week. 

I just was like, “I don’t think a ton is happening.” I ended up putting my little boy to sleep at 8:00 and I had finished my doses of what I was doing. At that point, I was breathing through them a little bit, but I kept telling everyone, “I am not in labor. If this is it, it’s very, very early. It is not happening.”

My mom was like, “Okay, that’s fine, but why don’t you just go back? You need to get some rest because if it is going to happen, you need to get some rest.” I told her, “Okay.” 

I went back to go get some rest and I don’t know why in my head I didn’t realize that I had been able to rest through all of them before in the week, but suddenly, I could not lay in bed. I just told my husband, “No. It’s really, really early if it’s happening.” 

I just sat on my ball. I rocked around on my ball for a little bit then I was getting pretty uncomfortable but I didn’t want to say it because I didn’t want it to be fake. I said, “You know what? I’m going to take a shower. I can’t stay in the shower for very long because I don’t want it to slow things down if it is picking up.” 

My husband asked, “Do you want me to come in there with you?” I said, “No. No, no. It’s early. I’m going to take a shower. I’m going to get clean. I’m going to come out and do some more on my ball and do Spinning Babies.” 

He said, “Okay.” 

I went in the shower and I couldn’t even really find a time. I probably got in the shower at 9:00. I couldn’t find a time to wash my body or wash my hair, so I thought, “You know what? Maybe this isn’t as early as I thought.” I went back in the room and it was very relaxing. I went to just go grab my phone and my husband was like, “What are you doing?” I was like, “I think I should just time them.” 

He was like, “Okay, I’m coming in there with you.” He went in there and he told me, I think at that point they were 3 minutes apart and he was like, “They are pretty close. I think you are farther than you are thinking.” 

I just was like, “No, no, no. This happened way too fast.” I was like, “No. I’m not. I’m going to keep being in the shower.” 

So I stayed in the shower and I just relaxed in there. it was great to be in there and then my sister came over at about 10:30 and at this point, they were a minute apart. My husband had called my doula and she told us to leave the house at 11:00. She had given him an hour timeframe. “If it stays at this for an hour, you should leave at 11:20 or something.” 

I was in the shower. My sister came over. I don’t really remember her coming over. I was just breathing through everything. She said she walked in and she was like, “I felt like it was the wrong house. It was very calm. I didn’t know anyone was in labor. I just walked in and you were breathing. You weren’t talking.” 

My sister finally came in and she told me at one point, “You’re doing it. You’re laboring at home. This is what you wanted for this labor.” That was the one time I remember her being there and I was like, “I am doing this. I am laboring at home.” I was so excited. 

46:11 Rushing to the hospital

Kristen: Everything was going really well. I was able to breathe through everything. My husband was getting the truck ready for us to leave and then I heard a pop, a visceral pop. It was crazy. It sounded like a water balloon popping and all of my water broke. My sister had just told me before this probably two contractions before, she was like, “Sis, they are really, really close. Are you sure you don’t want to leave right now?” 

I told her, “Yeah, I don’t feel like I’m getting a break, but she is not down. She is not engaged.” I had no pressure and I was like, “I know what that pressure feels like. I don’t have the pressure. It’s okay.” 

So then I felt a pop and my water broke and then I felt all of the pressure, absolutely all of the pressure. I looked at her and that was the first time that I had really made a sound. I think I grunted or I moaned and I was like, “Okay, we need to leave. We need to leave right now.” I felt like I could have her at that moment. 

Meagan: Yeah. 

Kristen: So then I got out of the shower and I put some clothes on. I was still buttoning my dress to even walk out of the door because I was like, “If we don’t leave right now, we will not make it.” I actually asked my sister to get me a towel. She asked me later why I asked her to get me a towel and I was like, “I really didn’t know if we were going to make it so I needed something to wrap the baby in if we didn’t.” 

We left and live 5 minutes from the hospital so we drove to the hospital and I had by the grace of God, one contraction in the truck. I was laying down in the truck and I had one contraction. I really was able to hold it pretty well. It wasn’t as intense as my contraction before so that was nice. 

48:06 Delivering her own baby in a wheelchair

Kristen: We got there and we parked. I started walking in. I had one contraction in the parking lot. I just remember being by a dumpster and I actually got mad at that point. I was like, “I will not have this baby in the parking lot by a dumpster.” 

I would have this baby in the truck or in the hospital, but I’m not doing it by the dumpster. I tried to walk through that contraction because I was like, No. I am not having this baby here. 

He kept telling me that I guess I kept saying, “She’s here. She’s here.” I was just holding myself, but we walked in and I got backward. The security guard brought over a wheelchair. I got backwards on my knees and I was sitting up. He pushed me through and I got to right outside the elevator and they were pressing the elevator doors. The elevator just was not coming and I had one contraction and I was like, “Okay.” I did not push. I think it was the fetal ejection reflex. I don’t know what it was, but I did not push. 

She just— 

Meagan: Came. 

Kristen: Yes. My husband said I was just pushing the butt in and he said, “I heard, ‘Here’s the head. Okay, here’s the shoulders. All right, she’s here. She’s here.” He was like, “You were just talking us all through it.” I just felt her and I was like, “All right, she’s here.” 

I pulled her up and this poor security guard was pushing my wheelchair so then everything came out, everything so he just got, the poor guy, he did not sign up for that. 

Meagan: Oh my gosh, what a ride for him. 

Kristen: Yeah, then we got into the elevator and my poor husband had to push. We had a family leave the elevator, he was like, “Sorry, guys. You’ve got to get out.” We got in and that elevator, I guess, wasn’t working so it took us down to the basement then it went back up to the first floor and back up to the second.

I was just holding my baby and trying to make her cry a ton because she had cried a little bit, but she was really quiet and calm. I was like, “Nope, scream. I want you to scream.”

We got up to the floor finally and then there was one nurse there. She was like, “Okay, she’s here. Baby is here.” We just ran back through and it ended up that they did awesome. I got to deliver my baby and it was great because all of the doctors were super stressed about everything and about my VBAC and induction and I felt like God was like, “Well, honey, you’re going to worry about this so much and then you are going to deliver your own baby.” 

Meagan: You’re going to do this. 

Kristen: And it will be fine. 

Meagan: Oh my gosh, what a shock. What a ride. I’m sure everybody around will never forget that day ever. Oh my word. Congratulations on all three of your sweet babies who I have been able to see throughout the episode. That is so fun.

 

Thank you so much for sharing your stories. 

Gosh, you went through a lot with switching and all of the things then catching your own baby. Oh my gosh. 

51:27 Preeclampsia article and calibrating your blood pressure cuff

Meagan: Okay, so there is an article essentially, a small review that is called Risk Factors and Maternal/Fetal Outcomes Complicated by Preeclampsia Following Cesarean After a Trial of Vaginal Birth. We’re not going to dive too much into it and even at the bottom, it says that they acknowledge that this is not a cohort study and therefore the evidence is not as strong as a randomized, clinical trial but the consistency of the data alongside evidence from the other larger published studies is reassuring. 

It says that they recommend a trial of labor for all pregnant with severe preeclampsia unless it is excluded for other indications. So just right there, I mean, again like I said, this right here is not as strong. They have some links and we are going to make sure that it is in the show notes for you to go read over. 

But again, if you have preeclampsia, if your numbers are showing preeclampsia, it is possible to have a VBAC. I encourage you to explore your options and then I wanted to touch on Kristen’s comment of how she brought her cuff in and it was so different. 

It really is something that a lot of people actually don’t know so I wanted to bring this up. But it’s really important to get it checked and calibrated by a professional lab or someone who takes blood pressure because often, it can be wrong. A lot of our preeclamptic moms are getting cuffs and then they are not calibrated, so we are having really high readings or really low readings and it’s the opposite. It’s not matching up. 

If you have a blood pressure cuff at home and you are feeling like something is off or you are getting weird readings and it’s not consistent with your hospital readings, don’t hesitate to go get it calibrated because that can definitely, definitely help. 

It’s supposed to be calibrated every 6 months so if you get one for one pregnancy and then two years later or one year later or whenever you are having your baby and you are using it again for whatever reason, know that you may need to have it calibrated because it has been a while. 

I just needed to throw that in there and thank you once again for being here with us today and congratulations again. 

Kristen: 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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Emily’s first birth experience was a home birth turned hospital transfer which ended in a C-section and then a birth center VBAC ending in hospital transfer and another C-section with her second. She found herself feeling alone, frustrated, and surrounded by people who just didn't get it as she worked to process the trauma and grief of not one but two back-to-back traumatic births and C-sections. 

Throughout her journey, Emily took charge of what she could, learned about her options, and made the right decisions even when they were disappointing. Emily has been proactive about physical and emotional healing. She has been open to new perspectives. Emily is grateful to share her story and all that she has learned for other mamas who have found themselves in similar situations. And we are so grateful that we can feel of her strength! 

The VBAC Link Blog: How to Cope When You Don't Get Your VBAC

The VBAC Link Blog: Deciding on VBAC vs Repeat Cesarean

NPR Article

Spinning Babies: What to Do When...

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

05:02 Review of the Week

09:10 Emily’s first pregnancy and labor

14:59 First C-section

17:47 Second pregnancy

21:16 Moving and switching providers

33:20 Pushing for 5 hours

35:45 Transferring

37:47 C-section

41:29 Tips for adhesions

44:20 Hospital births are beautiful

49:09 All about transferring

Meagan: Hello, everybody. It is Meagan and we have our friend, Emily, with us from Texas today. Hello, Emily. How are you?

Emily: I’m good. How are you?

Meagan: I am wonderful. I am so wonderful. I love recording these stories if you can’t tell. We are producing them a lot because I love recording. I love hearing these stories and sharing these stories. Your story is a CBAC story which I think is so important to share on The VBAC Link Podcast. As technically a CBAC mama myself because I don’t know if anybody knows who is listening, but I had a C-section then I wanted a VBAC and had a Cesarean and then I had a vaginal birth. So all over the place. 

CBAC is really special to my heart and I think that this is such an important topic to share on the podcast because we know that obviously, so many C-sections are happening, right? I also think it’s important to know that sometimes even when we are preparing for a VBAC, it might end in a Cesarean birth and even more important, I think it’s really important to know that Cesarean births can be healing and are a lot of the times healing. Would you agree with me, Emily? 

Emily: Yes. I mean, I loved hearing the healing stories. Mine was not and I think that’s what I yearned for to her is that I’m not alone and it’s okay to have a repeat C-section and I hate calling it a failed VBAC, but a repeat C-section that wasn’t wanted and wasn’t healing. I mean, my second birth was much more traumatic than my first. I mean, I hate saying traumatic because I have two beautiful, healthy babies, but I also want listeners to know that just because you have a healthy baby and you didn’t have serious complications you can’t feel what you felt about the trauma of it all. 

Meagan: Okay, and I love that you point that out too because just as much as Cesarean birth can be healing and can be amazing, it can also have a lot of that trauma. Trauma, I think, is a completely valid word to use. It can be used to be described as traumatic. It can be described as hurtful. I was angry. I was angry when I walked myself down for my second C-section. I didn’t want that. That was not what I wanted. It was not what I planned. 

Yeah. Also, going into that it doesn’t always happen the way we want to. It can go both ways so that’s why I think sharing CBAC stories on this podcast is so important because we have to learn both sides of things. We have to know that Cesarean birth can be healing and it can be exactly what someone needs and it can also be traumatic and not what someone needs. I think that through these stories and through the journeys, this is how we learn how to try to avoid trauma and anger and hurt along the way. 

05:02 Review of the Week

Meagan: Before we get into this story, I do want to read a review. Okay, Emily, so remind me. You had a home birth transfer? 

Emily: Yes. A home birth transfer C-section and then birth center transfer C-section. 

Meagan: Birth center transfer C-section, yeah. I also want to talk about transfers at the end. We’re going to talk a little bit about transferring and when it might be a good time to transfer, when it might be starting to give us signs that we might not be in the best place, and then also how to go about what to do after you transfer if you’re transferring because that can also be a big mess too sometimes transferring depending on how the hospital responds to you. 

We’ll dive in to these stories but I do want to read a Review of the Week. This was from winben18 from Apple Podcasts and it was on May 19, 2023, so a year ago right now. It says, “I had my first baby in 2021 11 pounds at 42 weeks via Cesarean because he wouldn’t descend. I was told I couldn’t birth him because he was too big and my pelvis was too small, but I always knew that wasn’t true. My mother, a very petite woman, birthed me naturally and I was 11 pounds, 9 ounces. In 2023, I had my VBAC with another 11-pound baby. No epidural, 7-hour labor, and I credit that success to The VBAC Link. I started listening to them religiously at 38 weeks when my provider started fearmongering me about birthing a big baby. I needed every little bit of encouragement and The VBAC Link provided that. It’s incredible how your body’s physical capabilities start with your mindset. Thank you ladies for all of your stories. I wouldn’t have been able to do it without you.” 

Wow, that was an amazing review and so grateful. Holy cow, winben18, yay for an 11-pound, 8-ounce baby. I agree with what she said that it starts with our mindset. A lot of the time it does. We can also be in the best mindset ever and things might not unfold that way but if we can set our mindset and get going and get the education and the empowerment and the encouragement, you never know. Things can go a really long way. 

So as always, if you guys have a moment, we would love your reviews. You can leave it on Apple Podcasts. You can leave it on Google even or on Spotify. We would love a 5-star review and if you can, comment. Tell us what you guys think. 

Emily: I love stories of petite women birthing big babies actually because I’m smaller and I had big babies. I’m like, I know I could do it.

Meagan: Yes. Yes. She talked about fearmongering. A lot of people do get fearmongered. They start saying, “Oh, I don’t really think you can,” and it’s so hard when we have a lot of people doubting our own bodies and then we start doubting them even though we didn’t have doubt originally. It’s so hard. It can be a tough cycle, but Women of Strength, it is possible. 

09:10 Emily’s first pregnancy and labor

Meagan: Okay, Emily. Let’s dive into these stories. I know you mentioned in the beginning that you had a second Cesarean and it wasn’t amazing. It wasn’t amazing, so I would love for you to of course share your stories but also maybe talk about tips you would suggest for someone in your situation maybe looking back where you’re like, Oh, I could have done this, or tips for people in your situation. 

Emily: Okay, so my first son was born in May 2022. I got pregnant with him in September 2021 and I knew immediately that I wanted midwifery care. I wanted a home birth and to be honest, I had no fear. I was very confident. I was like, I can do this. I’m in shape. I eat healthy. There is no reason why this isn’t going to go perfectly. 

I mean, I can’t be the only one who has thought that and it was the complete opposite. It was a fine pregnancy. I was very, very sick until about 20 weeks. I lost almost 10 pounds in my first trimester, but it turned out to be a wonderful pregnancy. I love being pregnant. I love it. 

Anyway, I went into labor at 6:00 AM and I guess active labor really started around noon. We were at home. My husband started filling up the birth pool. My midwife was on the way and she had an assistant midwife with her. So really, we just labored at home. 

Then I would say probably about early evening, they checked me and I hadn’t made very much progress. I think I was at a 4 or a 5 and I’m trying to remember correctly. I think that’s when they told me that the baby was at a tilt. 

Meagan: Asynclitic or the whole body? 

Emily: You know, I really don’t know and I think a lot of it has to do with why I have struggled so much with that birth because I feel like that birth catapulted me into the next C-section, but I feel like they had said anterior tilt, but I don’t think that is correct. 

They broke my water because I wasn’t progressing and then they were trying to turn him after the fact. I think that’s where things went downhill. They checked me. I wasn’t progressing. They were like, “We can break your water. It will speed things up.” And I agreed. 

I think that was my first mistake. I think a lot of that has to do with me not preparing as well as I should have and me with the mindset of, I can do this, no problem. That is my first regret from my first birth.

Anyway, so they broke my water and then after that as everyone knows, contractions were off the wall. They had me laboring in one position on the bed on my left side to try to get him to turn and then they had me on the toilet so I went back and forth between there. Every other contraction, they were in there trying to turn him. 

So basically, this went on until about 4:00 AM at home. It was my first labor. I was in an extreme amount of pain and I just was exhausted. I felt like it wasn’t going like I planned obviously. 

So anyway, we transferred to the hospital. That was about a 30-minute drive to the hospital which was not fun at all. It was the wee hours of the morning so we went in through the emergency room, got up to triage, and I think I got my epidural within 45 minutes to an hour and just from what I remember, that was a very intense hour. I just remember thinking, What the heck? This is not how childbirth should be. 

Anyway, so I got my epidural. I labored with an epidural for a few hours and they started me on Pitocin so epidural, Pitocin– 

Meagan: The usual. 

Emily: Yeah. Nothing was really happening. They were doing Spinning Babies with the peanut ball and the bed to try to get him positioned better. 

Long story short, we got to an 8 and this was probably gosh, almost 48 hours later that I got to an 8. The hospital where I birthed is very home-birth and transfer-friendly. I had midwives on staff there who cared for me. One of the midwives home birthed her babies too so that was cool to have her caring for me and understanding my mindset of wanting to birth at home and then obviously I wasn’t at home anymore. 

But regardless, they were saying, my water hadn’t broken for over 24 hours. They weren’t concerned about that and I loved the evidence-based care there. I love that. But they did tell me, “You know, the way things are going, you could get to a 10. You could push for a couple of hours and end up in an emergency C-section.” It’s almost like that verbiage right there was enough for me to be like, “This is it. Let’s call it. Let’s get the baby out. We want to meet our baby.” We were being surprised on the gender so we were very excited for this baby to get here. I went to 39+5 with him. 

14:59 First C-section

Emily: And so anyway, we called it and we did the C-section. I don’t think– obviously the birth was traumatic for reasons like I explained, but the C-section wasn’t awful. I didn’t feel any tugging. It was a very pleasant Cesarean. They did delayed cord clamping, not traditional delayed clamping, but they waited for it to stop pulsing and cut it. They took him to the table and did all of the hospital things and then wrapped him all up and gave him to me. I was able to do skin-to-skin and nurse while they put me back together. 

Then they took him off to the nursery. I remember them asking, “Do you want your husband to go with him?” I’m like, “Yes.” I think it was just those little things. Those are the moments and tidbits that I think any mom who has experienced traumatic births thinks back on. I didn’t get to touch him right away and I had all of these dreams. I wanted a water birth and my whole pregnancy, I was like, I’m going to pull this baby right up to my chest and nurse him and it’s going to be beautiful. 

When you have that dream and then you get the most extreme opposite, I mean not to the fact that I was under general anesthesia and it was horrible, but in my mind, it was the complete opposite of what I wanted and it sucked. 

Anyway, so then we go back to recovery and I’m nursing him and everyone who has had a C-section listens to this podcast or most of them. You don’t really feel a lot of pain until the second and third day when most everything wears off. It was just hard. It was a hard recovery. It was hard to hold him. He was almost 9 pounds. It was hard holding him. When you nurse a baby, they sit on your belly. It was just hard. 

I also struggled with vertigo and I got horrible vertigo on my last day at the hospital. I was throwing up which is awful after abdominal surgery and they gave me a pill to stop the vertigo. Then the lactation lady comes in and says, “Oh, that’s a level 3 dry-you-up pill.” 

So then I’m into supply issues and it was just an awful, awful recovery. I hate saying that. I want to be positive, but it just was not fun then on top of that, I was doing triple feeds. I was nursing, then supplementing, and pumping. My milk really didn’t come in for 3 weeks. I was very blessed. When it came in, it was in and I got over the dry-up. 

All in all, it wasn’t great. 

17:47 Second pregnancy

Emily: Anyway, fast forward, I got pregnant 6 months later. It was not planned. I remember taking a shower and I have unscented face soap and I could smell it. I was like, Oh my gosh, no. I took a test and it was positive. The baby was asleep. He was asleep in his bassinet right by my bed and I went to my husband, “I’m pregnant.” 

My husband, I want to give a shoutout to husbands who are supportive and there. I could not ask for a better partner during labor, during births, and recoveries. He is right there. He is an amazing man, so I want to give a shoutout to him. But yeah, so then I’m pregnant again with a 6-month-old and I knew immediately I wanted to VBAC. 

I started to look for supportive providers and we were in Austin which you would think Austin has wonderful doctors. It is very progressive in the medical industry, but I was really struggling to find a provider who would accept me. A lot of midwives turned me away. Birth centers turned me away. 

Meagan: Was that because of the duration or just because you were a VBAC in general?

 

Emily: It was the duration. 

Meagan: Okay. 

Emily: I should note that. My babies were 15 months apart. Most of the birth centers want you to be 12 months postpartum by the time you get pregnant and then OB offices are a hit-and-miss, I feel like, with any VBAC. 

But I found, for anyone who is local to central Texas, I found Austin Doulas I think it was what it was called. I called them and they gave me the name of an OB office. They assured me that all of the OBs on staff were very VBAC-friendly. 

I contacted them. I should note also that when I found out I was pregnant, I called my first midwife. I was like, “Listen.” I love my midwife. We connected on so many levels. I do think there were things done in labor that shouldn’t have happened that catapulted me into the transfer and the C-section, but nonetheless, I loved her. I called her and I was like, “Hey, I would love to do my prenatal care with you and then maybe deliver at the hospital.” This is where my mindset was at the time. 

She basically told me that yes she could do my prenatal care but I would have to have a planned C-section at 39 weeks. At that point, I was like, Okay. I have learned enough in the little prep I had done in my first birth to know that was not necessary. So I go and she did schedule me for a growth scan because I did not know how far along I was. I ended up being almost 8 weeks pregnant by the time I did the growth scan. 

Anyway, so then I started my care at the OB office around 12 weeks. They were very supportive. I remember at one of my appointments, they gave me this sheet. It was a VBAC facts sheet and they had you initial every line on every item. It was very much saying that VBAC is safer than a repeat C-section for the right client. 

I told my husband, “Wow, this is great. I love this.” So we stayed there for a while. I know I shared in my notes I transferred care at 34 weeks. I feel like before I talk about that, I should say that at 6 months pregnant, we moved. 

21:16 Moving and switching providers

Emily: For anyone listening, unless you have to, I don’t recommend that especially with a 10-month-old. I think he was 8 or 9 or 10 months at the time. It was a lot of work, but we were living in Austin. Austin is very busy. We didn’t have any family around. Our friends were far. It was a good hour drive from any of our friends so we decided to move back to my husband’s hometown where we had friends and family. It was just like we needed to go. 

As we know, the real estate market was in a really good position. I know it ebbs and flows but at the time, we were like, Now is a good time. Let’s just do it.

So anyway, we moved. I was 6 months pregnant when we moved and we continued care at my OB office in Austin. I was driving. I would take the baby to his grandma’s and then I would drive into town, a 2-hour drive for these appointments. 

At this point, it felt so difficult for me to find care and we live in a small town. Now after the fact, it’s hard to find supportive providers where we are without driving into Houston or Austin. 

So anyway, around 34 weeks, and this is probably silly on my part, but they stopped calling me a VBAC and started calling me a TOLAC, a trial of labor. 

Meagan: But they were calling you a VBAC prior. 

Emily: Yes. Yeah. We got closer and I think also when you’ve had midwifery care and you go to a traditional OB type of care, it’s just worlds different. You get big and big and later and later in your pregnancy and you are hormonal. It was just like, I did not get the warm fuzzies. I was in and out in 5 minutes. I had to ask them to feel the belly to find the baby’s positioning. I had a lot of trauma from the first birth about baby positioning. I worked very hard during this pregnancy to make sure I did everything that I could do to make sure this baby was in a good spot internally. 

So anyway, the appointments weren’t great. They started calling me a TOLAC. They started telling me things I couldn’t do in labor. They were talking about inductions at a certain time period and scheduled C-sections for X, Y, and Z. I told my husband, “Look, I know this is going to be expensive.” I prayed on it and I was like, I just feel like I need to switch. 

I should also note that I found this birth center when I was around 30 weeks pregnant and I was always like, Man, I wish I would have found them earlier. But they are extremely VBAC-supportive. For anyone in the Central Texas area, I cannot say more wonderful, amazing things about these women. They are Christian-based, very VBAC supportive, multiple VBAC supportive, wonderful success stories. They do breech births. 

Meagan: So good to know. 

Emily: Yeah. In my mind, I’m like, Oh gosh, with my last baby, positioning was hard. I know these women will be able to get this baby out. If the baby flips, I don’t have to stress out about a repeat C-section. Blah, blah, blah. 

So I switched to them at 34 weeks and like I said, it was the most wonderful care. Everything you would want from a midwifery practice. 

Meagan: What was their group called again? 

Emily: They’re called Dulce Birth and Wellness Center and they are in Killeen which if you are familiar with Texas, it’s north of Austin in between Austin and Waco on 35. 

But yeah. I was driving to that so I was driving an hour and a half to my OB office. I started driving 2 hours to the birth center for appointments. For anyone who is scared to travel in to birth somewhere that you feel fully supported, comfortable, at home, yes it can be difficult, but it is so worth it and even though I didn’t get my VBAC, I would have 1000% done it the same way that I did. 

27:47 Going into labor

Emily: So anyway, I’m with them at 34 weeks and I go into labor at literally 40 weeks on the dot at midnight on my due date. I was like, Wow, this baby is punctual. 

Meagan: Yeah. 

Emily: Yeah, so I started contractions around midnight. It wasn’t active labor. I was in contact with the midwives throughout the night. Around 10:00 AM the next morning, my contractions were pretty steadily 10 minutes apart. My doula, I also had a VBAC-specific doula who works with the birth center pretty closely. She was turned to my point. I asked her, “Can you just be my point of contact?” She was like, “Yes.” 

So around 10:00 AM, my contractions were 10 minutes apart and they were like, “I think y’all should head in.” My husband was at a meeting 45 minutes from the house so he came home. We packed up. We had all of the birth center cooler food prepped. I was going to bring some beers for after the birth. I was ready. I was so excited.

During this pregnancy, I prepared so much. I had chiropractic care. I had pelvic floor therapy once a week. I was doing the stretching, the exercises. I was doing breathwork. I was on it, on it, on it and I was so excited and I was so ready. I just knew that I could do this. 

So we drove in. I got adjusted as soon as we got into town because it’s a 2-hour drive. We went to the chiropractor and got adjusted. We got a hotel so we could labor at the hotel for a while before we went in. 

I was talking to my doula and they were all like, “Go out to lunch. Have a good day in the city.” So we ate lunch, checked into the hotel, laid by the pool, went out to dinner, and that was really when we got to dinner. We walked into a Chinese buffet. I don’t know why I thought that was a good idea. We got seated and I told my husband, “I can’t. They are too intense to eat here.” 

So we went to a sandwich shop, ate some sandwiches and by the end of dinner, I was like, “Okay, we’ve got to get back to this hotel.” Things were picking up. They were 5 minutes apart at this point. 

We got to the hotel. Our doula comes over. Probably within 45 minutes, I was at 3 minutes apart. I remember thinking to myself, Oh my gosh, Emily. You’re going to do this. Your labor is picking up. The contractions are how they should be. 

We packed up our bags. The birth center was 10 minutes away from the hotel and we went to the birth center. I was 3 minutes apart. I walked in and I think they got a new location since then, but regardless, the whole setting was just beautiful. Dimmed lights, we had a big birth suite with the pool, and bathroom. I labored and as soon as I got there, they welcomed me with open arms. They are just the sweetest ladies. 

Like I said, I would recommend this birth center a million times over to anyone even if you are not trying to VBAC. 

I labored in the shower for a while. That was nice. I had a birth ball in there. I was doing squats. Like I said, I was in a freaking good mindset. I was ready to have this baby. This baby was a surprise as well so I was excited. A surprise gender I should say. This baby was a surprise all around. 

So yeah, we labored in the shower for a little while then went back to the birth suite. I was in and out of the pool and the bed just doing whatever felt right which is another big reason that I wanted to switch because if you’re birthing in a hospital, you’re on a bed especially if you are a VBAC, you’re strapped to a monitor. At least that’s how they were going to do me. They weren’t going to do the intermittent monitoring because of the VBAC.

It was just a wonderful laboring experience. Contractions were picking up. They were starting to become not on top of each other yet, but I would say a minute apart. 

Meagan: They were a minute apart? Holy cow. That’s on top of each other. 

Emily: When I tell my stories, my friends are just like, “Oh my gosh. You’re just insane.” I’m like, I can’t be the only one who labors like this who has had these types of births. 

Like I was sharing with you earlier, I just wanted to find similar stories because it’s the similar stories that help you work through things in my opinion. 

So anyway, I got onto the toilet and they had the TENS unit on my back. That was okay. I had heard a lot of women. I listened to a natural birth podcast as well during this pregnancy and a lot of women were like, “The TENS unit was awesome.” Personally, it didn’t do anything for me. 

We went back to the bed. My water broke naturally and that’s when it was like contraction, contraction. It was no break at all. 

I guess I didn’t know any of this, but they went and got Trevor, my husband and they were like, “The baby is coming. It’s time.” They were like, “Okay, it’s time to push.” I pushed forever. 

33:20 Pushing for 5 hours

Emily: I was on the birth stool and I just kept pushing it felt like. I’d be like, you know you’re in labor and you’re unmedicated. You have choice words like, “Where is this baby? What’s going on?” I had chosen not to get cervical checks because the last time, cervical checks just really messed with me mentally with progression and everything. 

Anyway, I was on the birth stool and I was pushing. It was nice. I was on the birth stool with the hanging thing from the ceiling. 

Meagan: Yeah, like a rebozo. 

Emily: Yes. 

Meagan: Were you having the urge to push? How did they feel like you knew?

Emily: Yes. 

Meagan: Okay. 

Emily: And I’m sorry if my story is sporadic and all. 

Meagan: No, it’s good. This is good. 

Emily: But yeah, I had the urge to push and I had really done a lot of practice of breathing. You hear these women, “Oh, I breathed my baby out.” Anyway, I was trying to breathe and finally, they were like, “Okay, I think it’s time to push,” and I was like, “Okay, thank God. I’m ready.” 

So I pushed and my husband would tell me after the fact, “I mean, I was so excited. We were going to have this baby at a birth center.” He was like, “I could see this much of her head. She was coming.” 

Meagan: Oh, okay. 

Emily: Long story short, I pushed for 5 hours. I decided to get checked because I was like, What the heck is going on? I was fully dilated. I was practically crowning at this point, but she checked me and I had a cervical lip. I hadn’t done a lot of research on that. I do know that sometimes they naturally push out of the way, but she had me do some different positions during contractions to get the lip to go away. 

Then finally, as a last resort, she tried to push it away during contractions and that was just so painful. I just remember it being so painful. I know you’re unmedicated and you can feel everything. At that point, I was like, “Just give me the numbers. What are my chances to get this baby out here?” 

She was like, “Emily, I’m going to give you a 60/40.” At that point, I was like, “I need to transfer.” They were trying to get me to breathe through contractions and to not push because I was so swollen. It was like I couldn’t. My body was just doing it and I had no control. 

35:45 Transferring

Emily: So to speed things up, we transferred to the hospital. It was the same hospital system which I was grateful for. That’s St. David’s in Austin. My first baby was born at Main. This baby was born at the North hospital, the women’s center. They are very holistically minded, as much as you can be at hospitals. 

That transfer was a 50-minute drive so that was fun. I was like, Here we go again. Let’s do this transfer. We busted into triage, guns hot. They knew I was coming. I got my epidural pretty quickly within 30 minutes. They had me push a couple of times then they checked me and they were like, “You’re an 8.” I was like, Okay. Here we go again. 

Meagan: Swollen. 

Emily: Very swollen. I know I had probably regressed on the drive over just with everything going on. I’m trying to speed my story up so I can get to my thoughts and reflections on it, but basically, I labored at the hospital for a very long time. They started Pitocin. I know I keep saying long story short and it’s just a long story, but they came in. The baby’s heart rate wasn’t doing well. They took my temperature. It was 103. Boom. I had an infection. They gave me Tylenol. It brought the fever down, then around 2:00 AM and this was two days later. 

I don’t know with the timing how to explain it, but they were like, “It’s time.” My midwife and my doula who came with me agreed. It was nice that I had that second opinion. I just was so upset. I was crying. My husband was crying just because he knew. I think he just knew how badly I wanted it and how hard we worked. 

Meagan: Yeah. 

Emily: Anyway, I met the surgeon and he was wonderful. He was like, “What do you want? I want to make sure this is done right.” He gave us everything we wanted. Delayed cord clamping, my doula was in there. She took photos and everything. 

37:47 C-section

Emily: The C-section wasn’t great. I’m glad I had my doula in there. She was a VBA3C mama so she knew her stuff. I’m explaining, “I can feel tugging. I can feel this and that.” She was like, “That’s normal.” I didn’t feel that with my first C-section.

Yeah, they pulled her out. She was a baby girl. She was freaking screaming bloody murder, nothing like my son. My husband had announced both babies. He said, “It’s a girl,” and they let me touch her immediately. I just wanted to touch her and this is probably weird, but I feel like moms understand this. I wanted to touch her fresh out, blood and all. That’s my baby. I was able to do that and they took her away. 

I had a really bad infection, chorio. They had to flush my uterus and my abdomen. I was on double antibiotics for three days in the hospital. They were having to– I call it stabbing. They stabbed the baby every day to check on her and it was tough. I had in my mind, “When did this infection start?” I didn’t get checked until the very end. I don’t know. 

Yeah. It was hard. When we were in the C-section, he was like, “Who did your last C-section?” In my mind, I’m like, That’s a great question, why? “What’s wrong?” He was like, “You have really bad adhesions.” He fixed everything up. He came and checked on me the next day. 

Long story short, I will birth at this hospital again. But it wasn’t a healing Cesarean. It was tough. Again, the nursing, the pain. I feel like both times, I really struggled. I’m not saying I didn’t bond with my babies, but I think the toughest part of my births were the postpartums. It’s such a hard recovery. I feel like people who have never had a C-section before, they don’t really understand. 

I’m not saying that vaginal births aren’t difficult to recover from, but it’s not full-blown abdominal surgery and then boom, caring for a new life. I couldn’t hold the baby like I wanted to. I couldn’t do the things I wanted that I dreamt so hard of when I was attempting this VBAC. 

This mentally was hard because it was like, boom. A double C-section. All I’ve ever wanted were hands-off, holistic births. That’s why I struggled so much with the two C-sections. I don’t want to knock anyone. I had very supportive friends and family, but the “at least you have healthy babies”. 

Yes, I know I am so blessed. I don’t want to downplay that because I know a lot of women who don’t get that, but it doesn’t fix the birth and how awful it was. It was a tough C-section. I had incision issues, but I healed up and I was fine. I started scar work right away. I went to my pelvic floor therapist. She had me doing diaphragmatic breathing. 

I know I need to wrap up. So to kind of summarize, after my first C-section, I don’t think I took the steps necessary to really heal myself with the scar work. I was petrified to touch my scar. I’m sure other people can relate to that. Then I was pregnant and I was like, Well, what’s the point? It’s stretching out anyway. 

41:29 Tips for adhesions

Emily: To any mom who has just had a C-section or is preparing for a VBAC or a birth and you don’t know if you are going to have a C-section, that scar work and that internal breathing, that pelvic floor is huge on your recovery. I learned so much about adhesions. Last time, it was the baby positioning. With this next baby, I’m going to be freaking out about adhesions. 

But yeah, it was tough. So my midwives, bless their hearts. They do a home visit 3 days post-birth. They drove all the way out to where we were to do a home visit. They brought us dinner and my midwife was saying, “Emily, I could not believe that that baby was not flying out of you. You have a great pelvis. Your contractions were so strong. Your pushes were strong. I just could not believe it.” She was like, “I think it was the adhesions.” 

I had never even heard about adhesions which is silly. Again, prepping on my part, why did I not know about that? But yeah, so that is what they think held her in. It was a baby girl. I don’t know if I said that. 

Meagan: Adhesions, really, that’s a really common side effect or I don’t really know the right– it happens after a C-section. Sometimes it can happen more and we have really dense or many adhesions and then sometimes people have lower. 

That’s why I love pelvic floor therapy and people like Ask Janette on Instagram because they do talk about that care early on and how important it is early on. 

So many people like you don’t feel comfortable touching their C-section or their scar or they don’t like looking at it or have a negative feeling when thinking about it so processing your birth can also help get to that next step of working through those adhesions. 

Emily: Yeah. I will say my second birth was much, looking back on my first birth, yeah it was kind of traumatic, but this second birth was tough. I was FaceTiming my friend in the hospital afterward just sobbing about the infection. I don’t want to put this baby on antibiotics. I’m very holistically minded. The epidural and the Pitocin were a huge blow to me personally. I can’t be the only one who feels that way and that has had to have two C-sections. 

44:20 Hospital births are beautiful

Emily: In summary, I really want to share this with listeners. From my first positive test in September 2021 to now, my views have changed drastically on the hospital system for the better. I didn’t have an awful hospital experience. I think the trauma came from the extremities of my situation not getting what I wanted. It might seem selfish, but it’s the truth. 

Anyway, I am very grateful. I am very, very grateful for conventional medicine. I don’t know what would have happened with that first baby. He came out looking like he had been in a cage fight just beat up from whatever was going on in there and then my second baby with the infection and then myself, gosh. What a blessing that I didn’t go septic. 

I’m very grateful for conventional medicine. I am grateful for that second C-section even though I am still struggling to process. I didn’t want it, but to clean up the adhesions, to clean out the infection and all of that. 

But yeah, my views have changed drastically. I feel like I should share yes. I attempted a home birth. I don’t want to call it failure. I didn’t get my home birth. I didn’t get my birth center birth. You know, I’m not done having babies. That’s why VBAC is so important to me. Also, just pulling your baby out yourself, how cool. I want that so badly. I think I’ve wanted it from the get-go.

My plan is I want to birth again at St. David’s, at the women’s center. Yeah, I will travel in to do that. I feel like also, I got to the point in my labors where I couldn’t hold back pushing. I think it’s important to note for any women to weigh your pros and cons of, Do I want to birth in a birth center? For me personally, I don’t think that is a good option again. If I’m getting to the point where I can’t breathe through contractions and I’m swelling, that’s what modern medicine is there for. An epidural can calm you down and maybe get things going back on track. 

Between that, I told my sister-in-law, “I feel like God is working on my testimony through my births. I feel pulled by Him to share what I have gone through so other people know, yes. You may want a holistic pregnancy, a holistic birth, hands-off, do-it-yourself, midwifery, and that may not be in the cards. That’s okay. Don’t lose hope in the medical system. There are wonderful OBs. There are wonderful midwives who work in conjunction with hospitals and they know their stuff just as much as the holistic midwife does.” I think going in armed and ready and doing your research, not relying 100% on your provider to save the day is huge. 

But yeah, I just feel like that’s important to note because I know the holistic community, I don’t want to call it toxic, but you hear all these things like, “Oh, hospital births are bad. Epidural and Pitocin are so bad,” but it’s not bad for everyone. I think that’s something that needs to be shifted to where you have holistically minded medicine and conventional medicine working together. I feel like I’m the perfect example of how it didn’t go as planned, but my views have changed on that and I am very grateful even though the births– I’m not trying to downplay it. I still struggle to come to terms with why. Why? It all goes back to that first birth. If I could have avoided that first C-section, what could I have done? But I did the best I could with what I knew at the time and what a blessing that I’ve learned as much as I have since then. I want to share that with other women who want that holistic birth. 

There’s so much that you can be doing during pregnancy to set yourself up better than I did. Anyway, I’m rambling on and on. 

Meagan: No, you’re just fine. The prep is really important and to know how to prep and all of the ways to prep and it’s a lot. It’s so much. It’s so much for someone wanting to have a baby in general and then for VBAC moms, there is definitely this extra thing when it comes to preparing mentally, physically, emotionally, and all of the things. 

49:09 All about transferring

Meagan: I wanted to touch a little bit on transferring. If you are planning on a home birth or a birth center birth and it comes down to a potential transfer, one, what are some signs that we may need to transfer? For you, it was like, Okay. I just got this percentage. That, to me, was confirmation to transfer. You can have those questions. What are things looking like? Is this going to happen? What can we do? Is there something we can do? Sometimes in that holistic world with home birth and birth center, they may give Benadryl or they may have nitrous to help avoid the urge or whatever. They might have homeopathic stuff, I don’t know what your location has, but there are things you can try and then sometimes you are like,  I don’t know. We’re going to go. 

Or maybe you want epidural relief or baby has been having some nonreassuring heart tones here and there and that’s enough to make you want to transfer or for someone to want to transfer you. For first-time moms, I think NPR shares a little article and it says, “For first-time moms choosing home birth, up to 37% transfer to a hospital largely because the baby is unable to come out.” There is a lot of the time within this. I hear this and I’m like, why? Why are we not having babies come out? Sometimes I do feel like we push too early or we don’t recognize a positional thing. 

So a lot of the time when there is a cervical lip, we might have a malpositioned head. I mean, literally ever so slightly that needs some help, but it’s hard to know or there may be scarring or there may be something going on causing that lip to stay. Then, it can. It can swell so when people say, “Oh, you can’t go backward.” Well, yeah. It can swell. You can get swelling which then closes. 

So transferring and getting an epidural or getting an epidural at that point even if you’re in the hospital is a really great option for a lot of people because they want to avoid that urge to push causing more swelling. 

You just have to weigh out your pros and cons. They do point out that planned home births end up with fewer Cesareans. 53 births to 1,000 compared to 207 per 1000. This was in 2019. It’s been a little bit. We’ll include this in the show notes if you want to go give it read, but I think it also comes down to find the best location for you and then follow your heart. 

I love that you pointed out that hospital birth doesn’t have to be bad. It’s so true. There are so many beautiful hospital births. I’ve seen them personally as a doula. They don’t have to be traumatic and they don’t have to be crazy. 

Do your research. Find out the locations next to you and around you. I love that you mentioned that you traveled. Traveling is worth it if you find the right provider and right location that’s going to help you feel supported and loved and guide you through. 

I am grateful that you shared both of your Cesarean stories. I am sorry that it didn’t happen exactly how you wanted it to. It’s so hard when you’re like, The why. The why. Why did this happen? What could I have done? It reminds me of Julie’s radical acceptance episode. I don’t know if you’ve heard that, but it’s so hard to not understand the why or take out the what if, but through these experiences, I think we learn and we grow and sometimes we have to let go of the why. 

I still don’t know some of the why’s that happened in my VBAC. It’s frustrating and sometimes I find myself latching on and feeling very angry or frustrated or confused. It’s so hard to have those feelings, but I think that we grow. We grow as individuals and I can see that you are growing. You also said that you changed perspectives which can be sometimes hard to do so you are. You’re growing in the right directions. I hope that for your next births that whatever you decide to do, vaginal or a Cesarean, that they are a healing experience for you. 

Emily: Yeah. Well, I mean, like I said, I appreciate coming on so much. I just encourage everyone to listen to y’all even if you haven’t had a C-section. Knowing what you can do to avoid it from the get-go is huge. 

Also, I feel like I should say that I found an OB close to where we live and I hear a lot of them say, “Well, if you would have just had a C-section because of a breech baby.” It’s the trial of labors that turn people away from the VBA2Cs. “Your two C-sections were–” I already explained them, “and that’s why you’re not a good candidate for VBA2C.” You all have so many stories on here where people have failure to progress, small pelvis, you’re too small, your babies are too big. This, that, or the other I don’t feel are good reasons to just not attempt a VBAC if that’s what you are wanting to do and that’s where I have found myself is I’m trying to figure out what I want to do next because I already know the minute I find out I’m pregnant, people are going to be like, “No. No, no, no.” 

Meagan: Yeah. That is so hard. That is so hard. We’ll include a blog, How to Process When Things Don’t Go As Planned. We’ll include the blog, Cesarean or VBAC: How to Decide to try and help anyone who is in your same boat and relating to at least have a starting point of how to go and what to do. I just really appreciate you. Congratulations on both of your babies. I am so grateful that you were here today and have a wonderful one. 

Emily: Thank you. You too.

Closing

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

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Today’s episode is full of love. Meagan’s doula partner, Christin Carlson, joins as co-host today to hear their client, Janelle, share her beautiful VBAC story.

Janelle’s first baby was determined to stay frank breech even after two ECV attempts. Her water broke on its own before her scheduled date. In prep for her surgery, Janelle unexpectedly experienced vaginal cleansing. Though the surgery went well, it was not the introduction to motherhood Janelle was hoping for. She was also hit hard with postpartum depression. 

Janelle shares how she found The VBAC Link and became obsessed with all things VBAC prep. Surrounded by the most loving and empowering team, they helped her stay steady when labor was most intense. Even though it was harder than she imagined it would be, Janelle was able to dig deep and achieve the unmedicated VBAC she desired. 

Vaginal Cleansing Article

Postpartum Depression Article

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

02:40 Janelle’s PPD experience

07:25 Janelle’s stories

12:06 Arriving at the hospital

14:05 Janelle’s C-section

17:00 VBAC preparation

19:24 Appendicitis and second pregnancy

24:22 Going into labor

27:35 Laboring at the hospital

30:30 Transition

34:21 Achieving her VBAC

38:47 The power of a supportive partner

43:53 What is vaginal cleansing?

50:26 Symptoms of postpartum depression

Meagan: Hello, everybody. You guys, today I have a very special episode to my heart because this is one of our own doula clients here in Utah and another even more special thing is that this is my partner, Kristen who ended up attending her birth, is co-hosting. Hello, Christin and Janelle. 

Janelle: Hello. 

Christin: Hi. 

Meagan: How are you guys today? 

Janelle: So good, so good. 

Meagan: Before we started recording, we started talking about time and how fast things are going. You guys, I mean I think you probably know if you are pregnant or have a newborn in your arms how fast time goes, but really, holy cow. We were with Janelle, we just talked about, 8 months ago from the time we are recording which is wild to think about. 

Janelle: So weird. So weird. It’s crazy. 

Christin: It seems like it was a couple of weeks ago. 

Janelle: Yeah, it’s not fair. 

Meagan: I know. How have things been? How have you been going with postpartum?

Janelle: Things have been really good and I think that’s one of the things that pushed me to want a VBAC so badly is I was hoping for a better postpartum experience. I had pretty severe postpartum depression with my first baby and I felt like having the VBAC would be some sort of heavenly gateway into not having postpartum depression. In the beginning, that was true, but I ended up still having some of it. Things are good now, though. 

Meagan: Good. I actually love that you touched on that because I think that sometimes especially after a traumatic Cesarean or a traumatic experience that did lead to postpartum depression or anxiety or anything like that, that can be a big motivator for a different experience. I love that you talked about, “Well, it was a better experience, but I still had this a little bit. I’ve had to work through that.” I’m glad that you’re good now, but even sometimes when we have a different experience, we have similar things. 

So it’s important to recognize that. I love that you just pointed that out. 

Janelle: Yeah, for sure. Yeah. 

Meagan: Before we get going into the episode, do you have any tips on tackling that the second time around too? How were your feelings about things when you were starting to feel it and see it creep in? 

02:40 Janelle’s PPD experience

Janelle: Well, with both experiences, it did creep in just like you said, but with my daughter, it felt really dark really fast. She was my first baby and then with my first son, the VBAC, it was kind of a little bit sneaky. I guess just having someone on your support team. For me, it was my husband and I just said, “Look, if you see any of these signs, please say something to me.” 

It wasn’t like we had a code word or anything. He was just really open in his dialogue with me and said, “Hey, I think something is up with you. You are not your normal self.” As soon as he said that, I was like, “Yeah. You’re right.” 

It was really hard to admit because you want to be this strong mom and you want to be there for everyone and be everything that everyone need, but sometimes that’s just not how life works. It’s literally a chemical imbalance in your body and in your brain. It has nothing to do with your circumstances. Just having someone on your team and on your side to say, “Hey, I love you. Let’s get help,” was absolutely integral to helping me get on the other side. 

Christin: I think it may have helped because you had been through it before so you were aware of the warning signs. That’s something I think that we don’t realize because I struggled with postpartum depression too but it didn’t happen until my third baby so I didn’t have any inclination that that was even something that I was going to deal with. 

I think it’s important. We do all of this work to prepare for our VBACs and to prepare for the arrival of a new baby, but sometimes I don’t think we educate ourselves on what those warning signs of postpartum depression are because they can be very sneaky. It’s not always deep, dark thoughts. Sometimes it’s postpartum rage or postpartum anxiety where just you are either extremely emotional or extremely angry all of the time. To have your husband looking out for you or someone on your support team who is keeping an eye out for those things and noticing a shift in the way that you’re behaving, I think, is super important. I think that’s great that you guys have had this conversation ahead of time. 

Meagan: Yeah, and we will talk a little bit more about some of those signs and symptoms. Like Christin was saying about how they can differ between rage, anxiety, depression, and the baby blues a little bit more at the end for sure because yeah, I think Christin just nailed it. We focus so heavily, and I think even more sometimes– I don’t want to say this as a fact, but sometimes I feel like more as a VBAC mom, we are so hyper-focused on the end result of a vaginal birth that sometimes I feel like we do forget a lot. That’s like everybody. I think they are so focused on getting baby here, but VBAC sometimes has to fight harder, search harder, read more, and emotionally work through things a little bit more so yeah, we can forget. 

Then that creeps in or like Janelle said, it was like boom and darkness came over. We want to know how to handle that so we will talk a little bit more about that in the end. 

07:25 Janelle’s stories

Meagan: Okay, you guys. I wasn’t there, but in our practice, we have something that is like a live timeline that we have so whoever is at the birth can take notes of the timeline and we like to share that with our parents. We were all just sitting there watching it, checking in, and I just remember feeling this utter excitement inside of me for them as I was looking at the notes and following along with Christin’s updates. 

I’m excited to now be here with you both and hear it in a different way. I’m going to turn the time over to you. 

Janelle: Yes. I’m so excited. I was actually telling Meagan before we started that I was actually fangirling out. I don’t know exactly how I got started listening to The VBAC Link, but after I had my daughter, somehow I got onto it and I binged so hard on this podcast. It’s just really surreal to be recording with you. So thank you for allowing me to be here. 

Christin: You’ve come full circle. 

Meagan: Full circle. 

Janelle: I have. 

Meagan: I love that that happens with The VBAC Link. I love that it’s so often that it’s like, “I listened every day. You were in my ear and now here I am being in someone else’s ear. 

Janelle: Yeah, yep. So just to all the mamas out there who are preparing, you’ve got this. You can do this. 

With all VBACs, of course, there is a Cesarean that starts the story, right? We tried to get pregnant with my daughter for 14 months. We finally got pregnant and the pregnancy was super easy. I was going for a HypnoBirth unmedicated birth. I didn’t have a doula. I didn’t really have– I don’t know. You just don’t know what you don’t know and as a first-time mom, you think you know, but you don’t. You just don’t. 

Meagan: Or we have apps that tell us so we really think we know because the app said so. 

Janelle: Yes, but then you just don’t know until you’re in it. I gained 60ish pounds which was a lot, but I never had hypertension or a lot of issues with that. I never ended up with gestational diabetes which I was really grateful for and worried about, but in hindsight, it really wouldn’t have been a big deal. 

At my 36-week appointment, we found out my daughter was breech. Homegirl was freaking stuck. Let me just tell you, she has been stubborn ever since. We tried everything. We decided to do an ECV. We did it at 37 weeks and we just did that. I think a low dose of Fentanyl was the only medication. I was just trying to use my Hypnobirthing to breathe through it. The doctors told me that I was doing really well, but she was just stuck, and that one failed. 

We tried going to the chiropractor. We tried Spinning Babies. We tried basically everything that I could think of. We did not do acupuncture. That’s the only thing that we didn’t do and I never hired a doula. I could have done those things, but I didn’t. 

We tried a second ECV at my 38-week appointment. We did that one with a spinal block in the OR because they were like, “Well, sometimes on the second attempt, it can throw you into labor.” So I was like, Okay, well if that happens and we have any problems, they can just do a Cesarean right there. 

She was very, very stuck in my pelvis and the maternal-fetal medicine doctor actually tried to push her up vaginally and that was unsuccessful and very uncomfortable. Even though I was numb, it was still like, This is weird. I don’t know. I don’t like this. She just was stuck. 

She was frank breech, so I was like, Okay. We’re just going to go through with the Cesarean. 

I had 2 more weeks so two days later, I went out to dinner with a friend and then that night when I was sleeping, I got up to pee like you do a million times when you’re pregnant at the end and some water was leaking out as I was walking back from the bathroom and I was like, What the crap? I just peed. How is this happening?

My water had broken and there was meconium. I knew that it was going to be a little bit of an issue with meconium just because my doctor told me something like they were just worried about meconium with a breech baby. I don’t know. I don’t know if that’s true or evidence-based or not. 

12:06 Arriving at the hospital

Janelle: We drove to the hospital and we got there at 5:00. They had to do a COVID test and they cleaned me out. I don’t know if you’ve ever heard of that. 

Meagan: Like rectally? 

Janelle: No, like vaginally. They took some sort of– 

Meagan: They cleaned you out vaginally?

Janelle: Yeah, I don’t know if it was because of the meconium, but they took some iodine-something and it felt like a membrane sweep. I never have had one of those, but if I could imagine what that was like, that’s what it felt like. 

Meagan: Christin, have you ever seen that? 

Christin: It’s funny that you say that because I had never seen it before until Janelle told me that she had it and I was like, That just sounds so odd, but I actually just saw it at a birth the other day. 

Meagan: What is it for? I actually don’t know what this is. 

Christin: I had never seen it previously and I thought it was just an anomaly with your birth, Janelle, but I saw it the other day again. 

Janelle: Do they have a name for it? 

Meagan: I’m Googling it right now. 

Christin: They didn’t name it. They just used iodine swabs and just cleaned her out. 

Janelle: Was that also for meconium? 

Christin: Yeah. 

Janelle: Okay, interesting. 

Christin: Now that I think back on it, there was mec but I don’t think we knew there was mec until baby was born so I don’t know. 

Janelle: Oh, interesting. Okay. So yeah, that was the most unpleasant experience ever on top of mid-contraction, I was having the COVID swab up my nose so that was really great because this was early 2021. So yeah. 

Anyway, we waited for the ORand the nurse came in. I asked her, “Can you check me? I know I’m going back there for surgery, but I’m just curious. I’m having contractions. Can you just see if I’m dilating?” 

She’s like, “Yeah, you’re at a 4.” So I was like, "Oh, that’s kind of nice. My body’s actually doing the work here.” I was really excited about that. 

14:05 Janelle’s C-section

Janelle: Jumping to the surgery, I was so terrified. I don’t know what it was. You’re just going through so many emotions. You have to put so much trust in the nurses and the doctors and the anesthesiologists. You have to put so much trust that these people paid attention in med school that they know what they are doing, that they care about you, they care about your baby, and chances are they totally do and they did pay attention and they got good grades, but I just felt nervous as a first-time mom. 

They jostled me around and the anesthesiologist was really nice and he was just talking to me and telling me everything that was happening. When she was born, I knew it because I felt them yank her out. They had a clear drape, but I couldn’t see over it so I was really sad that I couldn’t see her. 

Because of the meconium, they had to take her and they cleaned her up and stuff. I was 16 minutes or something before I got to see her. In hindsight, it’s not that long, but it felt like forever. Then I got to see her sweet little face and oh gosh, it was just the most precious thing ever. 

My husband snuck a video of it. You’re not supposed to in the OR, but he snuck a video of it and it’s such a treasure for me to look back at the moment that I got to meet her because I didn’t get to be the first one to hold her. Yeah. 

Christin: I love that he did that though so you have the record of that memory. 

Janelle: Yeah. I never even asked him to. He just knew that I would want that. He’s the best. 

One thing I didn’t know about postpartum regardless of if you have a C-section or a vaginal birth, your nurses will push on your abdomen and it hurts like a mother trucker. Let me just tell you. 

Meagan: Crede-ing. 

Janelle: It’s what? 

Meagan: It’s called Crede-ing. They Crede and they are checking where the uterus is, if it’s clamping down, and making sure it’s not getting boggy and filling up. 

Janelle: Yep, and if you’re bleeding too much or not enough. It sucked. 

Then I had really bad postpartum depression. This one was not sneaky. This one was almost immediately. I felt like I bonded really well with my daughter, but there was just some darkness that was in my heart and I couldn’t figure out what it was. It took a while. I was actually maybe 6 or 8 weeks at my postpartum appointment and my doctor did the screening. She’s like, “Yeah, your score was really not good. Let’s get you some medication.” I was like, “Okay.” 

I was very reluctant, but I saw almost an immediate difference. I had it for a while, but it did help. 

17:00 VBAC preparation

Janelle: Anyway, so that was my daughter’s birth and ever since then, like I said, I was obsessed with The VBAC Link. I knew right away that I wanted a vaginal birth. Actually, come to think of it, right before we went back to surgery, I was talking to the doctors and I was like, “I really want to have another baby after this. Is there any way you guys could make sure that my scar looks really good and I could have more babies vaginally? That’s really important to me.” 

They were like, “Yeah. We will make sure you are taken care of.” I was very grateful for that. 

What I wanted out of this birth, I don’t know if what I told Christin is still what I have on my birth plan that I wrote down, but what I really wanted was a healthy mom, a healthy mindset, and a healthy baby obviously. Those are the minimum, right? Then I wanted baby out of my vagina. I wanted skin-to-skin. I wanted to be the first one to hold baby and I wanted to be fully present and fully included in all of the decisions. 

I don’t know if it was just, yeah. I don’t know exactly why that was so important to me at the moment, but it just felt like I didn’t want any of this robbed from me. I didn’t want any of the experience to be done to me. Do you know what I’m saying? I wanted as few interventions as possible. Those were what I really wanted out of this birth. Is that what you have, Christin?

Christin: Yeah, pretty darn close to that. I also have skin-to-skin was super important. 

Janelle: Yes. 

Christin: And I think it’s worth noting that you wanted to catch and deliver your own baby. You said I wanted to be the first one to hold her– sorry, hold the baby boy– but you also told me that was super important to you. You actually wanted to deliver your child. 

Janelle: Yes, okay. With my son, my daughter was maybe 20 months old. It was the Sunday before Thanksgiving and I felt some pain in my side. We had been trying for 6 months and something was just wrong. I didn’t have a big appetite and it was Thanksgiving dinner at my mom’s house and I just didn’t feel good. Something intuitively was just wrong and I knew it. 

My husband was like, “Well, why don’t you just try taking an antacid?” I was like, “No. I know something is wrong.” 

19:24 Appendicitis and second pregnancy

Janelle: We went to the ER and I had appendicitis and I was pregnant. So that was really fun to find out all at the same time. Because I was 3 weeks, 4 days pregnant, I had not even missed my period. I hadn’t taken a test, they said that nothing in the surgery would change because baby was still so small. I was like, Okay. Well, that’s good. 

I was really nervous for the surgery and that there were going to be complications afterward, but everything was fine. As soon as I started to heal from surgery, I got so nauseous. I was so sick the whole pregnancy until maybe 25 weeks. That’s when it finally started to wean off. 

Like I said, I lived in VBAC mode. I binged the podcast on the daily. I went on walks. I would listen to it while I was cleaning, driving, naptime, all of the things. I also was very into the Evidence-Based Birth Podcast because I was very curious about water birth and home birth and all of the statistics. 

My husband actually pulled me aside while I was in crazy VBAC mode as we call it. He was like, “Janelle, I’m just worried if you end up having a C-section, where are you going to be at mentally? Are you going to be okay with this if that ends up being your path?” I was like, “You know what? I really do need to prepare for that too,” because things really can go in any direction with birth. As soon as he said that to me and I started to prepare that way, I just became like, Okay. Whatever happens happens. This is okay. 

I did have the same VBAC-crazed mindset but I was also okay with things happening. I don’t know if that makes sense. 

Meagan: Yeah, it totally makes sense. I think a lot of the time as we are preparing for that, it is important to note that things can go and still prepare for the other but prepare, prepare, prepare, and then do all of those things while you are preparing so if it doesn’t happen, then you don’t have to look back and be like, But what if this and what if that? 

Then you are confident in the way you prepared, but then you know, Well, it could go this way. It’s not what I’m going to plan for, but it could go that way and I’m going to be more content because I’m doing everything within my control. 

Janelle: Yes. At 20 weeks, my insurance changed and I had to find a new provider. That was a whirlwind. I actually found my midwife through The VBAC Link list of providers. Her name is Kira Waters and she is the best. I love her so much. The first thing that I said to her when I interviewed her was, “How do you feel about VBACs?” She said, “I love VBACs!” I was like, “Oh my gosh, okay. Say no more.”

Yeah, after we met Kira, then we were on the search for a doula. I came across you guys. I met with Christin and the stars were just aligning like, this is going to work out. This is going to be perfect. I don’t know how to explain it. It wasn’t like an instant connection, but it was this deep trust that I instantly had in her if that makes sense. 

Meagan: Mhmm, yeah. 

Janelle: It was almost like I’d known her for a long time, but not like a high-school friend. She’s my long-lost aunt, I guess. She’s full of wisdom. 

Christin: I’ll take it. 

Meagan: Well, and there is something about a doula. Don’t you think? Fun fact, Christin and I actually had the same doula, but there was something about our doula– her name is Robin. She is amazing. I didn’t even know her that well. I mean, I knew her through the birth community and stuff but I didn’t know every detail about her, but there was this weird sense of confidence where I was like, It’s going to be fine. Then her partner, Angie, was also somebody who I was like, I know she has to be in my corner. I just knew that those two people had to be on my team and yeah. It wasn’t like I instantly knew them and felt the connection of being childbirth friends, but I was so deeply connected right away and still am to this day to them. 

Janelle: Mhmm, yep. It’s interesting. I’m kind of a private person and I didn’t want my mother-in-law or my mom in the birth room, but as soon as I met Christin, I’m like, “Yep. Come to the birth.”

24:22 Going into labor

Janelle: Let’s see, I think it was my 34th or 36th appointment and I met with the OB because if you are with the midwife, they want you to meet with the OB. He did the VBAC calculator. I think it said 47%. It was 47 or 50% chance. It was a pretty moderate chance of success. He was really nice, but I just was like, Eh, I don’t really want him to deliver my baby. 

Let’s see. I had gained a similar amount of weight, but again, no hypertension. Everything was pretty much the same to this point other than baby was head down at this time. 

I was 37 weeks and I went out to dinner with a friend. Fun fact, it was the same restaurant and the same order. That night, I went into labor. 

Christin: You’re onto something. 

Janelle: It was Zupas. 

Meagan: I was going to say, what was it? Zupas? 

Janelle: It was Zupas. 

Christin: Now we have to get your order too. 

Meagan: What was your order? 

Janelle: I want to say it was the pulled pork sandwich. Maybe one of the soups, like the cheesy soup, the Wisconsin…

Meagan: The Wisconsin Cauliflower? 

Janelle: That one, and then the pulled pork sandwich. That’s what I ordered both times. So if you want to go into labor…

I don’t know if that’s even tried and true, but it was so interesting. 

Christin: I’m pretty sure it’s not evidence-based. 

Janelle: No, but for me. 

Christin: For you it is. 

Meagan: You’ve got some good stats. 

Janelle: Yeah. So I went into labor that night and my husband, I didn’t say this before but when I went into labor with my daughter he was like, “No!” because it was so early and he’s a gamer so he was up that night playing games on the computer and he was just really tired. The same reaction was had from him this time too. He was like, “No!” 

Christin: It was early in the morning. 

Janelle: He was like, “Dang it!” 

I wanted to labor at home as long as I could so let’s see. I think we texted you pretty close to that time. Was it at 4:00 or 5:00? 

Christin: I got a text at 3:06 AM that you thought your water broke. 

Janelle: Yeah. So I labored at home in the tub for a while. My husband made me the best peanut butter and jelly sandwich that I ever had in my entire life. I ate a peach. I just hung out in the tub. When I would listen to the podcast before bed, I would listen in the tub and hang out and relax. It was a safe space for me that I was very used to. I hung out there for a long time. It really wasn’t that long, but when you’re in labor, it feels like a long time. 

I had my mom come over so she was with our daughter. Once my contractions were 4-5 minutes apart, we were like, Okay. Our hospital is 30-45 minutes away. We should probably head in just to be safe. 

27:35 Laboring at the hospital

Janelle: I got admitted around 6:00. Is that what you have, Christin? 

Christin: Yeah. It was around 6:00, a little bit before 6:00. 

Janelle: I agreed to be checked at that time. I didn’t want a lot of checks because I didn’t want to introduce bacteria by having my water being broken, but I was curious about where I was at. They said I was at a 4. I told the nurse beforehand, I was like, “I don’t want to know,” but she let it slip. She was like, “Oh, you didn’t want to know, huh?” I was like, “No, but that’s okay.” 

Meagan: Isn’t that where you were with the first one?

Janelle: Yeah, kinda. I was like, Okay, well at least I got this far before. 

She said I was 50% effaced and -2 station. At this point, my husband and I were kind of clueless because we only had one meeting with Christin. We hadn’t gone over counterpressures. We hadn’t gone over how he was going to be actively supporting me in birth so we were just like, Okay, now what?

Christin: I think we had your second prenatal scheduled for the day after you went into labor. Your baby just decided to beat us to the punch. 

Janelle: He was so excited. He just wanted to be a part of it. 

We were really clueless and I started feeling the contractions really intensely. I was not as prepared as I thought I was for contractions. I was second-guessing all of my life decisions because I again even wanted to be unmedicated. I even signed a consent form for the epidural at this point. I was like, Okay, just call it. I’m done.

Christin: Christin joined us I think an hour after I got there around 7:00. The second that she stepped in the room, the energy just shifted. I don’t know how to explain it. She just brought so much excitement like, I’ve got this. I got you. It’s all right. It’s going to be okay.

I know she wasn’t intending to be my savior, but she kind of was in that moment for energy’s sake. I don’t think I could have done it if she hadn’t walked in with the confidence and the joy that she had, just the excitement for birth, the passion to be there, and it just made such a huge difference in our experience and I just love you so much, Christin. Thank you. 

Christin: You’re going to make me cry. 

Meagan: She’s all emotional. 

Janelle: We’re all just crying here. It’s fine. 

Christin: It’s really the best job in the world. It’s the best job. 

Janelle: It’s really a sacred space. Like I said, I didn’t have my mom or my mother-in-law there. I just wanted it to be very intimate and Christin was so good at honoring how intimate it was. 

30:30 Transition

Janelle: Let’s see. Let me jump back to the story. Around 10:00, I got a new nurse. This nurse was awesome. Her name was Alisha and she was at St. Mark’s. If you ever get Alisha at St. Mark’s, she is a godsend. She was great. There were multiple times where Christin, Alisha, my midwife Kira, and my husband were all taking turns doing counterpressures on me. They all synced up and were so harmonious. 

Okay, so at 10:00, I was still 4 centimeters, 100% effaced. I labored in the tub at this point for a while. It really wasn’t that long, but in the moment, it felt like a long time. I loved and hated the tub because I didn’t have anything to brace myself on. Michael, my husband, couldn’t give me any counterpressure in the tub, but the relief afterward in the water was so amazing. I really loved that and then Christin was like, “I’m going to leave you two alone and have a little moment.” 

I think you had even brought these little tea light, like the electric tea lights. You had set those up in the bathroom and the lights were dimmed. It was such a special, sacred moment with Michael and I. He just was like, “I really get why you hired her. I love her. She is amazing.” I was like, “Yep. This is why.” He was like, “Yeah, we don’t ever want to do birth without her.’ 

Christin: Have more babies. I’ll be there. 

Janelle: Yes. Undecided. But we do, absolutely. 

Christin: Fair enough. Fair enough. 

Janelle: That was at 10:00. I was at a 4. Then I got in the bath. At 11:15, I was out of the bath by then. I had a cervical check and I was at a 7. I jumped a lot in that time. I was doing a lot of work. I was 100% effaced and I was at 0 station. I was moving all over in positions. We did the throne position. There was one where I was on hands and knees on the birthbed, but I didn’t have the birth ball. 

At 11:40ish, I was feeling really pushy and I got so emotional. Christin will remember this. I sobbed. It was ugly crying for a good half hour. This is now what we know is transition, but it was rough. I was having Charlie horses and oh, it was just rough. I just was crying a lot. I don’t know exactly what was happening, but I just was preparing, I guess, and releasing emotion for the baby to come out. 

Around 12:30, I was pushing here and there, and around 12:45ish, I started really pushing. Again, at this point, I was in the lithotomy position which is sitting upright how you picture in movies and stuff how people have babies. I was screaming this baby out. I was the loudest person on that floor of the hospital for sure. 

Meagan: I think there’s something to it. I think sometimes roaring your baby out is what people need. 

Christin: Absolutely. 

Janelle: I was absolutely a screamer. 

Christin: It’s funny because I don’t remember you being loud. 

Janelle: Oh my gosh, really? 

Christin: Yeah, I don’t remember it. 

Janelle: Oh, praise be. That’s great because I remember at one point– 

Christin: There’s a good chance you weren’t as loud as you thought you were. That happens a lot of the time. You think you are very loud and you probably aren’t. But I mean, there’s nothing wrong with that. A lot of women roar their babies out and it’s very powerful and very primal and natural to do so. 

Janelle: Mhmm, yeah. 

34:21 Achieving her VBAC

Janelle: I remember at one point, there was a nurse that came in. I could tell she was one of the baby nurses because she had the baby cart and stuff. I was in mid-push and I remember saying, “Get the f- out!” 

I’m pretty sure that everyone in the room thought I was talking about the baby, but I was talking about the nurse. I was like, “Get out!” 

Meagan: Like, “I don’t want you here.”

Janelle: I was like, “I don’t want anyone in here seeing this. It’s ugly.” 

Meagan: Oh my gosh, that’s funny. 

Janelle: Anyway, so I finally pushed the baby out at 1:30 so I was pushing for an hour. The moment that I got to push him out, I was very emotional and my midwife handed him to me and helped me finish. She delivered the first part of him and I had a little bit of a cervical lip so she was like, “You’ve got to really push him out,” or maybe it was the shoulder. Was it the shoulder that was stuck? I feel like I’m butchering this last part right now. 

Christin: No, you didn’t have an official shoulder dystocia. He just needed a little extra strength to get the rest of his body out. 

Janelle: Okay, yeah. That’s where we were at. She was like, “You really need to push here.” I just remember like you said, roaring him out. She helped me pull him to my chest and having that warm, gooey, slimy baby was just everything that I could have hoped for. I would not change that for the world. That oxytocin hit that you get from smelling that baby that comes out of you is just unreal. I was so happy that I got to be the first one to hold him and see him. I just am really, really grateful that I had the support that I did because I don’t feel like I could have done it without my husband, without Kira our midwife, without that nurse Alisha. 

Okay, like I said, I am butchering this best part because I forgot to say so many things that I wrote down. 

Okay, let me back up a little bit. So right around the time that I was crowning, I just felt like my skin was crawling and oxygen was not enough for me. I couldn’t get comfortable. I couldn’t get on top of my breathing. I was asking for an epidural. I had already signed the consent form, but my nurse Alisha was like, “Oh, the anesthesiologist is busy and by the time he comes, it’s going to be too late so sorry.” Sneaky little nurse because she knew what I wanted. 

I actually asked for a local anesthetic. I was asking for lidocaine or something. I was like, “What do you use to stitch people up? Use that on me because I am struggling here.” My contractions were, Kira told me they were three little ones and then one really, really big one then I would have a 5-minute break. That’s how my contractions were up until the end. 

Like I said, I couldn’t get on top of my breath. I remember looking at Christin and my husband. I just couldn’t figure it out. There was this moment inside of me that even though I had them there, I had to dig so deep in my own body and in my own soul. I even said a prayer to God and I was like, I have got to have some help here. I cannot push this baby out alone. Can you please send some angels or something to be with me because I can’t do it?

I got a little bit of a longer break in between contractions and I finally had Christin and Michael help me to get on top of my breathing and that’s when I was able to push the baby out. 

Meagan: It’s crazy how breath really is so impactful but then we are always told to hold it, so you’ve got to find the breath and find the strength and regrasp. Sometimes, that means taking a step back and rebreathing and finding that regrounding. 

Christin: Yeah. 

Janelle: It’s so hard in the moment. 

Like I said, you think you know but you don’t know until you’re there. 

38:47 The power of a supportive partner

Janelle: But I do have to say that the second I pulled him out and he was warm and gooey and on my chest, they were trying to arouse him a little bit because he was a little bit slower to take his first couple of breaths, I was just screaming, “I did it! I did it! I did it!” a million times. My husband just said, “I’m so proud of you. I’m so proud of you.” 

I actually wanted to say what he told his family. He said, “Today I saw what Janelle was made of and she freaking did it. I’m so proud of her.” The way that he said that about me unprovoked was really sweet. Yeah. So there it is. There’s my story. It’s choppy. 

Meagan: No, listen. I love that. I love that. And would you have anything to add, Christin, to that?

Christin: I would just say that Janelle went into this whole thing very prepared. She had educated herself and she was very prepared for whatever came at her. She did her work ahead of time. She found a fantastic provider and she knew what she was doing. She knew everything that she needed to know about a VBAC, but at the same time, she was very welcoming to let birth just unfold how it was going to unfold. 

There was a time. We talked about this a little bit earlier. You got to the hospital. You had been laboring really well at home and contractions had been coming very quickly. You were progressing really well and then you got to the hospital and everything just stopped. That’s completely normal. We see that happen all the time in birth where just that chance in scenery and the commotion tends to slow things down a little bit, but that didn’t get to you. You just needed to get back into your groove. You got settled back into the hospital and you and Michael had some time together. I don’t think we should ever discount those special moments that you have with just your husband. 

When I step out to give you time in the bathroom, that’s not me necessarily trying to take a break myself, it’s to give you guys time to help that oxytocin get flowing, to get labor progressing again, and to protect that intimate space. You guys were a phenomenal team. It was incredible to watch the two of you together. Michael was so incredibly supportive. 

That moment where he leaned down and just said to you, “I’m so proud of you, Janelle,” it was so touching just to watch his love and his pride for you. It was incredible. 

Janelle: He really is the best. I’m so emotional just thinking about him because I just love him. Obviously, none of my family would be possible without him, but I couldn’t do mom life without him and I couldn’t do the birth without him. He really was everything. So get yourself somebody who loves you and who loves the ugly parts of you too. 

Christin: You know, I say this too. I don’t think– I mean, moms obviously are going through so much during labor, but I don’t think dads are ever given as much credit as they deserve because they are watching someone they love go through the hardest thing they’ve ever done. While there are things to help mitigate some of that, there is nothing they can do to fix it or take it away and it is emotionally taxing on them. 

Meagan: I agree. I was just about to say the same thing. As mothers, thinking about your child doing one of the hardest things in their entire life and how they feel. Now, you are not his child, but you are someone he loves probably more than anyone on this earth, and especially at that time, he was feeling those things too and he watched you. He watched you prepare and he even was questioning, “I see how much you want this. How will this affect you if it doesn’t go this way?” He was literally taking into consideration that far before the birth even happened thinking about you that deeply. It just is amazing. 

I think that’s one of my personal favorite things about being a doula. Of course, seeing babies being born is just incredible. It’s absolutely incredible, but seeing what Christin just described, these two people who love each other more than anything that just brought this human into this life, and seeing them bond and grow and take pride in on another during the support of their baby is just really one of the coolest parts about being a doula. 

Janelle: When my kids are a little bit older, I think that’s what I want to do, but we’ll see. 

Meagan: Yes. Listen, I think that’s how a lot of us start. We get inspired by our own births then we find the time in our life when the journey feels right and we take off. I encourage you to. I encourage you to become a doula. Yeah, it’s such an amazing journey. 

43:53 What is vaginal cleansing?

Meagan: I definitely want to touch on the postpartum stuff that we wanted to talk about, but I also found a little article thing on the vaginal cleansing. I just wanted to share. 

Janelle: Oh, okay. 

Meagan: It’s actually from cochrane.org. This was published in April 2020 4 years ago. We’ll make sure to have the link here in the show notes, but I was just curious more about what it was and in one of the articles, it said “vaginal toileting”. I’m like, What? That’s weird.

Janelle: Odd. 

Meagan: Yes, toileting is a really strange vocabulary, but maybe in my head, I’m thinking that maybe they are getting rid of– I’m not going there. It’s called vaginal cleansing with antiseptic solution before Cesarean delivery to reduce infections after surgery. 

Janelle: Oh. 

Meagan: Kind of interesting. I’m not going to go through the whole thing because I really want to get to postpartum, but it says, “What evidence did we find? We searched for new evidence in July of 2019 and in this update, we have included 21 randomized controlled studies involving a total of 7,038 women” –which to men kind of sounds small– “undergoing a Cesarean section.” It goes down and it says, “Cleansing the vagina with antiseptic solution immediately before a Cesarean delivery probably reduces the incidence of post-Cesarean infection of the uterus. 20 trials of 6,918 women showed moderate-certainty evidence” –so they are moderately confident– “that the reduction was seen for both iodine-based solution and chlorhexidine-based solutions.” It says, “The risk of postoperative fever and post-operative wound infection was probably reduced by vaginal cleansing both moderately again.” 

It goes on even more talking about wound complications and infection of the uterus may be lower in women receiving pre-operative vaginal cleansing with solution. So that is interesting because one of the things for me and maybe I’m wrong, but I was under the impression that meconium was sterile. It’s poop, but the reason why they get so worried in the lungs is because it’s really thick and tarry poop. If you think about our lungs and tarry poop, right? That’s what my understanding was. It was more of that versus it was toxic to them but maybe I don’t know. Maybe I need to research my meconium evidence. Do you know, Christin?

Christin: I don’t. Does that study say that they do it specifically related to meconium or just in prep for a C-section? 

Meagan: Just in prep for the C-section. When you guys were talking about the relation to meconium, it just made me think because I thought that meconium was okay. It doesn’t really talk about it here at all. It did say that they did not observe any difference between groups of women with ruptured membranes and women with in-tact membranes which to me says– because in-tact membranes mean no meconium, right? 

Janelle: Right, no. 

Meagan: Yeah. They wouldn’t know or it wouldn’t be present, so it’s interesting. It’s interesting. 

Janelle: Yeah, interesting. 

Christin: It must have just been a coincidence with your C-section and meconium being present. Like I said, the one that I just saw– it might have been a week ago. 

Meagan: It ended in a Cesarean? 

Christin: Yeah, it was for a C-section, but I don’t think they knew that meconium was present at the time that they did the cleansing or the vaginal toileting I guess that we are calling it. 

Janelle: Vaginal toileting. That sounds so gross. 

Meagan: Vaginal toileting, I know. This article says vaginal cleansing specifically, but yeah. 

Janelle: I prefer that. 

Meagan: There was another article that talked about the effects of vaginal douching and another article that talked about the effects of vaginal toileting before a Cesarean. 

Janelle: I’m not a fan regardless. 

Meagan: Yeah. It’s so interesting. I honestly have never seen that. I mean, it was 4 years ago so maybe some places are catching up. I mean, I don’t know. Anyway, moderate. It may. It may not. It’s not complete. But anyway, there was that. I just had to throw that in because that was a big question. 

Janelle: Yes and touching on that, I think maybe it’s okay to decline that and I would have declined that had I known that was what was going to happen to me because it very much happened to me.

Christin: Yeah. Absolutely. 

Meagan: Yeah and it wasn’t discussed. You still didn’t even know the reason right now. You were still processing. Those are the types of things that as those things are happening, you can stop and say, “Hey, whoa. What is the evidence on this?” You can ask about that. Or, “Hey, can you tell me the pros and cons here because I don’t know if I want this?” Then again, it’s ultimately up to you to choose if you want that. 

Now, if you’re not expecting a Cesarean and all of a sudden they are doing this, that might be a red flag to start asking questions because they may be mentally on the other side of the wall preparing you for a Cesarean that you are not aware of. 

Christin: Yeah, I think this is a good example of just in general how much they don’t let you know how much is actually voluntary. A lot of times, the way they phrase things is, “Okay, I’m doing this to prepare for this or I’m going to do this” without letting you know, “Hey, if you don’t want this, we don’t have to do this.” 

Janelle: Right. 

Christin: So I think that happens with a lot of things, especially as a first-time mom, you don’t know. You don’t know what is– 

Janelle: Protocol. 

Christin: What you have to consent to and what is protocol and even if it is protocol, you can still decline it. You don’t know a lot of that stuff. 

Meagan: Yeah. Yeah. Okay, so we’ll be quick and we’ll include this link in there. 

50:26 Symptoms of postpartum depression

Meagan: This is from the Mayo Clinic. It talks about the different symptoms of postpartum depression. We talk about baby blues. I’m just going to talk about this really fast. I encourage everyone to go click on it. But baby blues symptoms may include things like mood swings, anxiety, sadness, irritability, feeling overwhelmed, reduced concentration, appetite problems, and even crying. 

No, postpartum depression symptoms they have listed as depressed mood or severe mood swings, crying too much, difficulty bonding with your baby, withdrawing from family and friends, overall tiredness, hopelessness, feeling worthless, restlessness, super anxiety, and stuff like that. Postpartum psychosis, getting confused and lost. A lot of the time, people with postpartum psychosis will be mid-thought and then they just stop and they literally have no idea what’s going on. They’re very confused. Having obsessive thoughts about your baby. Hallucinating kind of sometimes goes into that feeling very confused. Not sleeping or having too much energy. Almost feeling like you’re so exhausted but you are really, really, really high. Does that make sense on energy? 

Making attempts to harm yourself or your baby and then there is more. So when to see a doctor— if it goes past 2 weeks after your baby is born, you are noticing it getting worse. Your partner is noticing it getting worse. It is making it harder on you to physically take care of your baby or yourself and things like that. All good things to know and be aware of. 

Yes, like Janelle said, it is very hard to admit sometimes because we are in it, but get that supportive team. This is also a really great conversation to have prior to having a baby even if you have never had a baby before or never had any of these symptoms before to talk about it and create a plan for if these symptoms are coming in, what to do, what you want to do while you are in a different space. 

All right, I just ran really quickly through that because I know our time is up, but definitely check that out. Women of strength, know that it is okay to ask for help. It is okay. 

Janelle: Yes. I agree 100%. 

Christin: Absolutely. 

Meagan: Thank you guys so much for joining me today. It was such a pleasure. I loved seeing the emotion, the waterworks, the smiles, the uncontrolled laughter. It just was so much fun and I absolutely adore you both. 

Janelle: Aw, I love you. Thank you so much for having me. I love you, Christin. I love you, Meagan. 

Christin: Love you too. 

Meagan: Love you. 

Christin: Thank you so much, Megan. 

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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