The VBAC Link

Crystal Nightingale from The Mama Coach joined us a few months ago and is back again today diving deeper into postpartum and breastfeeding than we’ve ever gone before!

Did you know that new research is showing that cold compresses are more effective in helping clogged ducts than warm compresses or showers?

Crystal shares her valuable insight gained as a registered nurse and IBCLC of over 10 years. Meagan and Crystal discuss everything from appropriate newborn weight loss to all types of infant feeding to how to have a successful breastfeeding journey starting even before birth. 

As we kick off 2024, we promise to bring new topics, deeper discussions, and exciting changes that will empower you even more to continue to have better birth AND postpartum experiences.  

Additional Links

Crystal’s Website

The Mama Coach

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello you guys. It’s 2024. I cannot believe that 2023 went so stinking fast and we’re already here. I think the new year is super fun because I think about all of the exciting things that we want to do for the year and we have this extra motivation. 

Today, we’re actually going to be talking about something that we don’t talk about a lot on the podcast. This is going to be postpartum. I’m excited to talk about postpartum because, with The VBAC Link, we are all Women of Strength. You are all preparing for birth. You’re all preparing for pregnancy sometimes. We’re so focused on the birth, but we forget about what comes after the birth. 

So we have our friend, our dear, dear friend, Crystal. Hello, Crystal. 

Crystal: Hello, good morning. Happy New Year. 

Meagan: Good morning. I am so excited to have you on today. 

Crystal: I’m excited. Thank you. 

Meagan: Yes. You are a registered nurse, an international board-certified lactation consultant which is an IBCLC and for everyone who has never seen an IBCLC, you guys, I have three babies and I breastfed with all three of them. I’ve seen an IBCLC with each baby because I’ve found that each baby is so different. 

Crystal: Yes. 

Meagan: If you haven’t seen an IBCLC before, I would highly suggest it. They can help so much. But Crystal is from The Mama Coach and she is going to be talking with us today about postpartum and mood stuff and breastfeeding and so many powerful things. So hold on tight. We’re going to do a review and dive right in. 

Review of the Week

This review is from– I don’t even know how to say it– miralamb04 on Apple Podcasts and it says, “A Must Resource During Pregnancy.” It says, “The VBAC Link was most helpful and encouraging during my TOLAC (trial of labor after Cesarean) preparation. I used all of the episodes to everyone’s different expectations and outcomes to help me prepare for my VBAC. Finding out I was pregnant six months postpartum after a planned C-section due to a breech baby was frightening at first.”

We have talked a lot about this close duration. It says, “I knew immediately I wanted to VBAC and started doing my research. The VBAC Link was constant during my stroller walks with my baby and helped me mentally prepare for my second pregnancy. I used the resources provided to help open up conversation during my prenatal appointments and ultimately advocate for myself and my baby for a planned, hospital TOLAC. I successfully had my second baby via VBAC a few days ago and I’m so happy that I did. Everything I could have wanted and so much more. Thank you, Julie and Meagan.” 

I love that so much. You guys, this is what this platform is for. It’s for you to have the education, the information, and the empowerment to go on and make the best decision for you no matter how that is and what your birth outcome looks like. I love how she said, “To advocate for me and my baby.” Right? 

Crystal: Yes. Love it. 

Meagan: I love it. That is so cool.

Crystal: Very, very. 

Meagan: Thank you so much for that review. They touch me from the bottom of my heart and if you haven’t, please drop us a comment. Drop us a review. Let us know what you think about The VBAC Link. 

Crystal Nightingale 

Meagan: Okay, cute Crystal. Welcome, welcome. 

Crystal: Hi. Thank you for having me. 

Meagan: Absolutely. I’m so honored that you are here and taking the time out of your very busy day to talk more about that topic that we just don’t talk about. It’s not even that we don’t talk about it. I think it’s just that we don’t think about it. 

Crystal: Yeah, yeah. 

Meagan: It’s so far over there because we have such an event to get through. Birth is an event. 

Crystal: Yeah, it’s huge. 

Meagan: It’s such an event to get through that we can’t think about what we’re doing here or over here because we are right here in this moment preparing for this event. 

Crystal: Yeah. Yeah. 

Meagan: I mean, I have ridden tons of bike rides, races, long distances, and ran half marathons. I’m telling you that at mile 10, the only thing I was thinking about was where that finish line was, not where the next starting line was or that next experience. So I’m excited that you are here with us to talk more about this next journey because it is a whole other journey that leads us down a path through life in general and it can impact us for our next birth. Right? 

Crystal: Yes. Right. 

Meagan: It’s a circle. It all goes together. Let’s talk about it a little more. Let’s talk about your professional background. What got you into this? What got you into your passion for postpartum and serving moms and babies through postpartum and through breastfeeding? 

Crystal: Yeah, so I always knew that I wanted to work as a nurse or in the nursing field. I was just fascinated with labor and delivery and women’s health. Of course, being a woman and all of the amazing things that we can do. I had my oldest children younger so I was very naive. 

After I became a nurse, I really got into postpartum and mother and baby and just seeing new babies come into the world and helping the parents, the whole family, with breastfeeding and helping them take care of their newborn baby and just all of that fascinates me. It’s just incredible to me. 

I’ve been working with mothers and children as a nurse for a little over 10 years now and you know, just through my time in the hospital and the clinic, I have seen a trend. A lot of parents have the best intentions. They want to breastfeed and they want to do this, but then there is not a lot of support. The WHO, World Health Organization, and CDC all recommend breastfeeding for at least six months, but what? Then parents go back to work at six to eight weeks maybe? Some even sooner. I’ve seen some moms who have to go back to work within two or three weeks. So just seeing that lack of support postpartum for families just triggered, “Okay.” 

It’s very frustrating to be in a hospital or a large health organization setting and not be able to do as much as I want to because of all of the policies and regulations and things like that. So I teamed up with The Mama Coach to start my own private practice and being part of The Mama Coach has been awesome. 

We are a group of registered nurses and some nurse practitioners all around the world helping parents to make parenting easier through education, evidence-informed solutions, support, assessment, individualized plans, and all of the stuff to help support parents from the prenatal period to postpartum to feeding and starting solids, all the way up to five years of age with sleep and CPR and things like that. 

So yeah. That’s a little bit of my background. I have four kids and I did not get to breastfeed my older two because again, I was young and naive. I didn’t know anything. I “tried” to breastfeed not knowing that cluster feeding was normal. I just thought, “Oh no. I need to give formula because they sent me home with formula.” Then all of a sudden, my milk dried up and I was like, “Oh well. I guess I’ll just formula feed.” That wasn’t what I wanted to do. I just didn’t know how to continue the breastfeeding journey. 

Meagan: Yeah. This isn’t like anything that we talked about, but I kind of am wondering if you know the answer to this. We are talking about how all of these organizations– big organizations– encourage breastfeeding. We talk about how we don’t necessarily have the support but not only do we not have the support, but we have the alternatives given to us so easily which I think is great. I’m not saying it’s a bad thing, but it makes it easier or if we don’t know. Like with cluster feeding, you think you’re baby is starving. You think, “I’m not giving my baby enough. They are always hungry, always hungry and I have to supplement with formula,” when that’s not necessarily the case. Why do you think these companies are providing so much formula right out of the gate?

Crystal: You know, I’m not sure. I can say it probably is because they are not thinking of the long-term effects of starting formula. If it’s needed, how I always was taught especially working in the hospital is that really, formula should be used and treated as a medication. Use if absolutely needed. But, when some staff or doctors or whatever see that a mother is struggling maybe, they don’t automatically think, “Let’s support her and see how we can help her reach her goal. Let’s just feed the baby and deal with it later,” not knowing that that can negatively impact the breastfeeding relationship down the road. 

You know, like you said, that is there for a reason, and if a baby really needs it, of course, use it. I think the organizations are getting better, but they can still be better. 

Meagan: Yeah. Do you know what I would like to see more? I know that this can be tricky because of all of the things that are put into our bodies and in this world, but I would love to see milk bank donations more. 

Crystal: Yes. 

Meagan: There are certain countries that are literally like Winder Dairy and they bring breastmilk to your porch for people who are struggling. It’s so awesome and there are parents out there. There are moms out there who have an insane overproduction, but their baby isn’t necessarily using it and it could go to a preemie baby or to a mom that may have a little bit of a rough start or have had a Cesarean under general anesthesia and isn’t able to really even be present in that moment. I would love to see that happen more. I don’t even know. There are all of the things out there. There are all of the apples off of the tree that I would like to grab and make happen. 

Crystal: That would be so amazing. 

Meagan: But they are out there too. So if you are struggling in your breastfeeding journey, it doesn’t hurt to ask, “Hey, is there a breastmilk donation in our area or in this hospital?” because there are situations where some hospitals– it’s not talked about and it’s not big enough yet, but there are banks where people who donate. 

And because of the craziness in this world, they are really, really strict on who can donate. My cousin did one and you have to check a million boxes to be able to donate. So anyway. 

Crystal: It makes sense. 

Meagan: It could be weird to people like, “Someone else’s milk, what?” 

Crystal: I’ve definitely encountered that before. Everyone has their feelings, beliefs, and opinions, so it’s like, “Well, it’s there.” I am seeing more hospitals in my area up in northern California have donor breastmilk available in the hospital, but the problem with that is they give the donor milk in the hospital, but when they go home, there is still not that support or continuation of care because now, mom’s milk maybe is not quite sufficient yet and how do we help them when they go home? 

Meagan: Right. 

Crystal: That’s another thing that we’re seeing too. 

Meagan: Okay. So that is a question right there even. We can go home, but I’m going to go back and talk about breastfeeding with that. What do we need to not forget about the postpartum journey during the birth preparation? What are some things that people who are pregnant, preparing for birth, and preparing for their birth– they are so excited. They are figuring out if birth is right for them. What do we need to focus on and not forget about during that pregnancy journey? 

Crystal: Yeah, so of course, like we were saying earlier, getting ready for birth and preparing for birth is a huge event. We prepare for that and all of that, but then we don’t think about like we were saying, the postpartum. Think that postpartum can last a year or two years, sometimes even longer depending on how long you breastfeed if you plan to breastfeed. It takes 9-10 months for your hormones to increase and grow this baby and things like that, then of course, it can take– to me, this is my thinking– at least nine months for it to go back down to somewhat normal levels. 

If you’re breastfeeding, you’ve still got all kinds of hormones going on. So think about that. Babies have to be fed, so how are we going to feed them? Are you going to breastfeed? Do you know what to expect? Do you know what kind of bottles and what kind of formula to use? Do we know what to expect with just newborns in general and newborn care and diapers? Because babies’ poops look funky. They are different from ours, so it’s like, okay. All of these things, I feel like if parents are a little bit more prepared, then they will have less anxiousness for one because it’s a whole new thing whether you are a first-time parent or even if it’s your third or fourth baby– even with me for my fourth baby, I was like, “Wait. Is this normal?” I’m a nurse and I work in the field, but it’s so different when you’re on the other side. 

So just to be prepared for that so that way you have the expectations and you know, “Okay, what’s normal? What’s not normal?” Have somewhat of an idea of how to manage some things and know that there is support out there when you need the support. 

Meagan: Absolutely. Something that I– with my first baby, I ended up going back to work at 12 weeks postpartum. I already wasn’t prepared for a Cesarean, so then I was recovering from that, but when it came to feeding my baby and even my emotional status, I really wasn’t prepared for all that was happening in such a short period of time and then to shift. As soon as I started feeling like I was kind of getting the hang of it and things were in control or I had a routine, it was like my feet got swooshed underneath me and it was changing again. I was all of a sudden in a back storage room pumping every three hours. I was storing my milk in a fridge where everyone stored their lunch and then trying to figure out that and trying to get enough production for my baby while they were with the babysitter. It was so much. 

Crystal: It’s a lot, yeah. Definitely, going back to work after having a baby, no matter how soon whether it’s six weeks or six months is definitely a big change as well. That’s something that a lot of parents aren’t really thinking about or prepared for which is totally fine. There is so much more going on at the moment, but knowing that, “Okay. I need to prepare and be ready before I go back to work so I know what to expect.” And like I said, getting some support on how to manage that. Get a plan together. Get a schedule together. 

Meagan: Yeah. So as a doula, I work a lot with my clients right before pregnancy and sometimes they are a little caught off guard when I’m like, “What’s your postpartum plan?” They’re like, “Huh? Aren’t you a birth doula?” I’m like, “Yeah. I am a birth doula, but I know a lot about postpartum and I didn’t plan for it either. Let’s talk about it. How are you going to eat so you can feed your baby? How are you going to get sleep?” because just like you were talking about before, a lot of moms have to go back 12 or so weeks after. Some of them two weeks after. We also have an issue with our paternity leave– 

Crystal: Paternity leave for the fathers or the partners. 

Meagan: Yeah. We have one week. Especially if you have multiple kids, we have one week a lot of the time and then they’re gone and we’re like, “What are we going to do?” Get your meal trains. Get your support. Rally up together. Have your birth team. Have your postpartum team. Have a plan. We know plans change no matter what– birth, postpartum, everyday life. I sometimes plan to go to Costco and then I don’t go to Costco that day because something happened. Plans change, but if we can have a baseline of an idea, I will be like, “Okay.” 

I have a friend who gets mastitis with every baby. 

Crystal: Oh gosh. 

Meagan: With her third baby, she was like, “I’m going to do everything.” She had her IBCLC to go to the hospital on day one to get a good, established latch. She met with her as soon as she left the hospital. By day four, she was meeting with her again to make sure. You guys, she was on sunflower lecithin. I don’t know how you feel about that, but that helped her personally to not be so sticky. She was like, “I have got to get this under control. I have two other kids. I cannot be sick with mastitis.” Then she would end up getting thrush after that so she took a probiotic. 

Crystal: Oh my gosh. 

Meagan: There are things we can do and it’s really hard to focus on that in the pregnancy stage. 

Crystal: Yeah, yeah. 

Meagan: But there are things. We can get on those probiotics. We can contact those IBCLCs. We can have a plan in place so we are not just thrown into the fire. Especially in my case, where I did have a Cesarean and a repeat Cesarean, those were just things that were unexpected so prepare the best you can. I love that. I love your advice. This is so important and get that support. 

Crystal: Yeah, for sure. I just thought of something because I talked a lot about breastfeeding and feeding your baby, but you brought up a good point. As mothers, we for sure neglect ourselves all of the time so like you were talking about with eating, make sure you eat and hydrate. Moms are recovering too from birth so whether it’s vaginal or a Cesarean, planned or an emergency Cesarean, your body is doing a lot postpartum. It’s just crazy. 

Meagan: We’re amazing. We are amazing human beings. We are incredible.

Crystal: Yes. We are. We are. We so are, but then we have to remember to take care of ourselves as much as possible. That’s where the support and village come in because you can’t do it all yourself. I guess you could. I’m sure some women have, but you shouldn’t have to do it by yourself. 

Meagan: No, and I think like you are saying, we shouldn’t have to but for some reason, we do. 

Crystal: Yeah. I know. I know. 

Meagan: We don’t ask for help. We struggle asking for support. We struggle spending money on ourselves. We struggle getting postpartum doulas or going to an IBCLC because it costs so much and insurance doesn’t cover it. You guys, you are worth it. You are worth it. You are amazing. You grew a human. You birthed a human. You are now taking care of a human. You are feeding a human. There is so much to it. It’s okay to get that support and give back to yourself. 

Crystal: Totally, totally. I 1000% agree. 

Meagan: Yes and sometimes, that is finding a coach and just getting some advice or talking to someone and just being heard. Maybe you don’t physically need anything, you just need to be heard. 

Crystal: Yeah, yeah. 

Meagan: Yes. Okay, so now we’ve had our baby and everything. What can we look for in the first few weeks to know that maybe we need to ask for more help or get more resources or take care of ourselves? What are some things that we can look for in those first few weeks with nursing and postpartum just in general? 

Crystal: Yeah, yeah. So for moms, I have spoken to a lot of moms who weren’t aware that there would still be bleeding afterward so there is that. 

Meagan: That is a thing. 

Crystal: Yes, that is a thing. You are still bleeding. That is normal, but obviously, from a nursing standpoint, if there is excessive blood or you are filling a pad every hour, then for sure, you want to reach out. A lot of women tend to swell postpartum. Some are like, “No, I didn’t have any swelling during the pregnancy,” then all of a sudden postpartum, you just blow up. Your feet are swollen and things like that. That could be due to some IV fluids or other stuff going on, but for sure, you want to reach out to your provider with that. 

Contractions and cramping afterward are still a thing, especially with breastfeeding. Some women are just like, “Oh my gosh. I did not know about this.” Some women feel great after delivering. They are like, “Yeah. I don’t need to take my meds. I’m feeling okay,” but once they start breastfeeding and they start feeling these contractions, it’s like, “I’m in labor again.” That is normal. I know it’s uncomfortable, but that is definitely normal. If you still feel that when you’re not breastfeeding or it’s not relieved with pain meds, then for sure, I would highly recommend reaching out to the provider. 

Meagan: That can also get worse with each baby, right? 

Crystal: Yes. Yes, it can get stronger. 

Meagan: It can last a little longer and be a little bit more intense, yeah. 

Crystal: I know which is like, “Why? We already went through this. Why do we have to make it worse?” 

Meagan: Our uteruses have to shrink down. 

Crystal: I know. It’s a good thing. The cramping is a good thing. It’s a normal thing. We want that. It controls bleeding. It gets the uterus back down to the normal size and all of that. Engorgement. Even if a mom is not breastfeeding, the body’s natural, physiological response is to bring in milk. With the delivery of the placenta, your hormones drop and that triggers, “Oh, okay. Baby has been born. Let’s make milk.” 

Meagan: We have to feed it. 

Crystal: Yes. So whether you breastfeed or not, if you don’t breastfeed, you may not get as much engorgement, but there is still stuff going on there. If you are breastfeeding, you will almost 100% get engorged in the first few days anywhere from day three to five. Sometimes it is a little bit longer, but around there, your breasts will feel really full. Some women say their breast sizes double or triple. 

Meagan: Mhmm. 

Crystal: They can get really rock hard. That’s pretty normal because your milk is coming in. Getting support with latching well so the baby can empty it or if you need to, maybe you have to pump a little bit, but like I said, of course. Reach out for lactation support because depending on the situation or what’s going on, the lactation consultant can further guide you on how to manage that. But lumps, you may feel little lumps in the breast. That is pretty normal. Those are just basically milk ducts that are swollen or filling with milk because of the postpartum period with increased swelling and things like that. 

After engorgement, I’m thinking of the progression of things, a lot of parents see clogged ducts, but now we know that it’s called ductile narrowing instead of clogged ducts. 

Meagan: Oh. 

Crystal: Yes. Before, we thought that the milk was getting clogged. 

Meagan: Getting sticky. 

Crystal: Yes, then we had to somehow remove this milk plug, but the new research by the Academy of Breastfeeding Medicine is saying that it’s not that. It’s inflammation and swelling of the milk duct itself that causes the narrowing of the channel or the passageway that milk goes through and that makes it back up. It backs up the milk. 

Management for that beforehand was warm compresses and massage, massage, massage, dangle feeding or something like that. Now, they are saying that we should be using cold compresses. 

Meagan: Oh, okay to reduce inflammation. 

Crystal: Exactly, to reduce inflammation. I always tell parents that if we have a swollen ankle and the breasts are swollen, we wouldn’t put a hot or a warm compress on it. 

Meagan: No. Okay, I’m noting it. 

Crystal: You would do the ice or the cold compress to reduce the inflammation and when we reduce the inflammation in those milk ducts, now that passageway opens up, everything can calm down, and milk can flow a little bit easier. 

Meagan: Mind blown!!

 

Crystal: I know. 

Meagan: That is amazing. That would have been nice to know a long time ago. 

Crystal: I know. When I see moms say, “Oh my gosh, I have this lump and my breasts don’t feel empty even with breastfeeding or pumping. I’ve been doing hot showers and massaging it.” I’m like, “No. Try cold.” Almost always, it helps. 

Meagan: I am totally adding this to my doula toolbox. 

Crystal: Yes. Yes. 

Meagan: This is really good information. 

Crystal: It is. It’s so amazing when parents come back and they are like, “Oh my gosh. It worked. I can’t believe it.” Also, breast tissue is very delicate. It’s soft tissue. Some moms are just aggressively massaging their breasts like, “Oh my god. I have to get this out.” You don’t want to do that because you can further damage and cause trauma to the breast tissues. 

Meagan: More inflammation. 

Crystal: Yes, more inflammation, exactly. Light massage. If you need to, cold compresses for that. For moms, I’m going on and on right now. This episode is going to be forever. It’s going to be hours long. That’s kind of the basics of the immediate thing that we need to look for in mom physically. 

Emotionally and mentally, parents are sleep-deprived so we definitely want to make sure, like you said, have those meal trains. I even suggest adding this to the baby registry when you are pregnant like meal cards, Door Dash cards, a postpartum doula even. It’s like, “Whoa. Instead of giving me all of this, this is what I’m going to need help with in the first couple of weeks.” I know for me, I guess I’m thinking of myself and my baby, but I’m also thinking of everything else in the house that I need to do like, “Oh my gosh, I need to do the laundry. Oh my gosh. The other kids need to get rides to school,” or what have you. 

If there is anything, you know how friends and family are always saying, “Let me know if I can do anything to help,” please ask for help because moms and parents need sleep definitely. That helps because, for one, sleep is just a human need. Two, for sanity, and three, because the more rest that we can get as mothers, as a breastfeeding and lactating parent, the better our milk supply will be too. 

Meagan: Yeah, 100%. Like we were talking about, we are not thinking of drinking and that helps our breast supply. That helps our healing physically and keeps us in our minds. On that topic, Be Her Village– I’m sure you’ve heard us talk about it. Check out Be Her Village. You guys can create a registry just like Crystal is describing where you can go and register for a doula or childbirth education or money for an IBCLC or pelvic floor health or mental health. All of these things, if this is your registry– 

Crystal: Pelvic floor health, oh my gosh, is another thing. We don’t know about that. Most mothers are just– not that we don’t care, we just don’t know. There are just so many things going on down there that for sure you need some kind of pelvic floor rehabilitation afterwards even if you have a C-section. 

Meagan: 100%. It’s aggravating. I’m not going to spiral off on this tangent. It’s aggravating to me that so many insurance companies do not cover this as a standard part of postpartum. But they’re not covering postpartum pelvic floor issues. They’re not covering this. 

Crystal: Yeah. 

Meagan: I went and it was $250 per visit and as a new mom, especially if we invested in a doula and an IBCLC and a photographer or whatever. 

Crystal: All of those things, yeah. 

Meagan: It’s like, “Oh, whatever,” and now we have a newborn that has to have diapers at $50/box. It’s really hard. 

Crystal: Right and that’s where we neglect ourselves again. Not that we want to, but I don’t even know who to blame. Healthcare or insurance or whatever is preventing us from getting the proper care or support. I did the same thing. I just wanted to touch on that. I did the same thing. I was having issues holding my bladder and I asked for a referral from my doctor for pelvic floor health because doing our own research, we’re like, “Okay. I think I need to see a pelvic floor therapist.” They did not. They were like, “Well, normally we don’t do that.” I’m like, “Why?”

I did the same thing. I tried to look into it myself to pay out of pocket and it was expensive and I just kind of gave up and was just like, “Okay. I’ll just do my own research and find out some exercises on my own and just do it on my own,” which is sad. We shouldn’t have to do that. 

Meagan: I agree. I agree. 

Crystal: But okay, so on to what to expect because there are still a couple of other things. There is so much, but I just want to touch on the emotional and the mood disorders because that is very, very important and huge. I always recommend that when moms take classes prenatally they have a partner or a birth partner or something that is along for the ride with them who comes to the classes and things like that. I really recommend that postpartum too. Any time of postpartum class, newborn class, or breastfeeding class, the partner or caregiver should definitely be involved as well as the birthing parent because as moms, we don’t initially see that there is something more going on with us for postpartum anxiety, postpartum depression, and things like that. It’s usually a close family member who notices things going on first. 

Definitely, I feel like the whole family should be involved in that and if parents are just struggling with coping and with new life as a parent breastfeeding and all of the things, then definitely reach out for support because that can definitely happen with all of the hormones going on and the stress. 

Meagan: Lack of support. 

Crystal: Lack of support. 

Meagan: Lack of sleep. 

Crystal: Lack of sleep, yes. That’s definitely something big. 

Meagan: I want to talk just slightly about this. It’s really hard as a new mom to and I hope this isn’t triggering, pass your baby to someone so you can take care of yourself. We had a client years ago that was really struggling. She had a series of things and was really struggling. One of the things that we ended up coming up with was for her to go to her mom’s for the night. We came up with a good plan and had help with dad and the kids for baby. She ended up pumping and coming up with a supply and for one night– she did wake up engorged– she slept all night. All night. 

She went to bed at 8:30. She pumped before and went to bed. She woke up. I think she said it was at 6:30 which is still early, but 8:30 to 6:30 is a good stretch. She was probably so engorged that she had to wake up, but you guys, she was a new person. She said that. She was like, “Whoa. It’s like my funk was just sucked out of me just by getting that sleep.” That was really hard for her to do that. 

Crystal: Of course, I’m sure. 

Meagan: It was really hard for her to be like, “I’m giving up my baby who is four days old overnight.” It’s not ideal. It wasn’t ideal, but she spiraled quickly and she got to a place where that’s ultimately what she thought was going to be best. Anyway, it was amazing. She still had trials to get through because the next night, she had lack of sleep but she was able to build up that foundation a little bit more by getting a good night’s rest. 

Crystal: Of course. Exactly. 

Meagan: Her mom seriously had all of these broths and all of this high-protein food and all of these amazing things to fill her being with all of the good things. 

Crystal: Yeah, because as mom, we are filling everybody else’s cup usually, but we aren’t filling up our cup. 

Meagan: Yeah. You don’t have to leave your baby with anyone overnight, but going back to that, have someone fill your cup. Have someone fill your cup. Food, all of those things. 

Crystal: Everything. I’ve heard of some parents when they finally get three or four hours of sleep straight, they’re like, “Oh my gosh. That was amazing.” Same thing. “I feel like a new person.” Just because sleep is a human need, so we need that and if we’re just constantly days upon days upon days of getting only 1-2 hours at a time of sleep, that’s definitely not sustainable and not enough. 

Meagan: Yeah. Yeah. She started resenting her baby. 

Crystal: Yeah. Yeah. I’ve heard of that too. 

Meagan: She started having anxiety at nighttime. 

Crystal: Yeah. Yeah. I could definitely see how that can come about for sure especially if you’re breastfeeding, especially with that. We all know that of course, breast is best. Breastmilk is best, but we also have to think of the whole picture. I always tell this to all of my clients and patients that I work with. Mental and sleep health is very important. Very. I know breastmilk is too, but you do the best that you can. 

Meagan: It’s like when we’re on the airplane and they talk about if we’re in an emergency and the masks fall down, prepare your mask on you first before you help someone else. 

Crystal: Yes. 

Meagan: It’s a similar concept to me where if we cannot fuel ourselves with the oxygen and the sleep and these things, we cannot 100% take care of this baby. 

Crystal: Right, yeah. 

Meagan: We can’t make milk. 

Crystal: Right. 

Meagan: Because our body is going to protect us and sometimes we will see a milk dip with stresses and things like that. I have clients who are nursing really, really well and then a stressful event happens in their life and they’re like, “I’m losing my milk. I’m losing my milk. Is my baby not eating enough?” It’s crazy how just mentally our body can do that. It can stop making as much milk. Have you seen that?

Crystal: Yeah. I have. I have actually. A stressful event or if mom starts a new medication, especially birth control. They don’t know. They just don’t know. When I talk to my doula consultation, I say, “Any new medications?” They say, “Well, I just started taking birth control but my doctor said it should be fine and won’t affect my milk supply.” I’m like, anything new can. It can. 

Meagan: Hormones. 

Crystal: It’s not to say that we can’t get the milk supply back up, but at least being aware of it. Okay, this is why. It’s not because of something else or whatever. So yeah. I’ve seen that. 

Meagan: Yeah. 

Crystal: Periods, too. Moms starting their period again, it can–

Meagan: Throw it off. 

Crystal: Every month during your cycle, yeah. It throws it off. Lots of different things that could happen and will happen, so just something to have in the back of your mind like, “Okay. This is what I remember Crystal, The Mama Coach, saying or whoever saying that this can happen, but there are ways to work around it.” 

Meagan: This next question is a did-you-know. I feel like this is something actually that a lot of people do not know and that is that babies lose weight in the first few days. They can lose even more than the recommended loss if there was an induction, or a lot of fluids, or a surgery. Can we talk about that? 

Crystal: Yes. Yes. Correct. 

Meagan: Can we talk about what is normal? Because I feel like again, mentally, there is so much stress on feeding the baby, getting enough, cluster feeding, and all of these things, then we have this baby that weighed in at 7lb, 12 oz and is now weighing in at 6lb, 15oz, and we are like, “Whoa. This is a big loss.” We’ve got providers freaking out about it, suggesting supplements, and things like that. What’s normal? What is the average loss just without induction and things like that? Can we talk a little bit about that so we can offer some comfort to these mamas who might have a baby that’s losing weight? 

Crystal: Yeah, yeah. So babies can lose up to 10% of their birth weight within the first three to four days or so. Normal weight loss is about 2-3% per day. So with that being said, when babies are in the womb, they are swallowing amniotic fluid. They are swallowing, swallowing, swallowing, so technically, they are born full and their first stool is that sticky, black, tarry meconium that is just getting rid of all of that amniotic fluid that they were swallowing while they were in the womb. 

So that’s some weight loss because they are probably pooping five or six times within the first one or two days and it’s super sticky. Then, like you said, if mom was inducted or induced or got a lot of IV fluids, antibiotics, and a Cesarean, then they got extra fluids. Anything that mom gets during labor, baby gets some of it too. 

Really, some providers are saying that a newborn’s true weight can be seen 24 hours after birth versus one or two hours right after birth. That weight loss takes into account that. Fluids, getting rid of the meconium, and things like that, and then anything more than 10%, then we get kind of concerned. Like you said, some providers are like, “Oh my gosh. Let’s do all of this.” Me, as the lactation consultant, I am less freaked out because I know that especially if a mom is breastfeeding, babies’– we’re getting to probably one of our next questions– bellies are really small, so in the first couple of days, they are only taking 2-10 milliliters per feeding which is less than half of a teaspoon up to two teaspoons per feeding. 

That is the colostrum that they are receiving from mom, that yellow, thick, first milk that is expressed from mom’s breast and although it’s smaller in volume, it’s really packed with a lot of nutrients and antibodies and things like that. It is nutritionally–

Meagan: I say dense. 

Crystal: Dense, yeah. Nutritionally dense. So baby is getting what they need, it’s just a smaller volume because it makes up for the fact that it takes a couple of days for mom’s milk to increase and increase in volume and things like that. Babies are losing all of this excess fluids, pooping out all of this meconium, and then they’re just getting smaller, frequent amounts of colostrum. All of that are factors in weight loss. 

And then when mom’s milk starts to increase around day three to seven, they start taking in more volume and then we start to see some weight gain there. Now of course, as a lactation consultant, we look at the whole picture. What happened with the mom’s labor and delivery experience? Is this baby number one or two or multiple for them? Do they have any medical background that might be a factor in milk increasing or milk coming in? All things like that and when I look at that, I’m like, “Okay. Maybe we need to supplement just a little bit if we need to.”

And then I will tell moms, “Let’s maybe have you pump or hand express. Any extra colostrum or transitional milk that you can express, give that to baby first and we will see how that goes,” especially if they are not wanting to start formula. Every baby and family is different so I look at the whole picture, look at their goals, and see how best I can help them. But obviously, if a baby loses a significant amount of weight like 13-15%, then we are like, “Yes. We probably need to supplement.” 

So like I said in the beginning, formula is used when we need it if we need it, not just automatically, “Oh my gosh. Baby is at 9 or 10% weight loss. We need to give formula.” I definitely disagree with that. And it’s all the parent’s choice as well. I give them the options and they decide what they want to do and then I support them in whatever they decide. 

Meagan: Right. So as we are kind of working on getting our milk to come in and recovering and things like that, we talked about sleep, mental health, food, water, and things like that. That’s all going to help our breastmilk. But are there other things that we could be doing or should be doing to help our milk to come in quicker or once it comes in, to help it be more– savory comes to my mind, but really rich for the baby? 

You just talked about how some babies do lose up to 13% and then I guess a side question is, do we know why some babies lose a little bit more? Is there a reason or is there something that we as parents could do or should we just be like, supply and demand? Nurse your baby. Your milk will come in. Your milk is great. Just because your baby is not gaining as much weight doesn’t mean you should shame yourself or your milk is not good enough, because there is a lot of that too. Is there anything you would give us tip-wise to help milk come in? There are a lot of questions within this one question so I’m just going to turn the time over. 

Crystal: Okay. So yes. The best thing we can do is early hand expression. Typically, after birth, during the first 24 hours, babies are super sleepy. Super sleepy that it’s hard to get them to latch or want to nurse frequently. Thinking about how breastmilk supply works, the more you demand on the breast or remove milk, the more milk you will make. 

So if the baby is sleeping the first 24 hours, the baby is not expressing as much milk and that is where hand expression is important. Frequently, newborns tend to eat at least 8-12 times in a 24-hour period, so if we break it down by hours, it is just so much easier. Every 2-3 hours or so, attempt to put baby to the breast. Do what you can. If the baby is too sleepy or not latching well, then hand express. Hand expression and get out that colostrum. You can spoon-feed that to baby or cup-feed or syringe-feed that to baby, and then you’re still stimulating your supply. 

Sometimes, I hear parents say, “Oh my gosh, the first day or two, my baby was just so good and slept for four hours.” I’m like, “Did you hand express or pump at that time?” We just don’t know. They were like, “No, I didn’t. I slept too.” I’m like, “I’m glad you got sleep,” but to help your milk supply increase for baby, it is very, very important to express milk every few hours whether it’s hand-expressed, latching, or pumping. 

I’m trying to think what was the other question you had. Oh, how we can make it more savory. I always recommend doing breast massage prior to any breastfeeding or pumping or expressing session. That’s just because especially in the first couple of days, colostrum is very thick, so by massaging– and light massage. Not too hard, not too aggressively. You’re basically unsticking or loosening up that milk so that way it can be expressed and you can collect that good, sticky, fatty, colostrum or milk. 

That’s for even at any time. You might have heard of a foremilk and a hindmilk type of thing. That’s basically when you express, you see a little fat layer in the bottle or in the milk and to increase that, some researchers say that you can’t do anything to increase that, but we can help it to come out a little bit more. That’s by hand-expressing or doing what we call a breastmilk shake. I’ve done this myself with my last baby is just doing the breast massage before breastfeeding or nursing. I have seen a thicker fat layer on the milk, so you can do that. 

Meagan: That’s really good to know. With my son, he was kind of small to begin with, but when I would pump, I was like, “Oh my gosh. There is this much fat in this milk.” All of it separated and I had someone kind of suggest that, but it was a warm compress, not a cold compress. It was a warm compress, slight massage, and then nurse or even hand-express for just a second, and then nurse. 

Crystal: Yeah, yeah. Yeah. You can do that too. You can breastfeed or even hand-express a little bit too just to help that milk supply especially if baby didn’t have a good feeding or wasn’t quite latched very well just to ensure we stimulate the breast properly to give that signal of, “Okay, make the milk. Bring the milk in,” and things like that. 

I just wanted to say as a side note, all breastmilk is beneficial for baby whether you have a thin fat layer or not. 

Meagan: Good to know. 

Crystal: Your body still tailors and makes the breastmilk to your baby’s needs. 

Meagan: Awesome. So hand-expressing during pregnancy, we were talking about postpartum, but is it suggested to do a little bit during pregnancy? 

Crystal: You can, but you have to be considered at least term which is about 37-38 weeks or so, and of course, check with the OB provider because it depends on what risk factors you have. 

Meagan: Yeah, because it can stimulate. 

Crystal: It can stimulate because it does with the hand expression, the same hormone is released when you are having a contraction which is oxytocin so it can cause some cramping or contractions so you definitely want to get cleared by the OB first before just starting the hand expression, but yes. Once you get cleared, you can start antenatal hand expression and start collecting. It may be nothing or you might get drops. I’ve actually tried it on myself before and I didn’t get anything. I was kind of discouraged, but I was like, “No, knowing what I know, it’s fine,” but it’s good practice, too for hand expression postpartum. 

So practice, collect drops, and then you can freeze it and then bring it to the hospital if for some reason baby needs to be supplemented if they have low blood sugar or jaundice or whatever, so yeah. 

Meagan: So good to know. Okay, and then last but not least, we have different types of feeding. Bottles, paced bottle feeding, we talked a lot about breastfeeding. Can we talk about all of the different types of feeding?

Crystal: Yeah, yeah. So of course, you can do exclusive breastfeeding and that’s just feeding baby at the breast, or you can do breastfeeding and pumping so feeding breastmilk in some type of vessel whether it’s a bottle or syringe. I typically see bottle and syringe usually especially when the milk volume increases or you could do combo feeding which is breastfeeding, pumping, and formula feeding so you can do a combination of all three. 

Some moms do exclusively pumping. They don’t put baby to the breast at all for whatever reason. It could be their own preference or they were just struggling with latch and it just was not working out for them, or sometimes it takes a long time to breastfeed, 30-45 minutes, so some moms feel like that works better for them to just pump for 15-20 minutes and bottlefeed. 

Or some, whether it’s their own personal preference or medical reasons, exclusively formula feed. With that, when you do any type of feeding other than breastfeeding and you bottlefeed, you want to pace bottlefeed. We do that for several reasons. For one, sometimes, newborns don’t really know how to pace themselves and they will just take that whole bottle. 

Meagan: Chow it down. 

Crystal: Chow it down in one minute flat and we don’t want that because I always tell parents to think about how we eat. We don’t just shove food in our mouths. 

Meagan: Chew your food. 

Crystal: Yes, chew your food and things like that. One, it can help baby learn how to slow down their feeding and then learn their own hunger cues like signs of fullness which in turn can help in the longer term as they get older knowing their hunger cues and knowing when they’re full and not overeat. Then three, it can help with digestive issues. Gulping too much too fast or drinking too fast, they can take in more air which means they will be more gassy and more fussy and then we are like, “What’s going on? Why is my baby so fussy?” It’s because they are gassy most of the time. A lot of the time, babies are just not very comfortable when they have gas and they definitely express it and communicate that they are uncomfortable, so we want to prevent that. By pace bottle-feeding, we help to remedy that. 

Meagan: That makes total sense. Sometimes, I feel like when they are gasping all of that air, then they spit up a lot. This is not really one of the questions we talked about, but when a baby spits up, a lot of the time we see it, and it looks like a lot and we are like, “I can’t believe I just fed my baby and it’s right here on this blanket or all over myself.” Is there a rule of thumb to be like, “Okay, really, that is true. Every little ounce of that just came out?” Or is it like, “Okay, your baby still got quite a bit.” 

Crystal: That’s kind of hard to say because like you said, it does visually look more than it is which is why pace bottle-feeding is important because we want to take frequent breaks, little, quick breaks of a couple of minutes or so to burp, let that move down their belly, and get that excess air out, and then continue feeding. 

I always recommend that if your baby spits up and it looks like a lot, see how they’re doing and go by their cues. If it seems like they are looking for food again, try and give a little but maybe a smaller amount just to see how it goes. 

Meagan: Mhmm. That’s a good rule of thumb. 

Crystal: Keeping babies upright after feeding, if you can,  will help to lessen the chance of spit-up, but then again, sometimes babies spit up out of nowhere an hour after feeding. Parents are like, “I don’t know what’s going on. He spit up.” If that happens and you are burping your baby and keeping them upright after feedings, I would definitely talk to a provider because sometimes it can be the formula if they are drinking formula or something to that effect. 

Meagan: Mhmm. Yeah. Awesome. We’ve gone over so much. 

Crystal: I know. 

Meagan: I want to just end on The Mama Coach. How can people find you? What do you guys offer? How does The Mama Coach? I mean, I know how. It’s in amazing ways and who is a good, qualifier to go and find a Mama Coach?

Crystal: Yeah, like I mentioned earlier, The Mama Coach is a group of registered nurses all over the world. I am the owner here in Vacaville, California which is in Northern California. Our goal is just to help make parenting easier. Like I mentioned, we do have prenatal services. We have postpartum services and newborn services, helping with any type of feeding even if you are not breastfeeding. 

Meagan: Sleep?

Crystal: Sleep, yes. We have sleep. We help with newborn sleep, toddler sleep, potty training, CPR and choking classes, starting solids as well as one-on-one services here. For me, locally, I do home visits and home lactation visits. I can do any of the workshops one-on-one in home or virtually. My niche is breastfeeding– prenatal breastfeeding education and consultations as well as postpartum of course, newborn care, and sleep because those are all important things. 

Meagan: Very, very important things. 

Crystal: Very important. 

Meagan: You guys make it really, so easy. You just go to themamacoach.com. There is a “Find a Mama Coach”. You can search what you are looking for or you can type in your zip code and you can pull up all of the Mama Coaches near you and go over all of their services. I don’t think there is a single one that only does one thing. 

Crystal: No, we all pretty much do a lot. Yes, correct. Yep. For sure. If you are a new or expecting parent or even a parent of a three-year-old– any parent that is struggling and your baby is five years old or under, we can help you. I am on Instagram. My Instagram is crystal.night.themamacoach. We also have a website like you were saying. The main website is themamacoach.com. We each have our own individual sites as well and I’m sure we’ll post that information somewhere, but yeah. Reach out to any one of us and myself if you are in Northern California in the Vacaville area. We, like I said, almost all do virtual and then also locally in person too. 

I do ongoing workshops and that’s always posted on my website in the classes or on my Instagram. 

Meagan: So amazing. You guys are doing so much. You even have a blog where you can look specifically at pregnancy, newborn, sleep schedules, and parenting in general. I mean, these guys have amazing things so make sure to go follow. We’ll make sure to tag you today on our Instagram and our Facebook so you can go and find it. We’re going to have the website in the show notes. We’ll have all of the things we have talked about and seriously, thank you so much for helping our community because like I said, we don’t talk about postpartum as much. We don’t focus on it as much. We don’t focus on feeding and all of the things, so thank you so much for kicking off the 2024 season with a new type of topic. 

Crystal: Yes. Yes. Awesome. I was so happy to be on here. Thank you. 

Closing

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

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Meagan finishes out this year of podcasting by answering some of your most common questions! Topics range from the time between births, gentle induction methods, gestational diabetes, “just-in-case” epidurals, home birth, tips for having a successful VBAC, and how to cope if you don’t get your VBAC. 

“Women of Strength, I just want to thank you so much for all of your continued support. We love your support and we are so grateful that you are here.

I love you. I feel so passionate about helping you as an individual find the best path for you.

I want to help you walk through this journey and feel loved, supported, and educated.” 

Additional Links

Real Food for Gestational Diabetes by Lily Nichols

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello. Welcome to The VBAC Link. If you have been with us all year, I just want to say thank you and if you are new to joining The VBAC Link, I’d like to say welcome. Welcome to the show. This is the last episode of 2023 and it’s kind of hard to believe honestly. I went through all of our episodes and we have seriously so many incredible episodes. I am so honored for those who have come and shared their expertise and given us their time. 

I am so excited today to share this last episode of the year with the most common 2023 questions. We have some pretty common questions, but we have so many others as well. So of course, we have a Review of the Week. I want to dive into that really quickly before I get into those questions. 

Review of the Week

This is from cristab. It says, “I am a birth and postpartum doula who is always on the search for a birthy podcast to listen to in my car. I was so excited when I found The VBAC Link so I could listen to these amazing stories from women all over the world who have reached their goals through becoming educated thanks to Meagan and Julie. I’ve recently certified with The VBAC Link and as well, I’m so impressed with the thorough delivery in which their knowledge was shared in their training. I’m super excited to move into this next chapter of my career and I’m thrilled to do so with the amazing community and support.” 

Thank you so much and thank you for joining our family. Doulas, birth workers, birth photographers, if you love birth and you are wanting to learn more about VBAC and how you can support people out there who are wanting to VBAC, who are wanting to avoid Cesareans, and who are just needing support from the community, we have our VBAC Birth Worker, VBAC Doula birth course where we are going to teach you all of the things about VBAC as well as help you know what us as VBAC moms are up against. 

And parents, if you want to dive in and get more educated for your future birth, I highly suggest checking out our course. You can check it out at thevbaclink.com.

2023 VBAC Questions

Meagan: Okay, you guys. We have so many questions that we get all of the time. If you haven’t also joined us on Instagram, we do Q&A’s almost weekly. We love answering your questions even if it’s a question that we’ve had before. We’re going to get to it and we’re going to answer it. Here are some of the most common questions that we get. 

Number one on the list is how long after my C-section do I have to wait until I get pregnant? 

This honestly is a question that I think is personal. Now, there are suggestions out there by providers who are saying anywhere between 18-24 months is what we commonly hear, but we even have some providers who are like, “Yeah, cool. In 15 months, you can go on and have your baby.” There can be an increased risk of uterine rupture with a really small gap or duration. So if you have had a C-section and then three months later, you get pregnant, you may have a provider who is a little bit more skeptical or even six months later, you may have a provider who is a little more skeptical and talking about the risk of uterine rupture, but that still doesn’t mean that it’s not possible or impossible or that you are for sure going to rupture. 

I think a common rule of thumb is that 18-24 months, but again, it comes down to a very personal decision. If you want closer babies or it happens or whatever, I think that’s more of a personal choice, and then just finding the support out there to support you in your desires. 

I did a one-on-one consult with a mom back here in the fall and she had a six-month duration. She went from provider to provider to provider and they all said, “No. Absolutely not.” We got her in contact with another provider and they said, “Yeah. No problem. There is no reason.” I was so excited to get a text message from her after saying that she did it. She had her vaginal birth and she was so happy. That was a duration of six months. 

Okay, another question that is really common is, “Trying to go for a VBAC and really want to go into spontaneous labor, but her provider is saying they can’t go past 41 weeks.” They cannot go past 41 weeks. Now, I’m just going to say that I don’t like the answer to that. The follow-up question to that question was, “Should I switch my provider?” You know, we’re not here to tell you that for sure you need to switch a provider or anything like that, but if you have a provider that is putting stipulations on you like you cannot have a baby past this day and if you get to that day, you have to have a C-section, you may want to look into some other providers because that’s just not evidence-based.

Going past 41 weeks in general is something that has become more and more controversial, especially after the ARRIVE trial. We have episodes on the ARRIVE trial. We have blogs on the ARRIVE trial, so make sure to check those out as well. It’s kind of weird. They did an induction at 39 weeks for first-time moms to see if it would reduce complications like hypertension, preeclampsia, and even Cesareans. It’s kind of been since 2019, I feel like, more of a hot topic, but it’s actually pretty common for babies to go overdue. I am putting big quotes on this. “Overdue”, past 40 weeks. 

Know that if you have made it to 40 or 41 weeks, it’s very common and you’re okay. There are common things that a provider may do at 41 weeks. They may suggest a non-stress test just checking in on baby and making sure everything is going well, but it’s still okay. In fact, ACOG suggests, I think it’s 42 weeks, really. So, you know. At 41 weeks, you could still be pregnant or a week or you could have a baby in three days or even three hours. They have not really found any increased risk of uterine rupture or other complications necessarily like that after 40 weeks, however, there are things that can come into play where VBAC after 40 weeks may be lower or require interventions because there may be things like hypertension and things like that that come into play. 

But even if your provider is saying that you can’t go past 41 weeks and you have to schedule C-section, that right there is a red flag and something that would be concerning to me because induction is, which is also another question– can I be induced and have a VBAC or can a VBAC be induced? VBAC can be induced. It’s very reasonable. There are ways to do it. Some tips that I would suggest are doing as low and slow as possible. 

Now, we got a message back on one of the days that we did a Q&A from a mom saying that she did not believe that it was possible to do low and slow. I do disagree. I think that it is possible to do low and slow inductions. I’ve seen it. It happens all the time. You do have to sometimes fight for it and be educated so you can have that conversation and understand what that means. 

So let’s talk about low and slow meaning that if we are starting Pitocin, we are not upping it to 4 mL every 30 minutes. A lot of providers out there will suggest that. 4 milliliters every 30 minutes. Boom, boom, boom, boom. It’s a little overwhelming, first of all. Sometimes it takes our body a little bit longer to respond fully. Now, Pitocin, once it starts going in, it’s in the body, but it may not fully be responding so if we up it every 30 minutes and then we take 45 minutes to respond, then it may be too much, right? 

And 4 milliliters versus 2. So maybe you say, “Okay, let’s cut that in half. Instead of 4, we do 2 or even 1.” Sometimes there is a lot of pushback on that 1 because they are like, “Oh, it’s pointless. It will take forever,” but it’s still okay. It’s still okay so decide what milliliter is best for you and go for that. Fight for that. Low and slow there. 

Then another thing is avoiding breaking water or too many interventions all at once meaning we are going to place a Foley, start Pitocin, and break your water all at the same time. That is unnecessary. We really, really, really do not need to do that. That is just going to overwhelm everybody a lot of the time including the baby. 

But breaking waters. Breaking water in that earlier stage. Maybe we have– in fact, we are sharing a story. It’s coming up in 2024. I just recorded it not long ago where the mom was 2 centimeters and they broke her water. She wasn’t really contracting. They broke her water, started Pit, all of the things, and not a lot of progression. If we break our water early on, it’s not a guarantee that our body is going to go into labor, but a lot of the time, there is a selling factor of this breaking the water where it’s, “Oh, it’s the natural way.” 

Okay, all right. Breaking our water is natural. However, artificially breaking our water does not mean that that’s natural. That means that we are intervening and doing something that our body did not do at that point. So if we do that and we do that early on and our baby is high or our baby is in a weird position and then we have these floodgates open and the baby comes down, and the baby is in a wonky position, now we’ve got a poor fetal position, not a lot of progression because that often happens, a harder labor, a longer labor, maybe we’re introducing more interventions, so it kind of becomes a cascade. 

Maybe when I say slow, take it slow. Let’s not intervene with every single thing that there is possible in the labor and delivery unit. Maybe we just do a Foley or maybe we do Foley with a low dose Pit of 2 and we don’t up it from there. That’s it. That’s where we start. We wait for the Foley to come out and then we assess after that. Low and slow inductions and yes. You can be induced and no, you do not have to be induced at 41 or 40 weeks. 

So okay, one of the other questions– well, there are a ton, but one of the other questions I’m going to go to is about hypertension. “Can I still VBAC with hypertension?” So, yes. Absolutely, you can VBAC with hypertension. Sometimes, providers will come back and say that it can increase our blood pressure and things like that. It’s kind of weird. I don’t know if there actually is a study that shows this, but a lot of doula clients who have hypertension go to be induced, once they start labor, their blood pressure seems to kind of chill out. It’s kind of interesting. I do not know why, but yes, you can still have a VBAC if you have hypertension. 

So another question is, “If you get induced, does your risk of uterine rupture truly skyrocket to an insane amount?” We’ve heard people give us such crazy numbers like, “I have an 80% chance of rupturing.” I don’t know where providers are getting that, but no. Or, “I have a 60% chance or I have a 25% chance.” Now, if someone is telling you that you have these chances, I would like to challenge you to challenge them. Now, I never want to say to be combative and blah, blah, blah. That’s not what I’m saying, but I’m saying don’t be scared to ask, “Where do you get that information? Is there a link? Can you provide me with printed information on this topic or on this stat? I would like to see that. I would like to go over this so I can make the best, educated decision for myself.” If they are like, “Oh, well I don’t know. I don’t know if I can find that,” well, yeah. It’s because there’s not one. 

If there is one and you do receive that, will you please email me at [email protected]? I would love to see that. I’ve never seen a study that says that someone has an 80% chance of rupture because they have had a previous Cesarean. So statistically, uterine rupture really happens in about 0.4 to approximately 1%, maybe 1.2% depending on some providers and some studies. 

But overall, that’s pretty dang low. That’s really, really, really low. So if someone is telling you that you have a 60, 25, or 80% chance, that’s just not true.

Then another common question is about ways to avoid uterine rupture. Now, we don’t always know why uterine rupture happens. It’s hard to say exactly what caused that uterine rupture. I don’t know if you knew this and it’s very, very small, but uterine rupture can even happen in people who have not had a previous Cesarean. So that’s a thing too, but things that we can do are try to avoid those inductions that are absolutely unnecessary and if you do get induced, talk about those best methods like what we were talking about. We have a blog about that as well and we talk about that in our course. Really learn about those methods and avoid aggressive augmentation. 

Avoid Cytotec completely. That’s a big no. You know, and do everything you can to make sure that your baby is in a better position so maybe Spinning Babies, the Miles Circuit, hands and knees, do pelvic floor therapy so we can help our pelvic floor be in a position where we can push a baby out that way and things like that. 

Educate yourself. Listen to these stories. Attend our Q&A’s. All of these things can educate you so you can help reduce these things that may increase chances of uterine rupture like Cytotec or aggressive inductions. 

Okay, another common question is, “If I have gestational diabetes, can I have a VBAC?” Yes, yes, yes, and yes. Yes, if you have gestational diabetes, you can still go and have a VBAC. Sometimes, a provider may suggest an induction at 39 and I’ve even been hearing 38 weeks with gestational diabetes especially if it’s not managed well. One tip that I would highly suggest is really understanding gestational diabetes. Knowing that food and exercise and things like that can impact gestational diabetes and learning how to manage those if you can. 

Talking with your provider, understanding what they’re going to be looking for, what they’re going to be doing because that’s also going to help you stay more relaxed when you understand the process from them instead of just being caught off guard. I highly suggest checking out the book Real Food for Gestational Diabetes by Lily Nichols. We’ll make sure to put the link in the show notes as well, but that’s a really, really, really wonderful book to check out and it’s going to help you understand a little bit more about how to manage those sugars and just more about gestational diabetes. 

But also know that you do not have to be induced if you have gestational diabetes. You just don’t, but it’s going to be really common to have that be offered. 

Okay, so a couple of other questions that we get are, “I had failure to progress. Big air quotes, ‘failure to progress’ and my doctor is telling me that because my body didn’t do it the first time, it won’t ever do it again.” I’m sorry, but your provider is a big, fat liar. Such a big, fat liar. Just because you didn’t progress with one labor doesn’t mean you won’t with another one. Honestly, it’s more likely that you didn’t progress because of an environment, because of a rushed labor, because of a rupture of membranes artificially and baby was coming down so we got a wonky position, lack of ability to move during labor, and things like that. Progressing and trying to push labor on and it’s not progressing because labor wasn’t ready to begin– these are things that truly are going to be more of the reason for a failure to progress other than the reason that your body doesn’t know how to get to 10 centimeters. Truly, it does. 

Know that if your provider is putting doubt in your mind, that you can’t have a baby because your body didn’t do it before, you may not be with the right provider or you may have to fight hard. And again, it all comes down to, I think, finding that education and support. 

Another common question is, “Can I VBAC with twins? Is it safe?” Yes, you can VBAC with twins. Yes, it is safe. Sometimes, providers will have some stipulations as far as Baby A needs to be head down and Baby B is okay to be breech, or sometimes it’s like they both have to be head down. They might have some restrictions on that and a lot of the time, they will have you actually give birth in the OR. They’ll have you push and give birth in the OR, but yes. Research shows that a vaginal birth for twins is generally safer than a Cesarean, truly, even though some providers still discourage it. 

A podcast to check out is Dr. Stu and Midwife Blyss. They have an amazing, I think it’s Birthing Instincts, podcast and they talk about twins and delivery and things like that as well. 

Okay, so a common question is, “How can I prep? How can I prep for a VBAC?” I’m going to give you a couple of tips right here. I already have said it a couple of times, but your provider. Your provider is really, really, really, really important. You need to find a good provider, a provider that’s going to support you, a provider that wants this birth for you just as much, right? A provider that is not going to disregard you and pull out bait-and-switches in the end with non-evidence-based information to scare you and then make you feel like no one’s going to want to take you because you are already so late in pregnancy. 

Ask these questions before you settle in with a provider. Ask questions like, “How do you feel about VBAC?” not, “Do you support VBAC?” How do you feel about VBAC? Open-ended questions allow a provider to give you a lot of information without you even saying a word. If they stumble and say, “Oh, yeah, yeah, you know. I feel good. It’s fine. It’s fine. It’s fine.” Okay, know. If it’s like, “I actually feel like it’s a better option and this is something I would suggest and this is why. There are going to be pros and cons to it on both sides. There are going to be cons to having a VBAC for these. Here are the risks. There are going to be cons of having a C-section. Here are the risks.” Yes, there are risks to having a C-section. Also, if your provider ever tells you that there are no risks to having a C-section, that’s bullshit. I’m sorry. I’m saying. It’s the end of 2023. That is B.S. That is not true. 

So, talking to your provider with open-ended questions. How do you feel about VBAC? Another question, “How do you support your VBAC moms? What does that care look like?” If they’re like, “Yeah, totally. It’s just going to be like normal. We might check you if you go over 41 weeks. We might want to do an NST or we might want to do this,” or something like that and it’s lining up with evidence-based. Okay, that’s to be expected. If it’s like, “Yeah, no totally. We love VBAC, but you have to have the baby by 41 weeks. It has to be spontaneous. You can’t induce. You have to get a just-in-case epidural.” Those are all, again, the B.S. answers that are going to tell you that you’re probably not in the right place. Have open-ended questions for these providers. 

Number two– get the education. Educate yourself so that if you do have a provider coming in and telling you things that you are unsure of, you will have that resource to go back to and be like, “Oh, I actually do remember that and that’s not true,” or, “Yep, that’s right in line with evidence-based care.” It can also help you have a better discussion with your provider because you want that. They come in and they ask you. They say, “Do you have any questions?” They don’t really have a lot of time, honestly. These poor providers are overworked. They don’t have a lot of time, but too, it will help your time be better when you do go to those prenatals. 

I remember going and they were ten minutes long and it took a lot of energy to get there. I’m just like, “Why? What is the point of these visits?” Make a point to these visits. Ask these questions. Learn the education so you can have those educated discussions and get a better feel for your provider. They can get a better feel for you. They can learn that they can trust you also because you are educated. They are not going to second-guess you if you are saying no to something that they are offering to you in labor because they know that you are educated. 

Take a class. Listen to these podcasts. Read the blogs. Get into the Facebook communities. Learn about what people are saying. Read the links that are being shared. Education is important. 

Another way to prep truly is finding the support even outside of your provider. I feel like if you can have the support and the sounding board, it helps so much. With my VBAC after two C-section baby, I had it, but in places– I loved it in the places that I had it, but it lacked in the places that I wanted it, from my family and friends. That was really hard. I think that’s also another tip for where education comes in because you can help educate your family and friends along the way when they are like, “No. You can’t VBAC. No way.” 

Truly, finding that support is important, and also, prepping in a way that if you don’t have that support, let those people know that you love them with all of your heart, but unfortunately, you are not going to be sharing your desires and things. 

Nutritionally and physically, be healthy. Eat good food. Get good supplements like Needed. Drink your water. Stay hydrated. Make sure you are trying to get at least 30 minutes of walking a day and staying active. Of course, if you have certain situations, you want to always make sure with your provider that it’s all in line with your birthing plan and your personal situation, but taking care of yourself is truly important. 

As we have learned with Needed and things like that, we know we are not getting the nutrients. We know we’re not getting the hydration that we truly need every single day. If we can try and get that, it can help our pregnancy be better. It can help your birth be better. It can help in all areas and also mentally. I think if we are fueling our bodies with the right things, then we are truly going to be in a better spot. 

Okay, so another question that I have seen here and there and even more in the CBAC community is, “How do you deal or how do you cope with not getting a VBAC?” Now, this can be hard and this can be sensitive. Sometimes we have things in our head or we are told certain things and then it’s in our op report and we were led to believe something that actually didn’t happen or we were led to believe something that actually wasn’t documented. I think that’s a really good way to process. 

Really undersatnding that it’s okay to be mad or sad. It’s okay to feel those feelings, welcoming them in, and then working through the process step by step. I definitely think that knowing that sometimes we don’t know the answer and accepting that, we talked about that this year with our radical acceptance episodes. Sometimes not knowing the answer can hang us up and really, really impact us and bring us down, but knowing that sometimes we may not know the answer. We may not know the why. We may not know what happened and trying to accept that and let that go is really, really difficult. But trying to practice that radical acceptance is really powerful. 

Yeah. There are so many questions along the way that we have been asked, but these are kind of some of the most common. Another one, I think probably the last one that I will share today is about an epidural. “Do I have to have an epidural if I have a VBAC?” No, you don’t. No, no, no you don’t. You do not have to have a “just-in-case” epidural if you are wanting to go for a VBAC. You just don’t. It takes time to dose an epidural, so I think if you look at it and you think about it you’re like, “It kind of makes sense. Okay. They place the epidural. It’s already placed. That can take some time.” But then they have to dose it and then wait, what? Maybe it doesn’t make sense, right? 

Okay, so I’m just going to walk you through it. It sounds like it makes sense until you walk through it. So then they have to dose the epidural which then takes anywhere between 20-30 minutes to really work and get to a point where they can perform a C-section. So a “just-in-case” epidural, although yes, it takes the time of placing it, it doesn’t take the time of dosing. The “just–in-case” epidural is typically placed just in case there is an emergency. If there is a true emergency, they’re not going to have the time to dose the epidural and get it to a point that it is ready for you. They’re going to probably do general anesthesia at that point. 

The “just-in-case” epidural, I think, is just bull. I don’t like it. I don’t like when a provider puts a restriction on someone like that. Like, “You want to go unmedicated? Well, okay. Sorry, you can’t. You can VBAC, but you can’t go unmedicated or you have to have a ‘just-in-case’ epidural.” Do you have to have an epidural?

Another common question is, “Can I have a VBAC if I have an epidural?” Yes. Absolutely. Going unmedicated is not for everyone or if you want to go unmedicated and then you have a really long labor or something is happening and you decided to change your mind, that is okay. Women of Strength, plans change in labor. It changes all of the time. I see it time and time again through clients and through things. It doesn’t always mean the plan is to change from an epidural to no epidural. Maybe it’s from this to that. Maybe it’s, “I didn’t want IV fluids and now I need IV fluids because I can’t keep anything down.” It changes. Plans change, but yes, you can have an epidural with a VBAC and still have a VBAC.

Know that if you are wanting to VBAC, but you are not wanting to go unmedicated, you can still do that. If you are wanting to VBAC and you want to go unmedicated and your provider is telling you that you have to have an epidural or you have to have a “just-in-case” epidural, that is also false. Find what works best for you and it all circles back to education and finding the support in the provider and in the system. 

Okay, I lied. One more. Home birth. “Is home birth safe?” Yes. You can have a home birth. We have HBACs, home births after Cesareans, all of the time. We have them on the stories. We have them on the blogs. We have them on our Instagram. We see them in the community. Home birth is a reasonable option for VBAC. 

Now, the providers and ACOG are probably not going to suggest it. We go off of ACOG a lot, but know that these providers are probably not going to suggest and out-of-hopsital birth, but can you? Yes. Can you do it safely? Yes. Are there signs of uterine rupture typically before uterine rupture happens? Yes. Usually, do you have time to get to another location? Yes. 

So know that if you are desiring a home birth after Cesarean or even a home birth after multiple Cesareans like me, a VBAC after two C-sections, that is possible. It is totally, totally possible. 

Women of Strength, I just want to thank you so much for all of your continued support. We see it on Instagram. We see it on Facebook. We see it in our group. We get it in reviews here. We love your support and we are so grateful that you are here. We truly are here for you because we love you. I know I’ve said this before. It’s weird for me to say I love you because I’ve never met you, but I do. I love you. I feel so passionate about helping you as an individual find the best path for you whether that is VBAC, whether that is CBAC, whether that is unmedicated, medicated, in-hospital, out-of-hospital, inductions, or spontaneous. I don’t even care what type of birth you have. I want to help you walk through this journey and feel loved, supported, and educated. 

So again, if you are just with us, welcome. I’m so excited for 2024. We’ve got so many amazing things coming. If you have any questions about anything we offer on our podcast, our course, our blog or anything like that, always know you can email us at [email protected]. If you’ve been with us and you’ve had your VBAC or you are still working for your VBAC or you are a birth worker or whatever it may be and you are with us and you have been with us forever, thank you from the very, very, very bottom of my heart. I truly love you and I’m so grateful that you are here. We will see you in 2024. 

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 feel that what I would like to add to this radical acceptance part two episode is that yes, it is so important to feel all of the feelings, not judge them, and give them space to exist so that you can work through them and move on, but it is also equally important for you to not live there. 

You cannot live with those feelings 100% of the time, 24/7. You have to allow yourself space to get out of that funk, go enjoy life, and feel happiness, light, and joy.”

Women of Strength, we love you. We are proud of your healing journeys. We wish all the light and joy for you in this difficult, wonderful, exhausting, and rewarding season of motherhood. We are here for you!

Additional Links

The VBAC Link Podcast: Episode 251 Radical Acceptance Part One

Julie’s Website

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello everybody. You are listening to The VBAC Link and guess what? Julie is with me today. Hi Julie. 

Julie: Hi. 

Meagan: She’s actually looking right now for a message. We are going to do a Part Two of Radical Acceptance because we got so many messages on our social media and in our inbox and then even actually, some people who have my personal cell phone texted me about it and was like, “This episode did so much for me.” 

We are excited to have a little follow-up. Julie did get a message in her business inbox, right? 

Julie: Yeah. 

Meagan: We are going to read a little bit about that. 

Julie: Yes, so if you are coming in hot right now for the radical acceptance part two, you should go listen to the radial acceptance part one if you haven’t already. It’s episode 251, so go back, and yeah. It was such a good one. I got a couple of people reaching out to me as well on my business Instagram sharing about it and how much it touched them or helped them. 

I’m going to read this review that somebody– well, it’s not a review. It’s a message that somebody sent to me. 

Meagan: It’s a message and it’s in place of a Review of the Week. We are reading one of the messages that Julie got on her account. 

Julie: Yeah, since we are doing Radical Acceptance Part Two, we want to read a message from Radical Acceptance Part One. She said, “Hey, I listened to the radical acceptance as well as your episode about home versus hospital birth–” That is also a good one. 

Meagan: Yes, it is. 

Julie: “I wanted to thank you for sharing. My son’s first birthday is tomorrow and I feel I got completely railroaded by the medical system. With this birth, I so appreciate you and Meagan sharing your stories and giving me hope that there is light at the end of this tunnel.” 

I love that. It makes my heart happy. Obviously, since I’m not actively doing The VBAC Link or anything anymore, I don’t get as many people reaching out or whatever to connect in that capacity. 

Meagan: You don’t see these messages. 

Julie: I don’t see it, yeah. So it’s always fun when somebody pops into my Instagram DM’s and gives a little shoutout, so that was super fun. Thanks for that message. I don’t want to say the name just in case because it wasn’t a public message, but anyway. So yeah, we’re going to talk a little bit more about radical acceptance as a follow-up and then I don’t know what you would call it, like an addendum to it. Let’s do it. It’s going to be good. 

Meagan: It’s going to be so great. Even after that episode, it’s been weeks now, months. I’ve had situations and I’m like, “I need to practice radical acceptance. I need to practice radical acceptance.” It’s so powerful and it’s so easy to use, I think, in all things in life. 

Julie: Yeah, everything. 

Meagan: Yeah. I think this episode is going to be super fun to follow up. 

Julie: Yeah.

Meagan: Okay, you guys, it’s almost Christmas and we have had so many amazing episodes, but like we were saying in the beginning, this episode is piggybacking off of one of my personal favorites that Julie and I have done together all year. 

So we’re going to get into it. Julie, you said that you had a story. Do you want to start off with that or do you want to talk about feeling everything, and what we were talking about a little bit?

Julie: Yeah, yeah. I’ll share the story because it’s a good segue into the little addition or whatever to it. So I was at– well, it’s two stories really. So anyway, I was at a birth circle, and pregnancy group down near me and I like to go every month because I like to meet everybody and adult interaction is always fun because being a stay-at-home mom or a slave to your computer all day can take its toll. I go to socialize and meet people and things like that. 

One of the girls there had her baby and her birth didn’t go as she wanted. This was her rainbow baby. She had a late-term loss with her previous pregnancy, then this pregnancy started taking some– not scary turns– turns where you are just like, “Oh, now we’re a little bit worried about the health of mom and the health of baby.” 

She has a lot of stuff to work through already going into the pregnancy, right? Then the birth, the baby was healthy and everything was well with them physically, but she was triggered by how the birth went. There were some traumatic things that happened during that birth too. She was well-respected and well-cared for. She had a great birth team. All of those things are great, but she left trying to process the whirlwind of this birth along with still holding onto the loss of her prior pregnancy. 

At the end of the circle, she took some time to share her thoughts and feelings. She was like, “Guys, I just need help. I don’t know how to process through this. I don’t know how to get through this.” She was like, “I just don’t know what to do.” 

So me, being the talker that I am, I just told her kind of similar things that we talked about in the radical acceptance episode and said, “Just allow yourself to feel it. The fastest way to get through it is to feel it and sit with it and let it happen and be. Don’t judge it. Don’t give it a morally right or morally wrong. Your feelings are not morally right or morally wrong. They just are. You need to let them be. You don’t have to judge them or assign them or logic them or anything. You just have to let them be.” 

She was like, “I am getting really good at feeling all of the things.” She was like, “I’m doing really good at feeling everything. I just don’t know how to get out of it. I feel like I’m stuck here in this cycle of feeling.” 

It took me to this other conversation that I had with somebody who was similar. Similar things, we all have things. We all have things that we need to work through and process and deal with and radically accept or whatever, right? But it was another conversation I had with a good friend who was going through some really, really hard things. He actually ended up in a really bad, downward spiral and ended up checking himself into a mental health facility for a couple of weeks to do some trauma work and get on the right medications and stabilize himself. 

When I talked to him after he came out of the things, he said that his problem was that he was spending all of his time in the feeling bad and miserable stage. I don’t know if the right word it wallowing, but he was wallowing in that discouragement and that frustration and in that sorrow and in that struggle. He was allowing himself to live there. 

Meagan: It’s consuming. 

Julie: I think that other friend too, yeah. It was enveloping his whole life. I feel like my friend who was at the birth circle was in a similar situation allowing herself to be overcome by all of these feelings. It’s a tricky balance, right?

I feel that what maybe I would like to add to this radical acceptance part two episode is that yes. It is so important to feel all of the feelings and not judge them and give them space to exist so that you can work through them and move on, but it is also equally important for you to not live there. You cannot live with those feelings 100% of the time, 24/7. You have to allow yourself space to get out of that funk and to go and enjoy life and to feel happiness and light and joy. 

You have to give yourself space for that because if you don’t, you’re going to end up in a downward spiral and you’re never going to come out of it. I mean, probably not never, but it’s going to be a lot harder too. 

I told my friend at the birth circle, I’m like, “You can’t live there. You can’t live there so go and do something fun. Go to a show. Go to a movie. Go paint pottery or get a massage or go on a hike with your kids or something like that to create joy and allow space for the light to enter even though it might feel really hard. You have to give yourself a break from feeling all of those things.” 

Meagan: Yeah. I think that it can be hard sometimes to recognize that you need that break because we are “wallowing”. 

Julie: I know that it’s a horrible word for this context.

Meagan: But it’s really easy to get there. It’s really easy to be in that space. Sometimes, like the message that you got. She was realizing that there is a light at the end of the tunnel, but sometimes that tunnel is so dark that we see no light. 

Julie: Well, and sometimes we don’t think that we don’t deserve the light. 

Meagan: Yeah. 

Julie: Right? We’re like, “Oh my gosh. I made bad choices. I should not have done this. I deserve to feel like this,” and then we live there forever. I did. I can recognize moments of my life where I was so living in that darkness because I thought I was not worthy of the light. I got chills right now. I feel like we have all probably been there in one context or another. 

Meagan: Yeah. To some people, that thing that caused us to get there may be minute, right? Just tiny, tiny to somebody else, but it’s huge to us. It’s the same thing, so it goes back to not judging and understanding that everyone is going through their own journey and not judging. There are some things that you could be like, “Why are you upset about that? That’s not that big of a deal.” 

Julie: You have done that to me before. 

Meagan: I’m sure. 

Julie: I have done that to you before too actually. 

Meagan: It’s hard because I don’t understand, but it’s not up to another person to understand it. It doesn’t matter if they don’t understand. We are going through it, but we also have to understand that, okay. We feel this. We see this. We recognize this. Now, let’s get out and not, like you say, live in this feeling and let that feeling consume us. 

Julie: Well, and it’s so important. You keep going. I have a little ritual I was going to tell you about. 

Meagan: You’re just fine. I was just going to say that back to the first episode when we talked about, were our Cesareans needed? 

Julie: We have no idea. 

Meagan: I just had an interview with a mom this morning who had some hypertension. Not preeclampsia, just some hypertension at 36 weeks. At 37 weeks, she went in for her visit. Still hypertension, again, no preeclampsia or anything like that but they said, “We have to induce you today.” 

You guys cannot see Julie’s facial expression right now, but she’s like, “Oh, yeah.” 

Julie: Sorry. 

Meagan: But yeah, I was listening to this story and I’m like, “Okay, well do you remember what your numbers were?” Anyway, she had hypertension. She agreed to be induced. They did all of the things and after not very many hours said, “Well, this is probably not going to work. We’d better have a C-section.” Had a C-section, and things all happened. 

She was saying, “At this point, I’m at this spot of, was any of it necessary? Was an induction necessary? Was breaking my water at that time necessary? Was this necessary?” Those things, if we are just living constantly in the hamster wheel of questioning, it can make our hamster wheel dig right down into the dirt and like you say, we have no light. 

Then we start shaming ourselves because it’s like, “Well, I should have known more.” Right? 

Julie: That’s one exhausted hamster, Meagan.

Meagan: You know me and my hamsters, Julie. 

Julie: I love it. 

Meagan: But then there’s no light. We’re blaming ourselves and not deserving the light because we’ve dug it so far. I’m not saying this mom is that deep or anything like that. I’m just saying things like that can make us go so far down and so dark. It’s really hard to get out. 

Julie: Yeah. My gosh, I get that. I see that pattern in my life in all parts of my life. This is the part where radical acceptance comes in. I have gotten to the point where, yes. I have accepted that I will never know if my C-section was necessary or not. I mean, it probably was. I know the baby needed to get out so the induction was necessary, but I don’t know. Who really knows? 

But there are just so many other things in my life. It’s really funny because my C-section baby is now 10 and he has some things that he’s struggling with, like some mental health things. He’s in therapy and we talk. Every once in a while, I let my mind wander and I’d be like, “What did I do in his early life to cause him to have these struggles right now?” 

If I let myself get into that spiral, I would be a hot mess. I probably didn’t do anything, but I might have. I feel like all of our kids are going to need therapy at some point because we’re going to mess them up in some way. We all try to do better than our parents. I don’t know, maybe not all of us, but I try to do better than what I was given. I want my kids to have a happier life and be more successful and be happier and not have to deal with all of the struggles that I did. At the same time, I realize that in the struggles is where we grow. 

Meagan: Exactly. 

Julie: A muscle that does no work doesn’t get strong. You have to strain the muscle in order for it to grow and become stronger. That’s where the repair happens. When the repairs are happening, that’s when the strength comes. He’s probably going to be fine. He’s a great kid. I love him. But every once in a while, my mind will start down that path and I have to correct it and be like, “We’re addressing things now. It doesn’t matter what happened in the past. We’re going to live in this moment.” 

I wanted to share this ritual of something that I do before a birth sometimes when I enter the birth space that I think could probably help in this context. Sometimes it’s really, really hard when you’re in a funk and you’re in a mood and you’re living your life in a state of regret and in unworthiness and you feel not worthy of the happy things or you feel like you’re never going to be happy again, how do you get out of that?

This came to my head while we were talking. Sometimes, in fact a lot of time, when we get the call to birth as a doula and as a birth photographer, it’s not a convenient time in our lives. 

Meagan: No. You can say that again.

Julie: It’s 3:00 in the morning. 

Meagan: Or a soccer game. 

Julie: You have to leave a soccer game or you have a football game. Okay, so it’s been eight football seasons since I started birth work and I’ve only had to miss one football game. I got to watch it while my client was in the OR while my client was doing her C-section. I turned it on while my client was in her C-section. That was a few years ago, but anyway. 

It’s not a convenient time. Sometimes, you are in the middle of a fight with your spouse. And it’s fine because we do this work. There are lots of other great things about it, but sometimes, it is hard to separate your mind from the rest of your life before you go into the birth space especially if you are in a bad mood or having a hard day, you don’t want to walk into that birth space carrying all of your baggage. You just don’t. 

I have this thing I do when I’m on my way to birth or when I get to the parking lot unless mom is pushing, then I’m running my butt into the room as fast as I can. 

Meagan: You can’t even think about anything that’s happening in your life at that point. 

Julie: Yes, exactly. It gets shoved down. What I like to do and what I think is applicable here is after I park my car, I sit down. I take some big breaths in because we know that big breaths give oxygen to all of your body parts and help you. I just like to put my hands to my forehead and just pull out what’s going on in my life. I put it in the seat next to me. I physically do this because that physical motion helps so much. 

I’m like, “Okay. You are not forgotten. I’m going to leave you here until I get back and until I’m done with my work. I am pulling my thoughts out of my head and I”m putting them in a little package on my passenger’s seat.” I will be like, “This argument with Nick (my husband), I’m going to get to when I get back. This problem with football, if BYU is losing or whatever, I’m going to leave you right here and I’m going to talk crap about it to Nick when I get home. This problem going on with my son and if he’s going to make it to therapy today, I don’t know, but I’m going to leave you right here on my seat. I’m not ignoring you. I’m not trying to brush you off. I’m leaving you here so that I can pick you up when I get back or when I’m ready for another thing and when I’m ready to talk to you again. 

I feel like that practice might be helpful in these circumstances. You can feel your feelings. You have to feel them to get through them, but when you need a break, when it’s time for that reprieve and that joy and that happiness, pull them out of your brain. Put them in a little box in the passenger’s seat of your car, next to your nightstand, or whatever, and say, “I hear you. You are here. You are real. I’m going to feel you later. Right now, I need a break to go be happy.” 

Meagan: I love that. I love that. And yeah, like you said, we can apply that to anything. I think when we are preparing for a VBAC, there is a lot of clustered thoughts happening in our mind. We’re thinking about who to find as a provider, if we should hire a doula, if we can afford these things, where we should birth, if my risk is okay, and if this risk is okay with me. We’re going through all of that and then we have all of the outside people saying, “You’re going to what? You can’t. How would you even dare?” 

We already have the pressures of our everyday life, and then we have the other static on top of it when we are preparing for VBAC. I remember multiple nights, especially during pregnancy when I couldn’t even fall asleep because I was so wrapped up in my mind. To be able to pull that out and be like, “I’m going to set that right there. I’m going to rest so I can come back to you with a fresh mind so I can tackle this saying or tackle this topic with a fresh mind and fresh body.”

Again, like you said, you’re going into a birth. You’re removing these thoughts. You’re going into that birth. You’re holding space for that birth. I think that’s important to note. We have to hold space for ourselves. We have to. Like Julie was talking about being worthy of even having that light, we have to be worthy of giving that to ourselves and saying, “We’re going to stop. We’re going to take a minute and put this over here. We will come back when I’m ready, but until then, you’re just going to be right over there.” 

Julie: Yeah, absolutely. Yes. I love that. Sorry, I’m trying to collect my thoughts. I think it’s really important that you allow those feelings 100% of your energy and that space, but you can’t give it 100% 100% of the time. It’s important to allow yourself that space and that break. Carve times in your life. Maybe you have an hour a day where you allow yourself to feel and address and work with those feelings or something like that. Maybe it’s before bed after the kids are in bed and you have some quiet time. 

I don’t know about you, but sometimes my self-care is when I get home, I sit in my car in my garage for 5 or 10 minutes before I go into my house to kids and dogs and husband and chaos and everything. I allow myself that break between driving and doing the activities to go back. Do you do that? I feel like moms do that. 

Meagan: I totally do and then my husband or my kids will open the garage door and be like, “What are you doing?” 

Julie: Open the door and be like, “What are you doing?” 

Meagan: “I heard the garage door open 5 minutes ago.” I’m like, “I am sitting. I am just holding my own space for 5 minutes.” 

Julie: Yes, regrouping. Yes. It doesn’t have to be an hour. It can be a few minutes here and there and when you’re in it and when you’re feeling it, it’s important to give it your 100%, but don’t do it 100% of the time. 

Meagan: Well, on that note, we will end with that. But know that is exactly what she was saying, you don’t have to feel it 100% of the time. It’s okay to take the moments. You do not have to live in this feeling. There is a light at the end of the tunnel. 

If you are in this space, know that we are here. We are here. If you have a question about VBAC and you want to get that thought out of your mind and that is to get that question answered, email us. Write us on Instagram. Comment on these podcasts on your platform. We get them. We would love to talk about it with you and help you clear out the thoughts and the feelings and the emotions. We’re not therapists, though. I remember Julie said that in the beginning. We are not licensed therapists. We are just two ladies who love birth. 

Julie: Yes. This is not taken as medical advice. 

Meagan: None of our VBAC Link team members are trained and skilled in therapy or anything like that, but I just think these messages are powerful and thank you so much, Julie. 

Julie: You’re welcome. Always 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.

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

Here at The VBAC Link, we want to empower you with better birth experiences AND better postpartum experiences. The Lactation Network does just that. 

Caitlin McNeily is Vice President of Consultant Relations at The Lactation Network, working closely with thousands of International Board Certified Lactation Consultants in all 50 states. Her background in medical device sales led to the creation of Ashland Breast Pumps. It was through this work– connecting with new parents desperate for help– that led to The Lactation Network.

Chrisie Rosenthal is an International Board Certified Lactation Consultant and Director of Lactation Content and Programming at The Lactation Network.

She has helped more than 7,000 families through her successful private practice, The Land of Milk and Mommy. She's worked alongside large pediatric practices in Los Angeles and as a hospital-based IBCLC. In addition, Chrisie is the author of two best-selling breastfeeding books: Lactivate!: A User’s Guide to Breastfeeding published in 2019 and The First-Time Mom’s Breastfeeding Handbook: A Step-by-Step Guide from First Latch to Weaning published in 2020. 

Caitlin and Chrisie are both moms who had breastfeeding struggles of their own. They are passionate about helping other moms have the care and advice they wish they had!

Additional Links

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, Women of Strength. We have an amazing episode today for you with our friends, Caitlin and Chrisie. They are from our favorite, The Lactation Network, and are IBCLCs with The Lactation Network. 

We are going to get into the topic of how The Lactation Network came about but also, all of the questions and what it means to work with The Lactation Network and an IBCLC. We talk so much about preparing for birth and then birth. We talk a little bit about postpartum. We are starting to get more into postpartum because it is a really important topic, but this is a topic that is near and dear to my heart because I have had three babies and three pretty different experiences. I’ve had some challenges along the way, so we are excited to welcome our guests today talking about breastfeeding and pumping and going back to work and all of the things and what it looks like to work with an IBCLC through The Lactation Network. So, welcome ladies. 

Caitlin: Thank you. We are so excited to be here. 

Chrisie: Thanks, Meagan. 

Meagan: So excited to have you. I think maybe we can just start off right off the bat with what is TLN? We’ve been talking about it for a little while now, but what is The Lactation Network? How did it start and where are you today? 

Caitlin: Yeah. My name is Caitlin McNeily. I am the VP of consultant relations at TLN. TLN stands for The Lactation Network. We are the largest network nationally in the U.S. of IBCLCs, lactation consultants for short, but IBCLC stands for Internationally Board Certified Lactation Consultants. 

I am based in Chicago and have been with TLN since its inception and have seen it through a couple of iterations and have watched it grow as my fourth baby, as I sort of lovingly refer to it as. I do have three kiddos of my own– 13, 11, and 8. I had very different nursing experiences with all three of them. All three of them were C-sections and all of those were equally as different. 

So you know, when starting TLN, so much of it was very much in my wheelhouse at the time. I was pregnant with my third baby and going through that whole process. I wish I knew then what I know now about all of the amazing support that a lactation consultant can offer. 

The way that TLN was born, I think, is relevant to cover briefly but essentially when the Affordable Care Act mandated coverage of breastfeeding support and supplies, I was brought into a company to start a breast pump, what we call a DME which is a durable medical equipment company. I won’t get in the weeds there, but essentially, we provide equipment directly to patients and we handle the insurance component. 

It started with the breast pump DME, getting parents the essential tools that we need, certainly in the U.S. with limited maternal leave. We certainly need breast pumps if we expect them to continue their breastfeeding journey. 

That was where the business really started. Roughly 12-18 months into that endeavor, a lot of these parents were calling me back postpartum saying, “Hey, you were really helpful at getting me a breast pump, but now I’m really struggling with my breastfeeding journey. Can you help me?” I myself am not clinical, so it wouldn’t have been appropriate to try and troubleshoot their nursing issues. I leave that to the experts now. 

At the time, what happened was I reached out to an IBCLC locally here in Chicago and started sending her on some visits. Now, because the Affordable Care Act mandates that this care be covered, it was seemingly going to be a smooth transition from breast pumps into breastfeeding support. There is some lack of understanding, a lack of a pathway into insurance reimbursement for lactation care and I met that head-on by working directly with insurance providers and working through some new pathways that they could adopt to be able to cover this care for patients. 

As soon as there was progress made there with some insurers, we were sort of off to the races. Then what happened, was more lactation consultants were hearing about us. I was reaching out to more lactation consultants around the country as our patient base started to grow. It was very much an organic growth process, very supply and demand if you will. 

Now, our first visit was in 2016 so fast forward to 2023 and we’ve helped over 300,000 individuals with their breastfeeding journeys. 

Meagan: Wow. 

Caitlin: Yeah. It’s a huge nod to the exceptional care of our IBCLC network. It’s also really just standing up the reality that parents in this country deserve lactation care. I think a lot of times, we get very stuck in the conversation or drama or consideration around breastfeeding when the reality is lactation care is human health care. 

When you birth an infant, you are going to experience lactation on a variety of levels and in a variety of facets. However, this is a physiological and biological reality of the birth process and bodies that birth babies and lactate deserve healthcare surrounding that. 

Meagan: Amen. 

Caitlin: That is just our steadfast mission is to make this care accessible to all birthing families. 

Meagan: I love that so much. I love that you say lactation care in general because we are all going through different experiences. We all have these babies and then we are like, “What do we do with these things that are making milk? How do we feed these babies and how do we go back to work?” And all of the things, right? I love this network so much. I can literally scream it to the rooftops, you guys. This is amazing and it should be something that everyone gets. 

So you work with insurance, but are there still insurances that maybe aren’t quite there yet? How does that factor in? 

Caitlin: Yeah, yeah. That’s an excellent question. We are dogged in our pursuit of expanding lactation care within insurers that we do work with currently and expanding it into different pairs that are not currently working directly with The Lactation Network. We have no intention of stopping that mission or slowing down that mission. Our goal is to hold insurance companies accountable for this very essential care. 

The economic argument, the healthcare outcome argument– these things are black and white. There really is no gray area as it pertains to the benefit of taking care of lactating parents. In addition to insurance, understanding the importance of this care and the true economic value of this care, employers are starting to perk up as well meaning they want to make sure that when one of their parents goes out on maternity leave that they are set up for success in this arena because the statistics of predominantly women of childbearing age dropping out of the workforce to take care of their infant and their health and their mental health and their homes and all of those things. 

It can’t be overstated how beneficial it is for employers to take care of their employees in this capacity. They will have easier times recruiting. They will have easier times retaining top-tier talent. This generation of women having babies and families bringing babies into this world are very contemplative when they choose what business they want to enter into agreements with. So much of that right now is based on the benefits base. They want to know that their employer is going to support their endeavors at home to keep them productive at home and happy at work.

Meagan: Oh my gosh. Yeah, when I was working, I had my daughter and then I went back to work. I just remember the stress of, “How am I going to do this? How am I going to pump and keep my milk supply and feed my baby and do all of these things?” At the time, my work was like, “I guess you could go in the back storage room.” That was about all they gave me, then I was like, “Okay, well the milk has to be refrigerated.” They were like, “No. You can’t. No. Bring a cooler.” 

So every day, I was trucking in this big pump and this cooler and all of these things. It would have been so nice to have more of that support. I probably would have stayed longer-term maybe. I don’t know but it would have been nice to not feel– I mean, I still felt more support than I know some, but I still was like, “This is weird. They are not gung-ho about this.”

Caitlin: Yeah. It’s not ideal. 

Meagan: Yeah. It wasn’t ideal. 

Caitlin: It’s not ideal. Yeah. I think to paint the picture of what is available through The Lactation Network for those types of parents, it doesn’t matter if you are staying at home or going back to work. It’s not a one-size-fits-all-all, but the lactation care cadence that should be commonplace is that it should be preventative. That is where it falls in the Affordable Care Act. This is preventative care because as I mentioned before, your body is going to do this. 

Much like we go to scope out a pediatrician prior to the baby being born and then we go for our 7-day check-up and all of these things, we are really passionate about trying to shift the paradigm to match that type of preventative care as it pertains to lactation. What that can look like is a prenatal visit, a 3-day postpartum visit– so the day after you get home from the hospital, and then we can have adjustments because baby adjusts so much as your milk comes in and those first two weeks are so substantially different. You can have a troubleshooting visit. You can have a plan to go back to work and create a pumping schedule visit, storing milk. 

Occasionally, we’ll run into a case of mastitis or clogged ducts. Oftentimes, when a parent goes back to work, their milk supply can drop a little bit. It can be just trying to engage in a new schedule with your breast pump, engage in a new schedule with waking up early, stress,  hydration, and eating at work. Those things can all play into your milk supply. Working directly with a professional to a) set your mind at ease, but also to adjust that plan accordingly. 

Those visits can go all the way through weaning. This is really a journey. It’s a personal journey and this is where I would love to kick it to Chrisie because we are so fortunate to have her at TLN. She is just a top-notch human being and IBCLC on top of it. I think she can shed some light as to why TLN is so passionate about the IBCLC certification and why we only work with IBCLCs. 

Meagan: Yeah and more even on what IBCLCs truly do. We are talking about what those look like, but what more do you do, Chrisie, for parents? 

Chrisie: Yeah, thank you, Caitlin. I’d love to start with just what an IBCLC is because I think that there is a lot of confusion in the space of lactation caretakers to use that word, right? Lactation providers. IBCLCs are unique in that we are the highest credentialled healthcare providers specializing in lactation. We are truly the gold standard. 

One of the things that exists– and I always say that I love all of the supporters. I love all of the educators. There is a place for everybody, but I think it is important for families to know what differentiates an IBCLC. IBCLCs typically, it takes about 3-5 years to become an IBCLC. That includes a program that takes 90 hours of education in human lactation, coursework in 14 health science subjects, 300-1000 hours of supervised clinical experience, and then passing boards and recertifying every five years. It is definitely an in-depth program and process. 

Meagan: Very. 

Chrisie: Yes, absolutely. At TLN, we only work with IBCLCs. I think that’s important to mention. We connect these families with that gold standard in lactation care. As IBCLCs, we are working with the pediatrician and with the OB. We are focusing on the parent-baby diad and what breastfeeding looks like. Consultations definitely differ from LC to LC. We all do it a little bit differently, but in a typical consultation, we’re going to meet. We’re going to go over your medical history. We’re going to do an in-depth, deep-dive into how feeding has been going. 

We will probably observe a feed if that’s applicable. We’re going to talk about your feeding challenges, your feeding goals, where you want to go, and what’s getting in the way of that. I always make lots of space for parents to ask whatever questions are on their mind and make sure I share evidence-based information, then at the end, we’re going to create a plan for a follow-up and a plan for how to get from A to B and solve whatever issue it is that we are looking at. 

That’s typically what a consult looks like. As I said, we’re all a little bit different. I stay in touch with my patients in between consults. You know having been there that questions pop up all the time, just little questions. How long can I leave breastmilk out for? Just little things, especially if you’re a first-time parent. I always say that even for parents who have done this before, every baby is different. Every breastfeeding experience is different so as Caitlin said, really think of LCs as being there from beginning to end, from prenatal to weaning is so important. We know that it makes an incredible impact on the breastfeeding journey for parents and for babies. 

Meagan: Oh my gosh. Yes. I mean, I wish because I had a baby and then I was meeting with an IBCLC days later but I was already days behind in engorgement and a really upset, hungry baby. It wasn’t that I couldn’t feed my baby, it was just that my boobs were really rock-hard. I remember when I met with an IBCLC, she was like, “It would be really hard for you to latch onto a rock,” with my mouth like this. She was like, “We’ve got to soften these up.” I was like, “I don’t even know.” I was just a mess. If I had had that care before I had my baby, we would have been able to do exactly what you said– go over my plans, go over my goals, and come up with things to look for and what to know, then I would have had your help way before I was days past my breaking point of my husband being like, “I’m going to the store,” and I’m like, “I just want to feed my baby!” 

Chrisie: Exactly. I think that happens all the time, Meagan. I think that families are starting to take prenatal breastfeeding classes which is amazing. I always recommend my families do that. I think a piece that really needs to come to light is the value of prenatal consultation. It’s exactly what you are talking about. Meet with your IBCLC one-on-one consultation before baby is here. I highly recommend doing it if it’s not your first baby and if it’s your second baby. Talk about what happened last time. Talk about a plan for ideally how to avoid those speed bumps the next time.

Also, if this is a new IBCLC to you, you’re going to get a chance to connect with them before the baby is here and find out how they work and find out if you will work well together. Is this the person you want to support you in your breastfeeding journey? But to your point, we’re also going to talk about how to navigate those first few days, how to reach out for help, when to reach out for help, common speed bumps that happen including engorgement which you just mentioned, and how to navigate that. It really lays the foundation for getting off to a good start. 

Meagan: Absolutely. I just think it’s so beneficial and what’s so great about The Lactation Network is that it’s really so easy to get a consult and get going. You’ve made it so easy. It’s a matter of clicking, filling out a form, and starting your consultation. Right?

Chrisie: Yeah. We have IBCLCs across the nation in every state. If you don’t have an IBCLC, we will connect you with one. We will check your insurance to make sure we can get you covered, then right. It’s just a matter of scheduling. The other thing that I think is really important to mention is that IBCLCs practice in different ways. We have IBCLCs who do home visits, who have offices that you can come to, and who do virtual consults. Many of my families like a combination of those. They might start off with an in-person but then maybe move to some virtuals for follow-ups. There are lots of different ways to do this. 

I also think that sometimes people if they don’t know what to expect in a lactation consult, they might feel like– I’m just going to give you an example– they have to do a feed or maybe they have to do a feed virtually and that’s not always true. I think maybe they picture a very invasive physical exam. That is not true. 

So I also think that another thing that comes up is home visits. Sometimes people worry about, “Oh my gosh, postpartum. My house is a mess. I don’t want anybody to come in.” Oh my gosh. Don’t worry for a second about that. That is the farthest thing from our minds as LCs. We will come to you in the space that is most comfortable for you, take care of you, and make sure you have all the information and support that you need. 

Meagan: And truly make our lives easier and take out the question even before birth. There are different types of birth. Even like Caitlin just said, she had three C-sections. I’ve had C-sections. There are vaginal. There is VBAC. There are unexpected C-sections and planned C-sections. There are a whole bunch of things that happen in birth. We know that medication, fluids, and all of the things that happen– trauma responses and all of these things can impact maybe how and when our milk comes in. 

Then also, our mental state. I remember with my first, I came out of my C-section and I just remember being in my hospital room dozing off, coming up, and then there was a new person holding my baby. Then I’d doze off and wake up and then a new person was holding my baby. All I could think was, “What’s going on?” That’s all I could think, not, “I need to feed my baby. Everyone needs to leave. How do I feed my baby? I’m not awake enough to feed my baby.” 

You know? Should I have started pumping? There are all of the things. Do you guys have any tips even before scheduling a consult that would maybe say, “Hey, look out for these or do these things? Different births can impact the way that milk comes in and things like that.” 

Chrisie: Yeah, I think it is important to acknowledge that especially in the first few days how the birth that you have absolutely does impact your early breastfeeding experience. In fact, I recently found a study that points out that women who deliver by VBAC are 47% more likely to initiate breastfeeding than women who deliver by a scheduled Cesarean. 

Meagan: Whoa. 

Chrisie: I know, right? I felt like that was a little shocking when I saw that. We know that women who deliver via Cesarean birth are more likely to experience early difficulties with breastfeeding. They are less likely to have their baby to breast within 24 hours. All of that to say, it’s an added layer of significant complication in terms of initiating breastfeeding. 

I always like to tell my families, and in a prenatal consultation is definitely something that we cover, what your birth plans are, what your birth history is if you’ve had a baby before and how that will impact breastfeeding and what your struggles were the first time. I’m going to give you another example. If you have a long labor and you have a lot of IV fluids, that can postpone your milk transitioning. It can make it harder for your baby to latch. Your baby is more likely to lose a lot of weight quickly which means your baby is more likely to be supplemented in those early days, especially in the hospital. 

All of these have a real impact. Those are the things we are going to cover. With a Cesarean, there are positioning considerations. We’re going to probably move that baby off of the torso and find positions that are more comfortable. Typically, these challenges are surmountable in the first few weeks so I never want to paint the picture that these are things that we can’t have a plan for, but I think having a plan is key. Having the support is key. 

Having those conversations and having somebody that you can reach out to when you are experiencing any breastfeeding difficulty. 

Caitlin: I would like to piggyback on that. I think that a lot of people are like, “Well, I’m not one of those people who has a birth plan,” because the joke is always as soon as you make your plan, it changes. 

Meagan: It all goes out the door. 

Caitlin: Exactly. But I do think to Chrisie’s point, in hindsight, my first C-section was emergent and I was put under for it. All was well. Everything worked out, but even for my second and third, I wish that I had spoken up about different things. If I have to go under again, this is what I want to have happen. Remembering that when you’re in your labor and delivery suite, let everyone know, “Hey if this does have to go to a C-section, I want it communicated to the OR that I want the baby put on my chest immediately after delivery. I want it communicated that my intention in PACU is to immediately initiate breastfeeding and get skin-to-skin. 

Those are things where we can have all of the best intentions in the world, but it is worthwhile just thinking through some different scenarios. I think it is helpful to quell any of that anxiety because to Chrisie’s point, these things are out of our control and that is totally the job of the medical professionals to take the best care of us and our babies, but it is definitely possible to just have some of those high-level thoughts and conversations. 

For my daughter, she was my second C-section. I was conscious, but even then, it was sort of not really outwardly known that you could request immediate skin-to-skin, and then in PACU, the nurse wasn’t really working with me on breastfeeding very much. I lost some of that time and skin-to-skin that you only really realize later because you’re so in this mentality. It’s just such a whirlwind in the best possible way. They are the greatest moments ever, but really put pen to paper and think through some of those different scenarios. 

That’s why that prenatal visit with an IBCLC is so amazing because when you are meeting with your OB, they are really just making sure that everything is going smoothly. That’s not to say that they are not spectacular. Doulas are certainly helpful in getting some of these plans together, but as it pertains to breastfeeding and the potential different delivery methodologies, an IBCLC is really the best person to set you up for that type of success. 

Don’t overlook it. We can’t get all of the answers from Google. Breastfeeding is a very biological experience. We tend to like a lot of quick answers and quick fixes. Just knowing that you have time, relax into it, and reach out for help. It’s definitely the way to be prepared. You’ve made your Pinterest-perfect nursery. Let’s focus on what the actual delivery and feeding is going to look like because right after that baby arrives, that is where all attention goes. 

Meagan: Yeah. When we actually started talking about TLN, we had someone write in. She was like, “Can I do a review on an IBCLC and how important it is?” It impacted her. She had three C-sections. She had a history of getting mastitis with every single baby so she ended up working with an IBCLC before she had her third C-section that was planned and they worked on all of these things. She was able to avoid all of the things that she had last time. She was like, “She was literally at my hospital bed the day I had my baby.” They had scheduled it because it was a scheduled C-section so she was like, “I will come. You tell me when.” She was like, “It was so impactful. It made my experience with my newborn so much more powerful,” because she was able to take out the stress and the question and all of those things and have more of that Pinterest-perfect birth experience. It was so powerful for her. 

I think it’s so important to talk about those things. You know, she said, “If you can, get skin-to-skin in the OR. Do these things and then I’ll meet you later.” She did all of those things. She just said it was totally life-changing. 

Caitlin: I’m happy that you brought that up, Meagan. I think a great question for your delivering hospital is, do you have an IBCLC on staff and will I be able to see them? Because having one on staff doesn’t mean that you will be able to see them necessarily. If it is an extremely busy, university-setting hospital, they may have four or five lactation consultants, but they are really, really regulated to NICU. So ask those pertinent questions because once you’ve had your prenatal visit with a TLN IBCLC, you have their contact information. You can even, if you’re having a C-section, schedule your first postpartum visit for the day you get home or the day after you get home depending on how long you are going to stay in house. There are really ways to be so prepared in that capacity. 

For in-hospital care, it’s really important that you know going in if you’re going to have that bedside care from a hospital-based IBCLC. That would definitely be a valuable question to ask when you are preparing to deliver. 

Meagan: Absolutely. 

Chrisie: I will also piggyback on that. It’s such a great point because having worked in a couple of big hospitals here in Los Angeles, and I don’t know if this is true for every hospital, but even if there is a hospital IBCLC, we are often stretched pretty thin. One of the things that I tell my families when I connect with them prenatally is to request to be seen by an IBCLC when you move to the postpartum floor. I know from my experience that families requesting to be seen were at the top of the list. The next group was the patients that either the nurses or the doctors wanted to see to round on. 

The third group who might not get seen are the families that seem to be doing okay and haven’t asked for a visit. Again, that was my experience, but I think it helps to ask. That’s a great thing to have your support person do to advocate for you. Ask your nurse or the charge nurse to have the IBCLC come by every day when you’re in the hospital. 

Meagan: Yeah. I mean, one of my experiences, and this is why I think having an official lactation consultant, an IBCLC, is because I did request and they said, “It’s the weekend. They’re not here.” So to your point and to Caitlin’s point, asking ahead of time, “Hey, do you guys have IBCLCs? Not only do they have them, but do they work 7 days a week?” Because I was on the weekend and then I had these C-sections and then days later, I finally found an IBCLC and I was so far behind when I maybe could have connected. Maybe it could have even been a virtual like, “Hey, how does this latch look? It’s hurting,” or all of these things. We could have nipped a lot of problems in the butt honestly. 

Chrisie: Exactly and then to compound that issue, I often hear from families that while they are in the hospital, they will hear a lot of conflicting information about breastfeeding from different care providers and it’s so frustrating for them. Most families are coming from the place of, “I’ll do whatever I should be doing, but please provide a consistent plan.” That is where either the IBCLC on staff or the IBCLC you’ve connected with prenatally can jump in and help you and be the person who clarifies that plan for you and gives you a way forward.  

Meagan: Absolutely. Well, we have some questions that people from our VBAC Link community on Facebook asked if you don’t mind. I would love to ask some of them. 

This one was from a mom. It says she is due in April. It says that she is a stay-at-home mom and has a toddler as well. Her goal is to exclusively nurse because she thinks that pumping will be too much. “How do I navigate nursing a newborn and caring for a toddler’s schedules, general trips, etc.” She nursed and pumped last time. 

Chrisie: Such a great question. First, again, huge plug for a prenatal consult right there. Let’s have a plan. Let’s have a plan. Then, I’ll just share a couple of tips that I give my families in these situations. The first one is babywearing. Babywearing makes such a huge change. It really helps keep that newborn close. Skin-to-skin has so many benefits. We know breastfeeding does better when babies are skin-to-skin. Babywearing is just skin-to-skin while your hands are free and now you can also take care of your toddler. 

I’m also going to say a huge plug for support. We know where those difficult moments tend to be. The first six weeks, growth spurts, let’s plan for them. If you are alone with your baby and your toddler, let’s have a plan for support. Who is offering to come help? Who can help you take care of the toddler? Can somebody come to relieve you so you can get some shifts? Is it in the budget to hire a postpartum doula to come and support you? Support, support, support especially in those early weeks. 

Then as we progress a little farther into the breastfeeding journey, I always like to share with my families some tips for navigating feeding times with a baby while also having a toddler because you probably know this, but it tends to happen that you put the baby to the breast or to the chest and then your toddler wants your attention. 

Meagan: Mom!

Chrisie: It’s not a coincidence, right? It’s the moment when you’re doing this thing. “Oh, I’m really not available.” So how do we navigate that? Again, having a plan in advance. Maybe we reserve some special toys or activities for nursing time. Make it positive. Maybe that’s also snack time for your toddler. Maybe as breastfeeding gets a little bit easier, you’re able to have your toddler come sit with you and read a book. But basically have a plan to make breastfeeding a positive experience for your toddler as well so it’s not set up as this competition for them trying to get your attention during that time which is really difficult for parents to navigate. 

Meagan: Yeah. I love those tips. This other question from this mama says, “I will be tandem nursing when my next baby comes. My first daughter has a slight lip tie and has always had a little bit more shallow of a latch. Just wondering if there are any ways to get a solid latch if the next one comes with a slight lip tie. It didn’t seem to affect my first daughter getting milk out while nursing, but I do think it caused my supply to never really come in fully.” 

Chrisie: Yeah. Yeah. So love that she is asking this question in advance for sure. There is a lot we are still finding about restrictions or ties. One thing I would look into in this situation is if the second child does have a lip tie, is there also a tongue tie happening? Often, we know when there is a lip tie, there is a tongue tie. Not always, but often. That’s when working with an IBCLC, they’re going to help you navigate what’s happening with breastfeeding and do you need a referral to what we call a preferred provider? Typically an ENT or a dentist who specializes in ties. Let’s have that baby evaluated by the specialist. Let’s find out early on. Are there any lingual or bilingual restrictions that are preventing the baby from removing milk both efficiently and comfortably for the parent? Information is key there, right? Especially if we know there is a history. 

IBCLCs in your community will be able to give you the names and contact information for those preferred providers so that we can find out that information right away. I also love that she brings up an important point about supply. Sometimes, very strong supplies can mask tongue ties and lip ties even and really make those issues not so obvious in the beginning, but then they might show up later on. Like she said, maybe it affected her supply. 

I often see people who do okay even though their baby has some restrictions, but then the 3-month regulation hits, and suddenly their nipples are sore. Suddenly their supply is really feeling an impact and it’s because there was an underlying restriction this whole time. 

Meagan: Yeah. 

Chrisie: So early information, let’s find out. 

Meagan: Yeah, I was just going to ask you if IBCLCs can technically diagnose a lip or a tongue tie or if they can say, “Hey, it looks like maybe there is something going on.” I also had some restrictions. I had some issues in the beginning with my milk coming in. I talked at the beginning about how I was a little bit out of it. I had a rocky first start, but then when my daughter was five, she went to the dentist and the dentist said, “How did she eat? How did she eat as a newborn?” I was like, “We had our troubles, but we got through it.” He was like, “Good for you. She actually has a severe lip tie. We actually need to take care of it because it’s going to start impacting as her teeth are coming in.” 

It was so thick. I was like, “Oh.” So yeah, those two questions. Can an IBCLC diagnose or can they just say, “Hey, it looks like we may have some restrictions here. I would suggest you go to this provider.” 

Chrisie: The latter. We are not allowed to diagnose. It is not in our scope to diagnose, but we do connect you with the appropriate medical provider who does. 

Meagan: Yes. 

Chrisie: They will do an evaluation and make a recommendation. 

Meagan: Obviously, we love our pediatrician and we love our docs, but my pediatrician, I asked and she was like, “No, not at all.” Sometimes, I feel like pediatricians aren’t as skilled as IBCLCs at recognized, so maybe they can’t diagnose, but they can recognize and get you to that next-step provider to help your feeding journey and your supply and all of these things be better in the end. 

Chrisie: Exactly. Exactly. I second that. I also love pediatricians so much, but IBCLCs are really the experts in navigating the lactation aspect and referring you to again, what we call a preferred provider for evaluating lip ties and tongue ties. 

Meagan: Yeah. I love that. Again, a whole other reason why we need an IBCLC through The Lactation Network. 

Okay, so this question, I think again plugs into getting that prenatal or that consultation before. This mama says, “I would like for my husband to take some of the nighttime feedings to allow me longer stretches to sleep.” We know sleep is so important. It says, “He wants to help with this too. Is there any way to do this without negatively impacting breastfeeding or getting up in any way to pump?” You know, having her to actually lose sleep and giving it to the husband in a bottle. It says, “There is conflicting information online and I’ve heard from most mothers that they just end up doing the nighttime feedings anyway. Maybe their spouse could help with diapers instead.” 

This is such a good one because sleep is a good one we know for our mental health, especially after birth and recovery, especially if we’ve had a long birth or a Cesarean and things like that. We just need that sleep, but how can we help our partners be involved without negatively impacting? 

Chrisie: Yeah, I love that question. I will also say that it taps into something I hear all the time which is about conflicting information online. There is so much conflicting information about breastfeeding online. To be honest, there is so much bad information about breastfeeding online which again, is a plug for an IBCLC. That’s why you need that expert in your back pocket to be the person who says, “Okay. Here is the deal. Here is what we need to do.” 

In this specific example, I do have this conversation all the time because I think one thing that is important to note is that I find the first six weeks to be the hardest for so many reasons, right? But if you’re a first-time parent, I know it’s common, and I felt this myself, when it’s your first baby and you’re doing this for the first time, it can feel like, “Oh, this is what it feels like. I’m never going to sleep again. Oh my gosh. This is what breastfeeding is like.”

I think it’s important to know the different stages, what breastfeeding looks like, and what sleep looks like at the different stages. So just having those expectations and that information can go a long way. In the first six weeks, babies tend to be nocturnal. They tend to be more alert at night. Nights are tough for the first six weeks. Throw in growth spurts where we have all of the cluster feeding. Nights tend to be a little bit harder during those times. We know that. We know that sleep is going to be tough in the first six weeks. 

It’s important to know that it does get better. It usually does get better after what we call the six-week growth spurt. That is one factor. But to answer the specific question, I like to talk to my families about what I call tag-teaming at night which I think is what she is asking about. Once we introduce a bottle, then you do have a little bit of play in terms of how the partner can support those nighttime feeds. Again, it’s such an important topic to talk about before the baby gets here. How are we going to navigate nighttime feeds? It’s so important. Sleep is so important. 

One possible scenario and this really depends on the specifics that are happening within the family, but once we are introducing the bottle, it might be possible for the parent to pump before they go to bed. Maybe the partner grabs the next feed with a bottle and then the parent who pumped right before bed is able to skip that feed and then grab the next feed. So we kind of pre-pump essentially. 

This plan works for some people. We do have to introduce a bottle. Where a lot of people go as well, the standard information is that I shouldn’t introduce a bottle until 4-6 weeks so that plan is not going to help me. My take on that is that we don’t always have to wait 4-6 weeks. Let’s talk about the specifics that’s happening with your baby and your family. 

But also, it is important to note that in general, we do need a one-to-one ratio,  one pump session for every bottle in order to protect your supply and preserve your breast health. If we go too long, especially in those first six weeks, if we go too long before removing milk from the breast, we can get clogged ducts. We can get mastitis. We can get other issues. 

Now, unfortunately, prolactin which is the hormone that is driving a lot of this, peaks in the middle of the night. So often, we have our strongest supply right in the middle of the night. So how are we navigating all of that? That’s what comes down to the specifics of the IBCLC putting together a plan for you and your family. I will say that generally, we are usually able to carve out a longer stretch of sleep for the birthing parent after that six-week growth spurt. 

But absolutely, sometimes we can if we just take that scenario. Maybe the other parent or a support person is giving a bottle and it means you wake up, do a 15-minute pump session, and go back to sleep. That might be a lot faster than the process of feeding a baby from beginning to end. These are all things that we look at creating a plan for. 

Meagan: Yeah, plans are important. 

Caitlin: They are. They are. I’m not clinical, so mom to mom we’re saying a lot of things that can be interpreted as overwhelming. I want parents so much to settle into this amazingly delicious life moment and we are very much a fast-moving and fast-paced world. This time is so precious. It’s so amazing. You will just want to inhale your new baby. It’s so– I just think giving yourself permission to take those 4-6 weeks to really just rest, recuperate, and establish that connection. 

Your brain is going to really go to Target. Find some time to go to Target. Maybe that’s with a support person, so that if you get there and 15 minutes later, you need to ditch your cart and go nurse in the car, someone else can stand with your cart or they can say, “This is totally fine. I’ll put back the items and we’ll meet back in the car.” If you are feeling that real urge to get out and do things, make sure you get out and take a walk. 

I saw a really funny meme yesterday where it said, “Nap when the baby naps.” It’s this new parent with a stroller outside and she lies down on the sidewalk. Obviously, that’s great advice, but in practice, it’s difficult so just know that you will rest. You will sleep. It is the best, most special time and we are here to help you prepare for it the best we can. It’s not a Google time. It’s not something that you can really search Google for all of these answers. It’s important to go into it knowing you can trust yourself, trust your body, and advocate for help. 

This used to be done with a huge village. We lost that village a bit. Bring in an IBCLC in early and often to be that outside person who comes in and is solely focused on this feeding relationship to nourish yourself, your baby, and your family to give you, your spouse, the grandparents, the siblings– all will be impacted by this peace of mind and this support. It’s very, very crucial and lovely. I wish all of you tons of snuggles. 

Meagan: I literally just got the chills. Such a powerful message right there. So, so powerful. Women of Strength, if you want to schedule your consult right now, all you’ve got to do is click in the show notes or you can go to our Instagram and look in our bio. It’s really easy to schedule a consult and start your plan today. 

Then one last question– if we have IBCLCs maybe who are listening, because we do. We have such a large birth community who listens. They may want to join The Lactation Network. How could they do that or is that possible? 

Chrisie: Yeah, absolutely. 

Caitlin: Yeah, absolutely. I would encourage anyone listening to check out our website. It’s tln.care. T as in the, L as in lactation, and N as in network dot care. Come visit us. Come ask questions. We are just so, so passionate about this space and are so grateful that we have had this time. 

Meagan: Well, we love you guys so much. We are so grateful for your time. We just know that you are literally changing lives all over. 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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Sabrina’s first birth was a traumatic crash Cesarean. She and her baby were thankfully perfectly healthy, but Sabrina was left with no desire to have any more kids. She didn’t realize how much her birth experience played into those feelings until she became pregnant with her second. 

Sabrina found The VBAC Link through another birth podcast and listened every day on her way to work starting at four weeks pregnant! The beautiful stories from Women of Strength gave her the encouragement to go for it. 

And Sabrina absolutely proved the fight that was within her. After two weeks of prodromal labor, over 48 hours of labor, and listening to her intuition as plans changed during labor which included some help with forceps, Sabrina achieved the VBAC she was fighting for. Even though her labor and birth were physically brutal, Sabrina immediately felt like she could do it all again. 

Additional Links

Needed Website

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Welcome to The VBAC Link everybody. I am just so happy. I love reviews so much and want to encourage anyone who has maybe been with us for a while or has been listening to let us know your thoughts. Tell us what you think about The VBAC Link. 

Today, before we get into this review, I wanted to introduce our guest today. Her name is Sabrina. Hello. 

Sabrina: Hi. 

Meagan: It’s so fun to be here with you today. She jumped on and was like, “Oh, it’s so crazy. You were in my ear and now we’re here.” 

Sabrina: Yeah. It is crazy. 

Meagan: It’s so awesome though. I love when our guests come on and they are like, “I’ve literally been listening to you for so many years. This is so surreal.” It’s so fun. It’s just such an honor to have you guys sharing your stories because I want you to know that you guys are the reason why this podcast is amazing. Just saying. These storytellers are the reason why The VBAC Link is incredible and all of these professionals come on. They make this podcast what it is. 

Review of the Week

I’ll get into this review and then we’ll get into your story. This is from aliaholland. This was back in 2023 and it says, “Love the host.” Oh, that makes my heart sing. Sing and smile, apparently, my heart does a lot of things. It says, “I’m 35 weeks pregnant and planning an all-natural VBAC in the hospital. I’ve been listening to a few different podcasts but keep coming back to this show. The host is very interactive and nice to listen to. Format is a good blend of birth stories as well as good education.” 

Oh, that makes me happy and that is exactly what we want to have on the podcast. It is the birth stories and education. If you are out there and you are listening and you are a birth educator or you are a midwife or you are an OB or maybe an anesthesiologist and you work really heavily in the birth world and you think it would be cool to come on the podcast and talk about some education points, we would love that. Always feel free to reach out at [email protected]. 

Sabrina’s stories

Meagan: Okay, cute Sabrina. We are talking about two very dramatically different stories today within your own birth stories. I want to just, I don’t know if we need necessarily– what’s the word– a trigger warning, but at the same time, I think it’s really important to talk about how sometimes things just don’t go as planned, but then what we can overcome and how we can grow through experiences and have really, really great experiences. 

I was just telling Sabrina this before she got on. In her note, at the bottom as a reminder to this community, that doesn’t mean you failed. I love that message so much because I think so many times in this community, we do feel that feeling. Sometimes we don’t even just feel it, we are told that. 

Sabrina: Definitely. 

Meagan: Right? We are told. I want to turn the time over to you to share your stories. 

Sabrina: Perfect. Okay, well I have two little babies. They are two years apart and yes. I’ll just start obviously with my C-section story. I went into birth thinking, “I’m young. I can do it. This is easy. This is what I’m made to do.” Everything with my pregnancy with my first daughter was great. Nothing really happened and then at my 32-week midwife appointment, we were listening on the Doppler and her heart actually skipped some beats. 

It didn’t come to anything, but it kind of plays into the story a little later. I was just kind of like, “What’s that? Why can I notice this?”

Meagan: Abnormalities here. 

Sabrina: I could hear it so obviously something was going on. We did an ultrasound and everything was fine, so no worries there. My labor started pretty good. I woke up and had that weird feeling that it was coming. My dog was following me around and all of that stuff, so I was like, “Okay. This is the day.” 

Meagan: Something is happening, yes. 

Sabrina: The baby is coming. My husband was at work, so I just labored at home. My contractions actually came on right away at 10 minutes apart and progressed like that. He came home probably around 4:00 in the afternoon and we live 45 minutes from a city with a hospital birth at. 

So I was like, “Okay, we should probably go to the city now.” We go there. I actually had to labor at my in-laws’ so that was quite fun because they are asking you, “Do you want water? Do you want food?” I’m like, “I want to be left alone right now.” 

We stayed there until about 9:00 PM. My midwife was called and she was like, “Oh, you’re only 3 centimeters.” I was like, “Okay.” She was like, “We’ll see you later tonight.” I was like, “All right.” My husband went to bed. 1:30 comes and I’ve been walking around for the last four hours.” I was like, “Okay, now.”

Meagan: Exhausted. 

Sabrina: Yes. It has to be time now. I can go to the hospital. She comes. She’s like, “Yeah. You’re 5 centimeters. We can go now.” Oh, that’s my little baby. 

Meagan: That’s okay. 

Sabrina: We called one hospital that we were supposed to go to and they were actually full. It’s a blessing in disguise because we ended up going to a level 1 trauma hospital, so more advanced and actually probably helped with what happened to us. 

We go there. I’m still feeling good going through the motions. I wasn’t progressing very fast. This is where the interventions start. She asks if I want her to break my water. I obviously had no idea. I thought that was normal, so I was like, “Yeah, go ahead.” So she did and then as things do, they progressed quite quickly from there. That was probably at 3:00 in the morning. 

We got to about 6:00 in the morning and I was ready for an epidural. I was like, “This is way more than I imagined.” I’ve already been going about this for 20ish hours, so let’s do it. He came in. Everything was great. I felt great after that. I was like, “Okay, I can do this.” My contractions went from a minute apart to 10 minutes apart. I was like, “Okay well,” I didn’t know any better so I was chilling. 

My midwife was like, “Okay, we have to do something.” 

Meagan: They wanted to encourage labor to continue forward quicker. 

Sabrina; Yeah, exactly. I had no idea, so I was like, “Yeah. Let’s do something.” An OB comes in. We do Pitocin. We start it. Everything is going fine. We had a few dips, so they took it off and it wasn’t like anything was too concerning. She wasn’t recovering great after we took it off either. They said, “We’ll put in an internal monitor.” 

Meagan: Oh, an FSC. Fetal scalp electrode. 

Sabrina: Yeah, because she wasn’t recovering. They didn’t know if it was because they couldn’t find it with the belly ones or she was moving. I was like, “Okay.” We had it on for a little while and just hung out until she seemed stable, and I was still at 7 centimeters. Nothing had changed. 

Meagan: But still, that’s good. 

Sabrina: Yeah, it still wasn’t fast enough. They come back in and they’re like, “We’re going to start again.” This was probably 1:30. I’m like, “Okay, let’s start it.” They turn it on and probably within 5 minutes, there’s absolutely no heartbeat. 

There are two monitors on. They can’t find her. 

Meagan: So scary. 

Sabrina: I’m obviously hysterical because I can hear the machine not beeping. There’s nothing there. At that point, 15 people ran into the room. This one nurse comes running in. She’s like, “OR, right now.” I had no idea this was even an option. 

We get to the OR and all I remember is that this one nurse introduced herself to me and her name was also Sabrina. She’s like, “Okay, honey. Here we go.” I’m like, “Here we go, what? Where’s the baby? What’s going on?” She’s like, “You’re under general anesthetic. Your husband can’t come in. This is happening right now.” 

Obviously, I’m bawling my eyes out because I think my baby is no longer there. 

Meagan: Yeah. 

Sabrina: Yeah, super traumatic. My husband comes in. He’s crying. He’s like, “I can’t be in here. I can only give you a kiss. This is it. Good luck.” I was like, “Okay.”

Meagan: They’re kind of taking a long time. 

Sabrina: It seems like a long time in the thing, but honestly– 

Meagan: It was probably quicker. 

Sabrina: They were doing everything. I could feel them putting the iodine on my stomach and everything like that. The midwife was like, “Sabrina, babies are born two ways, vaginally or C-section. You’re having this baby. It’s going to be fine.” That’s really all I remember. 

Meagan: Knocked out after that. 

Sabrina: Yeah. Mask on, obviously. You’re under general anesthetic. Yeah, I wake up. We didn’t know the sex of the baby. I had no idea I had a baby. I wake up and they’re like, “Sabrina, you had a baby.” I was like, “I did what? I had what?” They’re like, “Yeah, she’s with her dad.” I was like, “She? It’s a girl?” 

That feeling is the best feeling I had in the whole world. She was perfectly fine and there was nothing wrong with her heart at all. It just wasn’t handling the Pitocin and they got her out quick enough that they didn’t have to do any resuscitation or anything like that. 

Meagan: What were her APGARs? Do you remember? 

Sabrina: I don’t know, but she got to go be with her dad right away. 

Meagan: Interesting. 

Sabrina: Yeah. I actually have a video of her screaming that my midwife took. I was like, “That’s actually crazy.”

Meagan: That is very interesting, yeah. 

Sabrina: Yeah, so I don’t know what was going on. She didn’t have any NICU stay or anything. She was perfect. 

They wheel me out. Obviously, I’m not very coherent. My husband is holding her and he’s like, “This is our baby.” I was like, “It’s a girl!” He was like, “Yeah, it is. She’s perfect.” Everything was great. I ended up having a hemorrhage during surgery. I had to stay for a while. Luckily, I didn’t need a blood transfusion, just iron transfusions. 

Yeah. That was it. I went home. I had the baby on Saturday and I went home on Tuesday. 

Meagan: Oh, okay. 

Sabrina: Everything was pretty good and that was my C-section story. Obviously, my midwife was like, “Everything that could go wrong went wrong, but you came out of it fine and so did she.” 

Meagan: Yeah. Yeah. 

Sabrina: Fast forward, I didn’t want another baby. I didn’t think it was trauma, I just didn’t want one. I couldn’t relate the two until I ended up with our surprise baby. 

Meagan: I bet. 

Sabrina: Three weeks before we were supposed to get married. 

Meagan: Oh my gosh. 

Sabrina: Yeah, we had a destination wedding planned in Mexico and I had a surprise pregnancy. It really struck me then that the reason I didn’t want a baby is that I didn’t want that fear happening again. I immediately started research and I was listening to actually a different podcast that you guys were a guest on. 

Meagan: Oh. 

Sabrina: Yeah, All About Pregnancy and Birth with Dr. Rankins. 

Meagan: Yeah, Nicole, yeah. 

Sabrina: Yeah, you guys were a guest and then I was like, “Oh, I should listen to them.” I was probably 4 weeks pregnant and I listened to every single episode on my drive to work every day. I was like, “This is what I’m doing.” It just gave me the encouragement to go for it. 

Yeah. We went ahead and we were trying for a VBAC. All of my family was like, “Mmm, are you sure?” “Yep. This is what I want. I don’t want to recover with a toddler and a newborn. My husband has to work. What am I gonna do?” 

I was definitely questioned a lot on it, but something the OB told me after my C-section was like, “You’re a great candidate for a VBAC because what went wrong wasn’t your fault. There is nothing wrong.” I mean, the too-small pelvis wrong thing that they say. There was nothing there that was bad. It was just her. 

So his pregnancy was great. I was anemic. I had iron infusions before I labored so if anything was to happen, we would be prepared for that. My midwife was super supportive. I came in at 10 weeks with all of the questions that I heard on The VBAC Link. What about induction? She was like, “We don’t induce until 41 and 3.” “What about all of these other things?” She was like, “No. This is what you want to do. You’re fine.” 

I was like, “Oh, okay.” So if anyone needs a midwife up in Canada in Calgary, Alberta specifically, Origins Midwifery is great. Everything went well. My first came early, so of course, when your second one comes late, it’s hard. I was 40 weeks pregnant. I had been having prodromal labor for two weeks. 

Meagan: Oh. 

Sabrina: I was waking up every night around the same time with contractions and was like, “Today’s the day. Okay. Today’s the day.”

Meagan: That darn prodromal labor. 

Sabrina: Yep. My husband came home one week before it actually happened and was like, “Okay, let’s go.” I was like, “Oh, now they’re stopped. Sorry babe.” I was doing the 10,000 steps every day. I ate all of the dates. I ate all of the things just to make sure that I didn’t go through this again. I was like, “I’m ready.” 

Meagan: Yeah. You did all of the things to prepare. 

Sabrina: Yeah, literally everything I could do, I did. So 40 and 3 comes. It’s 1:00 in the morning. I wake up with contractions again. I was like, “Okay, this has to be it. We’re overdue now. Let’s go.” 

Yeah. I wake up. I’m like, “Okay.” I wait it out. They’re not super strong, but again, they started 10 minutes apart. I had a midwife appointment that day as well, so I was like, “Do I call her right now and be like, ‘Cancel your day or do I wait it out?’” 

My midwife appointment was in the early afternoon, so I dropped off my toddler and I went there. I was like, “Okay. I’m definitely in early labor. It’s been 12 hours now. I’m on a clock. I’m having contractions consistently for 10 minutes. I’ve tried a shower to stop them. I’ve gone out of the house. I’ve tried to scare them away. They’re not stopping.” 

She was like, “Okay, let’s do a check.” I was like, “Sure. Let’s do a check.” She’s like, “Okay, well you are 1 centimeter dilated.” I was like, “Are you kidding?” I’ve been doing this for two weeks already and now 12 hours of this and I’m only 1 centimeter dilated?” 

She was like, “Yes, but I can feel the contractions.” I was like, “Okay.” She was like, “So I will see you later.” 

Meagan: You’re like, “Okay.” 

Sabrina: A week later or tonight later? So we went home. She did do a sweep at that point just to see if it would stretch at all. She said that it did. I don’t know what it did, but I went home. I was like, “Okay. I’ll just keep going through it.” They hadn’t stopped. They were still 10 minutes apart. 

My husband came home at his normal time. There was no real rush. We hung out and made dinner. It was our last dinner as a family of three and I was super emotional about it. We put our kid to bed and I was like, “I can’t sleep. They’re already strong enough that I’m not sleeping, so now I’ve been going at this all day already.”

1:00 in the morning comes and I’ve decided, “Okay. I’m going to have a shower. They’re getting pretty strong. I’m going to try to listen to HypnoBirthing tracks.” I wanted to labor at home as long as possible. I called my midwife. I was like, “Okay, things are changing. They are 5 minutes apart.” Again, we live 45 minutes from a hospital. 

She was like, “Do you want me to come check you or do you think you can keep waiting?” 

Meagan: That’s pretty cool that she was willing to come check you or even come see you. 

Sabrina: Yeah. I was like, “I don’t want you to have to drive all the way here and then drive all the way home and then have to drive to the hospital in a few hours.” I was like, “I’ll just keep going.” She was like, “Try another bath. Try another shower.”

I sent my husband back to bed and I was like, “Okay. I’ll just keep going.” I kept going and I was actually in my daughter’s room. She was sleeping in our room. I was over her rocking chair just on my knees with my hands over. This was probably at 3:30 in the morning. I felt this weird change which I learned later was my water breaking, but there was no water. It was a weird feeling and I was like, “Oh, that’s really weird.” 

Yeah, so then I just kept walking around. I had more mucusy discharge so I was like, “Okay. This is not good now.” It’s 5:00 in the morning. My husband was still sleeping. I was like, “It’s time to wake up.” I’m out here moaning through them. We need to go to the city. We are ready to go. 

So we call her. She’s like, “Okay. They sound different.” I told her about the water. She was like, “Okay, there’s no fluid?” I was like, “No. There’s nothing coming out.” So she met us there at the hospital. It’s 6:00 AM at this point. She was like, “We’ll check you.” I’m like, “Great.” She was like, “I don’t see your waters, but I can confirm they’re broken.” “Oh, okay sure.” 

She was like, “You’re only 4 centimeters.” I was like, “Are you kidding me?” 

Meagan: Yeah, super frustrating. 

Sabrina: Yeah. 24 hours of consistent contractions and I’m only 4 centimeters? What? She was like, “Okay, because you’re not coping well and you live this far away, we’re going to admit you.” I was like, “Okay, fine.” So we got admitted. I was doing all of the walking and everything like that in our room and by 8:00, she checked me and I was 8 centimeters. I was like, “Oh, okay.” Two hours and I am 4 centimeters further along. Great. Let’s keep going. 

So I was at the point where they were so bad. I was so tired and I was like, “Okay, I want an epidural.” The midwife was like, “You just made it from 4 to 8 in a few hours. Keep going.” I was like, “Oh, okay.” I was over the bed, on the toilet, everywhere I could go and now, it was 12:00. I was like, “Okay. I am dying.” 

Meagan: So tired, I’m sure. 

Sabrina: Yeah. I’m crying at this point. I need an epidural. She’s like, “Okay, let me check you.” She’s like, “You’re still 8 centimeters.” I was like, “What? There’s no way. How did I progress so quickly to here from 4 to 8 and now I’m just stuck?” She’s like, “Okay. Give yourself a time. Give yourself a time limit until you can’t do it anymore.” I was like, “Okay. I’ll go until 2:00. Two more hours. I will just fight through this. At that point, if I’m not any different, call them.” 

2:00 comes around and I was like, “Okay, I’m just going to push it a little longer. I really want it.” At 2:45, I was like, “All right, where am I at?” She was like, “You’re still 8.” So we called the anesthesiologist in. I had been doing all of the labor positions. I was on my hands and knees. I tried the peanut ball. I tried a birthing ball and nothing was helping.

Meagan: Did you know his position? When she checked, could she tell his position at all? 

Sabrina: Not really, he was just there. That does play in. He does become asynclitic later on which explains even more of why nothing was happening. So then I was just going through the motions. I was like, “Okay. Maybe my body needs to rest. Maybe I just get it and things are going to happen.”

I was very upset because I wanted no interventions. My husband was like, “Just do it, Sabrina. You’ve been at this for a long time.” They come in. It’s 3:30 and at this point, I’m throwing up. I was like, “Oh, this is transition.” It wasn’t. I was just tired and sick. 

Meagan: Exhausted. 

Sabrina: They’re like, “Okay.” They gave me the epidural and I was like, “Okay, I feel good. I’m just going to hang out and rest a little bit.” Yeah, then again, nothing happens. I thought I would get some rest and things would keep progressing fast and that was not true. 

So we were still 8 at about 6:00 PM. My midwife was like, “Okay, if your waters did break at 3:00 AM, you are coming up on a time limit here.” I was like, “Oh.” 

Meagan: Were you showing any signs of infection?

Sabrina: Nothing. I felt good. His heart rate was good. I was just tired and emotional at that point. She was like, “We have to call in an OB.” I was like, “Okay.” She was like, “You have options.” She was like, “You have an option to have a C-section right now.” I was like, “Okay.” She was like, “Or you have the option to start Pitocin.” I was like, “I really don’t want that. I really don’t want it.” 

I cried about it for about an hour. My husband was like, “This is a different birth. This is a different baby. If it goes wrong, they can still take the baby out.” I was like, “Okay.” The OB warned me. She was like, “If you start Pitocin and he gets down into the birth canal, you cannot go back and have a C-section. You will be birthing this baby.” I was like, “Okay.” 

Meagan: If something went awry, they totally could. 

Sabrina: They would, but she was like, “You’re not getting all the way there and then tapping out.” I was like, “It’s not really tapping out, but whatever.” 

Meagan: Interesting, yeah, that they said that. 

Sabrina: Then she told me, “I do have a high rate of forceps.” I was like, “Okay, I appreciate the honesty.”

Meagan: Like a high success rate or do they use them all the time?

Sabrina: She uses them a lot. 

Meagan: That’s interesting. 

Sabrina: Yeah, it was. She was like, “Okay, what are your hard no’s?” I was like, “I would not like forceps and I would not like an episiotomy.” She was like, “Okay, but if you need it, would you accept it?” I was like, “Yeah, obviously, for the safety of my baby.” 

Meagan: Like you would choose that over a C-section maybe that is what she was trying to say. 

Sabrina: Yeah. We start the Pitocin maybe at about 8:00 PM. I was like, “Okay, here we go.” They’re coming in every half hour doing it up. She said that she had no limit on how much she would give even with a previous C-section. I guess some OBs have a limit. 

Meagan: Yes, they do. Yeah. 

Sabrina: She said that she didn’t. 

Meagan: Interesting, okay. 

Sabrina: She was like, “If you want to do this, I am game to do it.” I was like, “Okay. Let’s do it.” So we started Pitocin. She came back around 10 and she was like, “You’re still only 8 centimeters.” I had been on Pitocin for two hours now. 

Meagan: This is seriously a positional issue now. 

Sabrina: Then she’s like, “Let’s check him.” She’s like, “Oh, I think he’s asynclitic.” I was like, “Could we have not discovered this–

Meagan: Hours ago?

 

Sabrina: This morning. So she was like, “Try the peanut ball some more. If he doesn’t move in two hours, you’re having a C-section.” I was like, “Okay, fine.” 

We’re going at it. I’m on the peanut ball. I’m switching positions. I must have had a decent epidural because I was able to do all of this on my own. My nurse checked me at 11:30. She was like, “You’re 9.5.” I was like, “What?”

Meagan: Positional changes. 

Sabrina: She was like, “You’re mindset, this physician. Keep going.” I was like, “Okay. I can do it.” Midnight rolls around. She checked me and she was like, “You’re 10 centimeters.” I was like, “We did it. We made it. Now this baby is being born.” It is now two days later. Here we go. My appointment was on Wednesday morning. It is now Friday morning. Let’s get it. 

I was pumped. I’m ready to start pushing. Great. So they gave me guided pushes to begin with. She’s like, “You have it. You’re doing great. Keep going.” The worst part is in between every contraction, I had to throw up. My husband is holding my leg while I’m pushing then he immediately has to put my leg down and has to grab a bucket. It was between every single one. There was no break. I hadn’t been eating because– 

Meagan: That is, of course, if they don’t let you eat. 

Sabrina: Yeah. It had been two days. I’m just, yeah. It was rough. 

He makes a joke of it all the time that he was the nurse. He was like, “I pick up her leg. Put her leg down. Grab the bucket. Put the bucket down. Grab the leg.” 

So pushing comes up. 2:00 AM. She was like, “Okay, well you’re pushing effectively, but nothing is really going on. You’re coming up to 24 hours on a broken water.” I was like, “Oh my goodness. Just give me more time. I just need– 

Meagan: Again, no signs of infection, correct? 

Sabrina: Nothing. 

Meagan: So yeah, you have 24 hours but baby’s fine. There are zero signs of infection. 

Sabrina: Yeah, there are zero signs of infection. His heart hadn’t dipped one time. They were saying that his heart rate was too perfect. 

Meagan: So it doesn’t really need to be a conversation. Women of Strength, just listen to that. If infection is coming into play, then okay, but that just causes stress on you that you didn’t need. 

Sabrina: Yeah, exactly. I think they were just saying it to say it at that point. Nothing was wrong. So then I continued to push and it’s coming up 4:00 AM. I’ve now been pushing for four hours. I’m so tired. I’ve been up for over two days and literally over 48 hours I’ve been up at this point. I’ve had contractions for 48 hours nonstop, no breaks. I’m looking at my husband and I’m like, “I can’t anymore. My body can’t push. My muscles are weak.”

I tried all of the pushing positions with your legs up on your back. I tried the squat bar. I tried with the sheet. I tried over the back of the bed. I tried everything and I can’t do it. I’m literally saying to him, “I can’t do it. I have no strength left. My body is quivering.” I’m bawling my eyes out and he looks at the nurse. He’s like, “Call the OB. She can’t. What is she supposed to do? Keep going?” 

It takes her a while to get there obviously because everyone else was having their babies. She comes in and she’s like, “What do you want to do?” I’m just like, “You just need to get the baby out. I don’t care what it is at this point. Just take the baby out.” 

Meagan: You’re so exhausted. 

Sabrina: Yeah. I wasn’t even upset about anything, but I was just crying because I had no control over anything at that point. My body was tired. My emotions were tired. I hadn’t slept and she was like, “Do you consent to forceps?” I was like, “I consent to whatever you need to do. Just get him out.” She was like, “Okay, I want to do some guided pushes to see if I can help you.” 

I pushed. She was like, “Your pushing is really good, so something is just not letting him come through.” I was like, “Okay.” 

Meagan: Did she do any feeling of the head at that point internally? 

Sabrina: Yeah. Yeah, she was. Then she was like, “I have to go in further to try to turn him a little more.” She tried to stick her whole hand in and I remember the feeling. I was like, “Whoa, whoa, whoa, whoa, whoa. Stop. This is so painful.” She was like, “You can’t use forceps if you can feel that.” I was like, “Oh my goodness.” 

Then they had to wait and call the anesthesiologist to get a top off of fentanyl or whatever. 

Meagan: Your epidural. 

Sabrina: Yeah. She comes in. She’s like, “Okay. We’ve got about 15 minutes before this isn’t as strong. Are you ready?” I was like, “I guess so.” She was like, “Just because you have the medication doesn’t mean it’s going to feel good.” I was like, “Okay.” She was like, “It’s a lot of pressure.” I was like, “Okay. I’m trying to birth a baby. It’s a lot of pressure already.” She was like, “Okay.” 

She sticks them in and it was not great. It was pretty awful feeling, but she only had to pull twice. She puts in and pulls once. It doesn’t do anything. She was like, “Okay, push really hard,” and then all of a sudden, he was born. I remember just the feeling. All of the pain went away. All of the hardness of the birth was gone. I did have to get an episiotomy and I did feel her cut. She didn’t tell me she was doing it, but I felt it. That was hard for me because I was just like, “I didn’t want that.” 

Meagan: That’s hard. 

Sabrina: But you have nothing left and you are just getting that baby out. Yeah. He was born at 4:49 in the morning after 49 hours of labor. He was perfectly healthy. He was a big boy, 8 pounds, 7 ounces. 

Yeah, and everyone thought it was going to be a girl because boys’ heart rates are wonky usually and girls like to talk on the phone so they are asynclitic. 

Meagan: Oh, that’s hilarious. I’ve never heard of that. Girls like to talk on the phone so they come out asynclitic. 

Sabrina: Yeah. That’s what the OB said, the midwife said, and the nurses said. Then the OB comes up to me. She was like, “Those ladies going for VBACs, they’re determined. They don’t care what they’re doing. They just want the VBAC and they’ll do anything to achieve it and you did it.” I was like, “Wow, that was really supportive of you.” 

Obviously, I didn’t get a natural, no intervention– 

Meagan: Unmedicated. 

Sabrina: Yeah, a no-intervention birth, but I did get a VBAC. This is the funny part. They are stitching me up. Obviously, I have my baby. I’m laying on my back and they have a mirror above my eyes so I can see what they’re doing. I was like, “Um, this is a design flaw in this room. I don’t think everyone wants to watch.” 

Meagan: Yeah, I mean, maybe coming out but I don’t know about suturing. 

Sabrina: Yeah, and I didn’t notice it was there until they were doing that. He was healthy and everything was fine. Obviously, I had quite a bit of stitching. I had torn plus she had to cut medially so to the sides. 

Meagan: Mmm, ouch. 

Sabrina: Yeah, it didn’t feel good. She made a comment that was like, “It’s just the skin that I cut.” I was like, “Okay, that still sucks.” But yeah. He was born and then the next day, we got to go home. I was telling my husband, I was like, “This is why people have four babies.” This is way better than a C-section. I feel great. 

Meagan: Aww, I’m so happy. 

Sabrina: He was like, “What?” I was like, “I feel great. I could do it again.” 

Meagan: Yes. 

Sabrina: To me, even though it was very different than I had planned, I achieved what I wanted and I got my baby. I got my VBAC and I birthed him myself. 

Meagan: Yes, and you made it through a really long, tough labor. I want to actually talk about assisted birth because this is actually a really great question to ask yourself as you are preparing for your VBAC. Something that we go through in our doula practice is asking ourselves what they said. You have options. There is a point where we can use an operative vacuum or forceps or go to the OR. 

There are going to be pros and cons to both. One of the cons can be damage to baby and damage to mom, especially pelvic floor trauma and things like that. So you have to weigh out your pros and cons there as well and decide if that’s acceptable to you or if a Cesarean would be a better route at that point. I encourage you to talk to your providers even before you go into labor about their method of assistance. 

If you don’t– so a lot of the time, midwives aren’t the ones doing vacuums and forceps. They’ll have, just like in your situation, an OB come in so you can talk to them and say, “Who would be doing this? What is their method?” Obviously, this provider is very forceps-pro versus prone to go to forceps versus vacuum. She apparently uses them a lot. 

Asking those questions beforehand so you can know and then looking at the information. We actually have a blog which we will put in the show notes today all about operative delivery and the studies and stuff and the risks, the pros, and the cons. I think that is a really important thing to know. 

Where you were at, you were like, “I would rather do this than that.” Some people are different. Some people are like, “I don’t want to risk a forceps or a vacuum and I’d rather have a Cesarean,” so asking yourself those questions beforehand and knowing what your provider’s style is beforehand is actually a really, really good thing to think about in case you’re in a situation like this. 

Sabrina: Oh my goodness, yeah. 

Meagan: You would say that it was worth it for you. 

Sabrina: Yeah, definitely. 

Meagan: And baby was good. 

Sabrina: Baby was fine. I would do it again. That’s what my midwife said at my six-week appointment. She was like, “Wouldn’t it be crazy how you would feel if you didn’t have that?” I was like, “Oh, I’m sure my husband would be going for a vasectomy tomorrow. I would want all of the babies.” It’s just so rewarding if you have that goal in mind to achieve it. 

Obviously, I didn’t get what I wanted, but I still had the empowered feeling of doing it. 

Meagan: Good. Good. So good. And it’s not even that you didn’t get it. That’s so hard. Birth isn’t always happening exactly how we want it or envision it. There are some bumps and curves along the way, but the mindset, right? We can be in a space where we are making those decisions and not being told we have to do something, I mean, and Dr. Fox talked about that on the podcast. 

Sometimes a provider will come in because they’re almost obligated to say, “We need to do this,” like maybe your first birth. “We need to go to the OR right now.” But then there are some times where it’s like, “Hey, this is what I would suggest but  here are the pros and cons and here are your options.” 

I think that there is something that is very empowering when a mom is able to really have some informed consent and make a decision that she feels is best for her. 

Sabrina: Yeah. Yeah, even if in the end you are begging them to take the baby out. 

Meagan: Right. 

Sabrina: But yeah, I would totally do it all over again. Even just what she said to me, “Women trying to VBAC are the most determined. You can do it.” I was just like, “Okay. I can do it.” 

Meagan: You can do it. You can do it. There is something unique about us VBAC moms where we have this– I mean, we all have a mission to have a baby, but I think sometimes, we have a mission to have a different experience. 

Sabrina: Yeah. 

Meagan: We want something more. We are working hard and we’re doing these things. We’re eating the dates and we’re going to the chiropractor and we’re getting massages and we’re curb-walking and getting our steps in and finding providers and listening to podcasts. We’re doing all of these things and we want to try to get what we are prepping for. That’s okay. That’s okay that you want that, but there is some special determination I believe in the VBAC community, 100%. 

Sabrina: Yeah, definitely. 

Meagan: Well, thank you so much for being here with us today and sharing your stories. Huge congrats. 

Sabrina: Oh, thank you.

Closing

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

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We have another follow-up story on the podcast this week! We love hearing from our previous guests and today, we get to follow up with our friend, Amy. Amy was on the podcast for episode 102 sharing her VBA2C story and now we get to hear her HBA2C story!

Amy talks about her journey to embracing home birth with her fourth baby, how she found the right team, and how she worked through her fears. When labor began, Amy was steady and strong. She was ready and so was her team. 

Then everything completely stopped. Instead of giving in to discouragement, Amy trusted the process. Her team went home and she knew she needed rest. 10 hours later, labor kicked in HARD. Amy birthed her baby shortly after!

Meagan and Amy discuss the pros and cons of cervical exams before and during labor. Women of Strength, you do not have to have a cervical exam if you do not want one!

Additional Links

The VBAC Link Episode 102: Amy’s VBA2C

ICAN of Summit County

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello you guys. We only have a couple of weeks left of 2023 and it is blowing my mind. I cannot believe how fast the year has gone and how much has happened. I hope that you have had an amazing year and are gearing up for the holidays. I definitely have had a good year and am not ready for the holidays. I’m never ready for the holidays. It is always a crazy hustle and bustle. 

But I am always ready for a new episode and story to share. Today we have a special episode. I feel like this is a fun one because we like follow-ups. It’s really fun to sometimes have follow-ups. We have an HBAC after two Cesarean births to share with you today. I’m going to let our guest tell you more about her births and I’ll give you a little bit of a preview, but Amy, is it 102 what you said? It’s 102. 

Amy: Yes. It’s 102. 

Meagan: So episode 102. If you want to go and hear more, she’s got four babies you guys. If you want to hear more of the other babies’ stories, definitely go check out episode 102. 

Review of the Week 

But of course, we have a Review of the Week so we want to get into that. This is by meganlindsayyy. It says, “The support that I needed.” It says, “After my C-section, I said I wouldn’t even consider getting pregnant again unless I was guaranteed a VBAC. When we were surprised by our current pregnancy, I felt like I had already lost control and a say in the outcome. I immediately went back to my same OB and hoped for the best. Something happened when I was about 20 weeks pregnant. I wasn’t able to sleep. I got up at 4:00 AM and I began researching how to have a successful VBAC. That was the morning I found Meagan and Julie on Facebook. I was listening to their podcast later that day. By the evening, I knew that I had to totally change my plans.” 

Ooh, that just gave me the chills right there. 

It says, “I was going to let my birth happen to me.” I was going to let my birth happen to me. That is so powerful right there. Women of Strength, you do not need to let birth happen to you. You can go and you can birth and you can be in control of a lot of things in your birth. 

It says, “Because of these women I realized that I have a voice in what happens to me. I switched my provider and hospital and am in the process of hiring a doula. I am creating a thought about our birth plan. It is because of these women that I feel confident to go for my VBAC.”

Well, meganlindsayyy, I am so happy that you felt that you were able to find your voice again and find your power and take control of your birth and not let birth happen to you. This was back in 2022 and here we are at the end of 2023 so meganlindsayyy, if you are still listening, please let us know. How did things go? How did your birth go? I hope that it went really well and that you felt empowered no matter how it ended. 

You too, Women of Strength. If you are in a situation where you are not feeling that support and you’re not feeling the love, know that it is okay. It is okay to do what’s best for you. If that’s leaving a provider or switching things up birth location-wise, that’s okay. I know it seems daunting. It is. It is daunting. I did it myself at 24 weeks, but it is so worth it usually. 

Of course, if you haven’t had a chance to leave a review in the 2024 year, we would love to bring in some new reviews. Go over to Apple Podcasts or Google Play or you Android users. I don’t know. Google whatever or you can actually Google “The VBAC Link” and leave us a review there. 

Amy’s Stories 

Meagan: Okay, cutie pie. I am so excited to have you back today. So, so excited. I’m so excited to get into this story, but I also want to talk about something that we are going to talk about at the end. I know that this kind of goes into your birth about cervical exams. I want to talk about cervical exams. What do they look for? What do they do? What do they tell us? Are they necessary? And all of those things. We are going to talk more about cervical exams at the end, but I would love to turn the time over to you and your cute little baby. You guys, if you hear the cute little baby noises, we’ve got a baby on the show today. 

Amy: We do. We’ve got a wide-awake 6-month-old. Don’t mind the squawks. Well, thank you so much. Obviously, I’m incredibly excited to be back. I didn’t think that was ever even going to happen. If anybody has listened to my first episode, at the end of the episode, Julie was cheering on our husband. She was cheering on us both to have a fourth baby. It was a joke between you and I and it was an ongoing thing in our home. My husband would call it nagging. I just called it persistence, but here we are. Honestly, I really didn’t think I was going to have another baby so I just feel incredibly blessed, excited, and just really happy to share another story. 

I’m just really hoping that this story can help somebody else who maybe is feeling some fears about a VBAC or a home birth or any part of my story. I feel like there is a lot of different kind of factors that play into it, so thank you for having me. I’m super excited. 

But yeah. I guess I’ll get started. We know that with every VBAC story, we start with our C-sections. Like you mentioned and I mentioned if you want to hear the full two Cesarean stories and my first VBAC after two C-sections story, check out episode 102 because there are some long, detailed stories. I’m not going to go through them all, but I do think they are important just to hear how I got to where I am today because each birth and pregnancy really builds upon the last. My knowledge, my passion, and just all of the information I learned played a role in my decisions for the next one. 

So just a real quick birth history. Gosh, it’s been almost 10 years ago. My oldest is 9.5. I will go back to 2013. I really did plan the most natural delivery possible with a birth plan but I didn’t have a doula. I was induced at 41.5 and on Pitocin for 30 hours. Two epidurals, every drain and tube and monitor coming out of me that could possibly come out of me even though I really wanted none of it and then after two hours of pushing, the covering OB came in and said, “We should have done a C-section hours ago.” I gave up. My body just– you know, the adrenaline kind of left my body and I said, “That’s fine. Whatever.”

She was 10 pounds and probably OP. I started planning my VBAC in the postpartum room. Let’s fast forward a couple of years. I switched providers and thought she was VBAC-supportive. It was a little bit of a bait and switch and some scare tactics at the end. I ended somehow in a scheduled C-section at 40 weeks and day with no TOLAC. 

I didn’t really realize it was insane until I met my next provider, but her C-section was straightforward. It was really nice to have a C-section without the labor and 30 hours of Pitocin, but I just didn’t feel like honestly, that was even a chance at a VBAC. She had some big baby fears because she is VBAC-supportive with other people so that was hard to learn about after the fact. 

My second, Delaney, which is my Delaney. I know you have a Delaney. She’s 7. My oldest is Adeline and she is 9.5. My second is Delaney and she is 7. She was my “scheduled” C-section, but I kind of look at her as a CBAC because I really, really did in my heart plan for a VBAC. She was 9 pounds and 3 ounces so also larger. 

Fast forward a couple more years. I switched to yet another doctor, kind of the VBAC king in the area. I did all of the research and all of the prep, the chiropractic care, and did all of the things, right? I got a doula and I did have my– which is when I was on the podcast– VBAC after two C-sections just riddled with a lot of interventions after getting to the hospital. The most significant one was him breaking my water at 4 centimeters when I got there for really no apparent reason. Baby turning OP, pushing for an hour, and then it was a forceps assist. 

I think while it was empowering and it was really life-changing, I think after the fact as I thought more about it, I did this big mental dump on my computer even though I assumed we would never have another baby. I did this big document of what I would do next time. It’s really interesting to look back because I did it pretty quickly after the birth. Not necessarily regrets, but how I would do things differently even down to the first trimester. 

Meagan: I actually think that’s really powerful. 

Amy: It was. It was helpful. 

Meagan: I really think that’s great. 

Amy: I’m glad I did it because I did look back at it and it was interesting to look at. Although it was a VBAC, and I will say I still feel really blessed and I do think it paved the way physically and emotionally to have another baby vaginally, I didn’t really have those healing moments that I was hoping for. That was really hard for me because the NICU team whisked him away. 

It was a boy and that was the first gender we didn’t know. It was really special to have two girls and then a boy. He was our smallest baby. He was 8lbs, 12 oz and I think he was 41.4 but I didn’t get to hold him after. I didn’t get to do the golden hour. I didn’t get to do immediate skin-to-skin. He did spend an hour in the NICU for observation which was hard. I was happy he was healthy but with a forceps assist and an OP baby, I could have had a lot more damage than I did and I only had a second-degree tear which I was very grateful for because it could have been a lot worse. 

But he was fine and we were healthy and I healed well. It was a really great postpartum period and the hormones were real and the birth high is real. That really solidified my passion for birth and what I wanted to do moving forward. I met another mom through my same OB because everybody flocked to this OB. She actually recorded a podcast episode around the same time as me, Tanya. I hope it’s okay if I share her name. 

We actually ended up through meetings and through our VBACs starting an ICAN chapter in our community in November of 2020 amidst the pandemic. We went through the ICAN leadership training which was really exciting. We now have an ICAN chapter that’s been going pretty strong now for about 3 years and we have just grown our passion even more and connected even more to the birth community. 

So yeah. Those are my three stories in a nutshell. 

Meagan: Tell everybody how to find that ICAN chapter in your area if they’re listening.

Amy: Okay, sure. I wasn’t sure if I should share the details. ICAN of Summit County. I live in the greater Akron area. We serve the whole Summit County area. There is also a very active, large ICAN chapter in Cleveland which is one of the longest-standing ICAN chapters or the longest-standing which is really neat. That is the chapter we started going to and it really helped us. We love having our own chapter here. We’re growing but juggling a lot of babies. I had to take some pauses at times, so that’s been really exciting and has really just helped grow our passion and desire to keep doing this kind of work. 

Yeah. Through all of that, I still kept listening to podcasts and just devouring everything I could. I had plans to become a doula and just hadn’t been able to pull the trigger yet, but have always had this hope that one day I will be able to help other women. 

As the years went by, I still didn’t feel like our family was complete, but I do want to add that I know a lot of women deal with this so I want to speak to this because sometimes, I think that maybe women are not afraid or ashamed to talk about it, but I did struggle with the difference between if I really wanted another baby or child and do I really want another birth experience to do differently. I’ve heard other people talk about that. 

I’m glad I took quite a few years to trick my husband into having another baby, no, to get pregnant again because I wanted to make sure that I was doing it for the right reasons. But yeah. It was tugging at my soul and I think he was unofficially done. Around comes Mother’s Day 2022 and I conceived baby number four and that was the best Mother’s Day gift ever. That’s where the story starts. 

I think always in the back of my head, I daydreamed and dreamt of this home birth plan. I said, “That’s a dream of mine that will never happen because of my history and because we’re not having any more kids and because my body probably can’t do that. I’ve always needed an epidural. XYZ.” I had my birth team planned in my mind for years even. This is what I’m going to do if I get pregnant again, but I never thought I’d actually have to commit to that. 

Along comes this pregnancy and we’re super excited about it. I started my OB care with the same doctor who is extremely supportive. I knew he did co-care for home births just from talking to other women. I went along with my pregnancy. It was textbook. I tried to stay as active as I could. I wasn’t as sick this time, so I was just trying to really stay healthy and do all of the things right that I could because I know that I have big babies. I don’t know if my weight gain plays into it, but I tend to gain a lot of weight every time no matter what I’m doing. 

With my son, he was the smallest and I had been running the whole pregnancy, so I thought, “I’m going to try to have another smaller baby.” I continued with OB care. I didn’t do all of the VBAC things. We have the lists, right? The Spinning Babies and the red raspberry leaf tea and the dates and stuff. I had three kids and I was working. I didn’t have time to do all of the things, but I really tried to prioritize what I thought was most important. I tried to start early by interviewing as many doulas as possible and really trying to find somebody who would really be the best support for me whether I was in the hospital or at home because I still hadn’t committed even though I knew in my heart I really wanted to at least try for a home birth. 

I interviewed a lot of doulas. I found one who was spectacular. She wasn’t necessarily the most experienced years-wise, but I was okay with that because of some great reviews from friends and we just really clicked. She was comfortable with the idea of home birth or hospital birth and I know not all doulas are. I think that is one important thing to take into consideration. 

I did start Webster’s chiropractic care pretty early because I knew the only time my body ever went into labor on its own was with my third, my VBAC. For me, that was a really huge thing. It was a really huge deal to know that my body wasn’t broken because it never went into labor with my first two. Thankfully, that wasn’t really a fear of mine anymore because I knew it could be done and I knew it could happen. The other thing that I really did was I wanted to do some mental health work around some of my fears and anxieties to try to really figure out if I was nervous about a home birth because my intuition, like you talk about, had a fear that something was going to go wrong medically or if it was just anxiety. 

I worked a little bit with a mental health therapist and it was just nice to talk it out. I worked through those things and what my hesitations were and why and what my fears were and why. I really do think that helped a lot. 

Meagan: Do you have any tips for our listeners that your therapist gave you to help recognize fear versus intuition? Do you know what I mean? We talk about this a lot on the podcast. 

Amy: She probably gave me tools and I have an awful memory. There were some charts she wanted me to make, so I’ll have to find those and send them to you, but it had to do with working through the root and then figuring out the why and not so much– I just had a weird fear of having a really catastrophic emergency. I don’t know if that’s just because I’m a nurse and that’s where my mind goes or if because people tell me that it’s so dangerous, so then I finally worked through that by looking at statistics and listening to all of the stories and realizing that it isn’t an irrational fear but that we needed to come up with a plan. We had all of the different plans set in place for that. But yeah. I’ll have to see. I’m sure she had some. I probably didn’t do the homework, but she probably had some exercises for me. 

Meagan: I think you did. 

Amy: Yeah, I guess in a roundabout way. It helped to talk to someone who is not your partner and not your mom and not your coworker. So yeah. We did the prenatal co-care. He was on board with the home birth plans as much as an OB can. He was really great in that sense, but I was dragging my feet to make a decision and I think this is partly my procrastination and partly my not-commiting to the idea because then I wouldn’t have to do it. 

I interviewed a lot of midwives and around 28 weeks, I hired a midwife and the medical professional in me decided to go with a CNM. In Ohio, laws are different everywhere, but certified nurse midwives are the nurses who have the nursing school and a master's degree in nursing. Most of those do not practice in the home birth setting in Ohio. Those are the midwives you would get in the hospital and we do not have any free-standing birth centers sadly, so we just have very few options here. But there are about four nurse-midwives now that do practice home births or come to the home. 

So I hired one and she was really wonderful. I kind of knew her a little bit personally through another friend. I had my first visit with her and I was feeling really excited. I had my doula hired. I had my photographer hired who was a home birth mama herself times two and I loved the idea that she also would just really understand the space and what I needed. She wasn’t just a photographer. She was like another doula through my whole pregnancy and she was wonderful too. 

Unfortunately, after my first visit, we waited about four weeks to see each other again, and then the day of that visit, she let me go as a patient over the phone unfortunately due to some things she read in my records. It’s frustrating because she really knew my history really well and I gave her this huge stack of records to be nice. In the op report, it talked about the uterine window which we all know is a little bogus. I understand why she was–

Meagan: I had that too. 

Amy: Yeah. I wonder if she had never seen that, but who knows? I do feel that things worked out the way that they were supposed to but the only reason it was difficult was because I was now 31 weeks and you don’t want to have to change providers that late. I respected her and I would rather have someone who was 110% comfortable anyway. The other CNMs in the area, I will say, wanted to do continuous fetal monitoring at home. One wanted to put in a hep lock at home. They are just a little bit more conservative because of, I think, the climate in Ohio and their license which I totally understand. 

It worked out for the best in the end. But I raced to interview a couple more midwives and thankfully, one that I had heard of but never talked to, we clicked instantly. My husband talked to her. He told some kind of joke about a uterus and she laughed then he hired her on the spot. We fell in love with her. She is just amazing and we just instantly clicked and I knew she was my person. 

 I continued my care with her. That was 33 weeks on and her office was an hour away. That was one of my hesitations originally with some people up north was the distance. I did some co-care with my OB and with her. Then at 37 weeks, my OB who our whole area just adores, and beyond. Women drove to him from other states. He was unfortunately let go from the hospital. I don’t know the details. I hate to say the word fired, but yeah. Terminated. It left a lot of women. It was really devastating for the birthing community up here in northeast Ohio because a lot of women go to him for breech deliveries, twin, triplet vaginal birth. You know, the renegade of the hospital who is kind of operating on his own accord. He would go to home births and a lot of women would never have even been given an option to have a vaginal delivery without him. It was really heartbreaking. 

Meagan: One of the most supportive people at birth was let go for whatever reason. 

Amy: Yeah, unfortunately. There were a lot of tears shed by a lot of people who had delivered with him and who worked with him. Anyway, I don’t want to get too caught up by that, but it was really upsetting for somebody whose hospital transfer plan was an amazing OB. I had all of these birth plans written out and now, my non-urgent hospital transfer– I didn’t really have that option. 

To me, I’m like, “Well, there goes my home birth because what if I need pain relief or whatnot?” I did transfer to the local hospital midwife group in the hospital about 2 miles down the road in Akron. Thankfully, I delivered my first with them and they had records. They were really wonderful when I went in at 39 weeks saying, “Hey. I had co-care for a home birth.” Even this one OB walked in and I got so nervous because it was supposed to be a midwife. She was running behind and this OB walked in. I’m like, “Oh crap.” 

The OB just goes, “What do you need from me? I see you are planning a home birth.” I almost cried on the spot because it was wonderful to have this fresh out-of-school OB be okay with that. I’m like, “Thank you so much for that. I really needed that today,” because I am 39 weeks. 

The end of the pregnancy went fine. I did all of the things, some Miles circuits. I didn’t go crazy with the dates or the tea or anything. I tried to stay active. I didn’t have as many Braxton Hicks as I had in the past, but I definitely had the heavy pressure in the pelvis. I could hardly walk and everything. I felt really low this time and a lot of back pain and hip pressure and hip pain this time. 

I tried not to focus on the when. When is labor going to start? You can get really obsessive with that, especially when you are known to go over too. I tried to stay really present and be there for the kids and enjoy those last days. I did begin to lose my mucus plug at my midwife’s office which was really funny at 39 weeks. I’m like, “What is this?” She was like, “It’s your mucus plug.” I was giving a urine sample. I’m like, “Oh my gosh.” 

Things were starting to brew a little earlier which was really exciting. I started having some mild contractions and then I think I was– so let’s see. I was due on February 2nd. The actual early labor contractions that were noticeable started on a Monday. I was 40 and 4. My parents were over for dinner and they were consistent enough. I was just getting irritable so I went up to my room. I excused myself from dinner. I’m like, “I’m going to go lay down.” 

That was my first day off work. That was a Monday. My last day of work was the previous Thursday. I had gotten a manicure. I’m like, “This is going to be a pampering day,” which was maybe helpful I think. I think a day of rest really did help my body switch into gear. I know that everyone says to rest and that it will happen when it’s time and it did. 

So yeah. Contractions kind of started kicking up that night. Something of note with my first VBAC, so my third birth was that my contractions immediately went to 1-2 minutes apart and that’s why I went to the hospital so early. I was like, “Don’t call everybody in too soon. You know that this is how your body is in early labor.” I took a shower and I rested. I was just out in the sunroom which was my happy spot in our new house. I think I was watching The Bachelor which was ridiculous but I was like, “Okay. If I can still watch TV, it’s still early labor.” 

It went on. I texted my team a little bit, but just said, “Hey, I think things are brewing. I had some bloody show around 8:00 PM, but I’m going to just keep doing what I’m doing and resting.” So I think it was around 11:00 PM that I could no longer watch TV or want to so I was like, “Okay. I’m going to keep everybody updated, but no reason to call in the troops yet. I’m going to let my husband sleep.” 

I think I did text everyone around midnight. Contractions were 2-3 minutes apart. They were definitely getting more painful. I was still breathing through them, but just getting nervous because my midwife was an hour away. I think my husband woke up around 1:00 AM and urged everybody to come over. Everybody got there around 2:00 AM. This was 2:00 AM on Tuesday morning, so February 7th. It was the day she was born. 

My doula got there first. She kind of just stayed by my side. She did hip squeezes and rubbed my back. She was just super wonderful and supportive. Everyone, as they came into the house, just let me be. What I love about home birth is that they don’t disrupt you. They hold the space for you. They are quiet and respectful of your environment and just check on you when they need to. They take your vitals every so often, listen to the baby’s heartbeat, and really, they just hung out in my living room until I needed them again. I just labored up in my bedroom for most of the night. I took a lot of showers. It was a lot of leaning over the bed and hip rolls on the ball. 

Nobody ever checked me, so talking about cervical exams. I never really thought about it and they never asked. It would have been interesting to know where I was through all of this, but yeah. I never got checked once during the whole birth. That was, I think, really cool in the end. Everybody filed in around 2:00 AM and stayed through most of the night. 

Then around 9:00 AM, I went downstairs to see my older kids. They stayed home from school because they were up throughout the night too coming in and out of the room. I really did want them there for the birth. They were really interested and I thought it would be really special. But when I went down to see them, everything stalled and fizzled out completely. 

I guess I just didn’t think of this as an option. I was really in it, I felt. I was having painful contractions that were coming regularly. I was really having to work through them. Everything died down. I had some food. I said goodbye to them. My husband took them to my mother-in-law’s for the day. We just thought I was going to rest. I went on a walk with my doula. We did some curb walking. I felt huge pressure to get things moving faster because my team had been there since 2:00 AM. I was doing the thing. We were here. I thought this was the real deal and then it fizzles. 

I finally had this talk with my midwife. I think I was naked or maybe in a robe after getting out my one of my million showers which I loved the shower. She was like, “Let’s just regroup. Let’s just have a chat. I think you need to–let’s just reset. I think we need to get out of your space. Things are happening. You’re doing the work. I don’t doubt that, but I think you just need to rest.” I’m a people pleaser and I wanted them to go home and get some rest. The whole team stayed there for 12 hours. They have babies of their own and they were amazing. 

She said, “I think this will be good for you.” I had a big cry. That release, I felt so guilty that they had all been there. I felt like maybe this was a false alarm and I just had everybody come over for no reason, but in the end, it was good for us. We had a rest. We napped on and off and ate some food. He’s smearing blueberries all over my shirt. We ate some food, took some showers, and just hunkered down just my husband and I. I think it was really good for us to just have some time. 

I was napping on and off and my husband decided to take some clothes to the kids at my mother-in-law’s house which is about 20 minutes away. Around 7:00, my mom and dad came over. He planned this behind my back without bothering me. I was like, “Okay, whatever.” My mom had talked about being a deliveries in the past, but it just never felt like the right time. It never really felt right to have someone else in the room. I said, “Whatever. She can sit with me. That’s great.” 

She was just sitting in the corner quietly of the room and I was resting and then all of a sudden, 7:00 hits. My husband is still gone and I am just like, all of a sudden, contractions come back out of the blue super strong and powerful. My husband Facetimes me with the kids a little after 7:00 and then all of a sudden, I had this giant contraction. I threw my phone out of the bed and yelled, “I can’t talk.” I felt really bad. I just managed to text, “Come home now. Not doing well,” or something like that. 

I just didn’t even know this could happen where you could labor, have this break, and then it could just shoot you right into active labor, transition. He comes home as fast as he can. My mom is in the room. God love her. She’s a nurse by trade of 50 years. Never in OB and she was just like, “Okay. Do you want help? Do you not want help?” Finally, I’m like, “Rub my back or something.” I couldn’t really talk at this point. It really went from 0 to 100. 

She was doing hip squeezes as best as she could. We’re getting myself in and out of the tub a couple of times, having to keep putting new hot water in it. God love my mom with her bucket of water and we’re doing it. It was just me and her here. I think I texted the group, “Can’t do this much longer,” to the birth team but not much information got relayed to the team. No one’s fault, it was just a lack of communication between me, my mom, and my husband who was the communicator. 

Things are getting pretty hard. I’m very vocal and my contractions are back-to-back. My back is just killing me. I think at this point, my husband is home. At 7:40 at night, he’s home. He’s moving cars to the neighbor’s driveway. I’m in the water at this point and there was a pop in the water. I knew from past episodes of other birth stories that that’s when your water breaks in the water, Amy. I didn’t want to believe that was happening because my water has never broken on its own. It was broken for me. 

This never gets relayed to anybody. My mom was like, “I knew you were probably in transition, but I just didn’t tell anyone.” I’m like, “Okay,” after the fact. Then I was vomiting too. That never got relayed to the team. They’re asking my husband, “Are here contractions different? Has she tried an Epsom salt bath? Where are they located?” I’m looking back at the texts and he’s like, “She’s not answering. They’re different. She wants to be checked now.” I feel like I was yelling but I was probably whispering. At that point, I was like, I need to be checked now because if I’m not very close, I can’t do this anymore. 

A lot of things, I think I verbalized but they were probably in my head. I was like, “I need an epidural. This isn’t going to happen soon. Get me to the hospital.” I was just–

Meagan: Well, that’s what happens in the end. We have this sense of, “I can’t. I don’t want to. I’m done,” but that’s the end. 

Amy: Yep. Yep. I’m not going to sugarcoat it. It was pure misery and it felt like my bones were breaking but I was trying. I was relaxing my body as much as I could because I knew I needed to. I was in the tub for most of that portion. So I was definitely in transition and nobody knew. I think my husband called my doula and just recently, she said, “I heard you in the background and I grabbed my keys and ran,” because I think I was doing the low, birthy moaning but no one else. 

I just never thought to call my midwives because in those moments, I couldn’t have even thought straight. I wasn’t thinking to text or call anyone because I was just trying to survive in that primal birth state. She was like, “I sped so fast.” God love my doula. She walks in the door first. I think it was 8:45 at this point, so 7:00 PM was when everything kicked up fast. 

She walks in and she was really just doing all of the comfort measures she could. I was in the water. I think all the other birth team started heading over. My midwife had an hour drive and she got stuck behind a train. The midwife assistant, who was hired because she lived more in my area which is great, happened to be nearby at a basketball game for her son so she headed over to “check” me. 

It’s important to note that when they were there the first time, they had all of their equipment, but they packed it all back up and took it home. So when she comes upstairs to check me, she has a flashlight and a doppler, maybe a pair of gloves in her pocket. 

I never get checked so that’s the end of that. That story ends, but she heads in and our photographer gets there at 9:45. One of the heartbreaking parts of my VBAC was that my photographer left the hospital during my epidural and never came back. I was very heartbroken that I didn’t have photos. God love my photographer. She made it just in the nick of time. She shows up and she also had an hour drive and a baby of her own at home. 

She gets there at 9:45 and at this point, I think I’m just up to the bathroom a lot. I couldn’t stop going to the bathroom. TMI, but pooping. I just remember the midwife was dragging me off the toilet. She is very direct and I didn’t know her that well. She is a midwife in training also thankfully, so she is very close to the end of her midwifery training thank God, but she was like, “We need to go. Come on, honey. It’s okay if you keep pooping. Come on. Get off the toilet now.” I was bearing down. I didn’t know it, but I was definitely having fetal ejection reflex at that point. I think I was still in denial that it was the baby.

I was doing these grunts and moans. I just think I was still like, “Oh, I’m probably 6 centimeters.” I didn’t want to let myself down. I still had so many fears of, “Am I going to end up in the hospital for pain relief? Am I going to get to 10 centimeters? Is the baby going to be OP again?” and all of these things. I get back in the tub and it’s all very blurry and fuzzy at this point. But piecing together from what people told me in texts, I know she said to reach down and see what you feel. I said, “It burns.” I was like, “Oh my gosh, it burns.” 

She was like, “Well, what do you feel?” I was like, “I don’t know what that is. It’s fleshy.” In that moment, I thought it was a butt. I thought, “Oh my gosh. This baby is coming out breech. My midwife isn’t here yet and I’m at home.” I think it was the head. I don’t know. I really didn’t know what I was feeling. I was kind of afraid to touch it. 

Meagan: Probably cap it or– 

Amy: I was like, “What is this?” I guess we knew it was close. She’s trying to look with a flashlight. I really did think I wanted a waterbirth, but I guess I wasn’t in a position that the midwife assistant liked because I kept liking kneeling where I was giving no room for the baby to come out. She kept going, “You have to lean forward or sit back. You can’t kneel like that because the baby can’t come out if you’re sitting on your leg.” You know, whatever. 

We decided to get out of the tub which was very hard to get up over that edge of the tub. For anyone who has seen my birth video because I had posted it to the group, they helped me out of the tub. It was very difficult and very miserable. I made my way to the side of the bed. At that point, I think my body is pushing and I don’t even realize it. I don’t remember if there was pain. It’s all kind of a blur. It was just all very intense. I know that from photos, I was squatting next to my bed with my arms around my husband’s neck. He’s holding up all of my weight. They said that I was pulling him over. He is 6’1”, 250. I’m 5’5”. 

I was a maniac, pulling on him with all of my strength. I birthed her head next to the bed and I honestly don’t remember feeling it. I do not remember any crazy pain or anything. I think I was just so in birthland. Her head comes out and I just remember my body shuts down. No urge to push. No contractions. I’ve heard other people say this, I think, on your podcast so it felt very validating to hear this. Everybody was like, “You’ve got to keep pushing.” 

I really didn’t want coached pushing. From the hospital, you get yelled at to push, push, push. But she was like, “You’ve got to push. The head’s out.” I just remember it being very– not scary, but just very urgent and very matter-of-fact. “We need you to push.” 

Meagan: “You’ve got to do this.” 

Amy: Yeah. “You’ve got to do this.” By my husband, there’s a small spot next to the bed. You always birth in small spots. My husband is behind me. My doula is next to me. My mom is somewhere in there. The photographer is across the room. I just instinctively rolled onto the bed. You have to remember, there are no chucks pads down. We are not having a baby on a bed right now. We aren’t planning for it, so I had a mattress protector down, thank God, but no chucks pads. I rolled onto my side. My leg was up in the air, and at that point, it gets a little intense because the midwife assistant was by herself and they do like to have two people there. The resuscitation equipment is not in the house. There is nothing to help me or baby if anything goes wrong. 

There was some intensity in the moment and she did tell my mom to put a timer on the clock and that after 60 seconds, we were going to call EMS. When I heard that, when I heard her say– 

So 60 seconds does go by and thank God, my mom is a nurse but nobody knows she’s a nurse. The funny part is that nobody knows that she was an RN of 50 years and on the other side of the house, my dad, I didn’t know he was there. He is a physician by trade, retired. Nobody knows any of that so it was funny after the fact. Funny, but not funny. Comical, after the fact. 

She’s like, “Put 60 seconds on the clock.” I think it is a conservative amount. I know the head can be out for longer, but I think coloring and other things factor in. So as soon as I heard my midwife very calmly– and everything was very calm I have to say. It was the most beautifully handled situation. I never felt scared. I didn’t feel traumatized after, but she very calmly said, “Please call 9-1-1,” to my mom which has to be hard for a grandma who was supportive of home birth– I know my mom and dad were supportive and I know my dad especially was concerned from his background. I know they had a lot of questions and they trusted me and my research. I live really close to two huge, big hospitals, but that had to be really scary. 

When she did it, she did great. She went downstairs to open the doors for EMS and she missed the baby being born because when I heard, “Call 9-1-1,” I gave the most roaring push my doula called it. I scream pushed and my midwife did go in and released her arm. 

Meagan: She had shoulder dystocia, right?

Amy: She did have shoulder dystocia, yeah. I guess technically it was a dystocia if I don’t know. I felt like I needed to know and I’ve done a lot of research of was it really? Could I have changed positions or was it rushed? In the end, I think we’ll call it dystocia because she went in and she helped, but she popped right out with a little bit of assistance. 

By the time my mom got upstairs from opening up the door, baby was born. It’s all such a blur. I think she needed a little stimulation. Her coloring wasn’t perfect coming out, but I don’t think there were any concerns. Her APGARs were fine. We just stimulated her a little bit. She started crying. Everybody had this huge sigh of relief because we didn’t have the equipment. My midwife still wasn’t there yet. She did a beautiful job and I’m just forever grateful for her skill set and the fact that she knew how to handle it. 

I love that my story can show people that situations can arise. I don’t want to say emergencies, but tough situations can arise where these skills are needed and these midwives are wonderfully trained. 

EMS walks in and they see this baby that is crying and pinked up. We’re all laughing and happy and riding the birth high. They’re just like, “Okay, you’re good here?” We’re like, “Yep, we’re good.” They’re like, “Congratulations.” They left. They did not. They said, “We would rather deal with a gunshot wound than deliver a baby.” They had a cord clamp. They were like, “Do you need a cord clamp?” We’re like, “No, thanks though.” That was all they brought with them. It was cute. 

There was apparently a line of men down my steps, nine EMS, two squads, three guys–

Meagan: They didn’t need anything. 

Amy: No. I’m glad they responded. It’s not that I wanted that to be a part of my story necessarily but it was what needed to happen and she felt that she took the steps she needed to feel comfortable delivering on her own. It all ended up wonderfully. Things can go wrong with shoulder dystocia, so I was very blessed that she came out as well as she did. I didn’t have a tear. I had maybe a first-degree tear which was great. She was 9.5 pounds so not my smallest either, my second biggest. We found out she was a girl and yeah. 

The rest is just the beautiful postpartum bliss. My midwife shows up, I don’t know. She was born at 10:10 PM. The midwife shows up at 10:25 totally bummed because you don’t want to miss it. I loved her and we had such a great bond. I’m so glad she was there with me a lot of the day. She was just, there was just so much joy in the room. They did all of the postpartum stuff you do at a home birth. They weighed her and measured her. We latched. My placenta– I’ll go back. 

My placenta, I love that they don’t rush it in home birth. I stood up. They were like, “Maybe gravity will help.” I had cramps. I wanted to get up and take a shower. We just crack up because I walked a few steps across the room and my midwife, God love her, had this chucks pad under me because I’m sure I was bleeding and dripping. I gave this little cough push and midway walking through my room, the placenta just plops out like rapid speed. It drops the chucks pad down to the ground. It lands on it. We all start cracking up. We might have named it my plopcenta. 

Meagan: Plopcenta. 

Amy: To this day, my daughter still calls it that. But it was hilarious. It was kind of fun. So that happened. I took my shower. She was here. I still couldn’t believe it went down that way and that my mom was there for the birth even though she never was really planning on it. Yeah. 

I’m sure there are so many details in there I missed, but I’ve been talked forever. Literally, it was just going from thinking you have this scarlet letter of big babies and C-sections and OP babies to– I don’t know. It was really fast. From 7:00 PM to 10:00, it all happened really fast. 

Meagan: Yeah. 

Amy: With hardly a push, maybe two coached pushes at the end there with a little bit of help from a midwife, but yeah. It’s wild how each delivery is different. I’m just really grateful that I had the team I had and trusted myself and body and the process and yeah. We’re just really grateful. In the end, it was beautiful. 

Meagan: I am so happy for you. So happy. And look how beautiful. I know everybody right now can’t see her, but she’s so beautiful and so darling. 

With having EMS and stuff like that involved, that a lot of the time can have trauma involved with that too or maybe for future kids, maybe some people will say, “Oh, well this had to happen last time,” and maybe question you doing home birth. Do you have any tips for anyone? Like you said, “It’s not necessarily what I would have loved to have happen, but it happened and it was fine.” 

Amy: I think I had to debrief a lot because I’m the type that wants to know why. So kind of what happened with my first VBAC, I felt really victorious, then as I started nitpicking the birth and all of the interventions, I kind of had a huge dip in my mood and got really upset about it. I have to work through it and go through all of the details. 

With this, I remember saying it out loud. I really didn’t feel like it was traumatic. I really had to think about the why and why they were called. I felt like it was–

Meagan: Extra precaution, yeah. 

Amy: I said to my midwife after the fact– she’s been catching babies for 10 years. I said, “Would you have called at 60 seconds?” I just don’t know if she can answer that without having been there because I think you do have to look at baby’s coloring. I think they can tell by the cardinal movements as they are coming out. I don’t think she was turning as she was supposed to. She wasn’t turtling in, but she wasn’t doing the cardinal movements that she was supposed to. 

I don’t know had there been two sets of hands if they would have been called that soon. Maybe we would have gotten baby out before, but I’m actually just really grateful they called and I have to reframe it that way. Maybe working with a therapist if you felt like some of the things that happened weren’t necessarily healing or what you wanted. Yes, you love blowing raspberries. 

I just thought of it as, “Hey.” Some of my medical friends that I work with or colleagues who thought home birth was so dangerous, look how proactive they were. There are some midwives who think they can do it but they don’t help at the right time or they don’t transfer quickly enough. My midwife always said, “I will never second-guess your intuition. If you say that you need to go to the hospital, I’m going to follow your guidance. We’re never going to risk anything and we’re never going to cut things close.” 

That’s why I felt so comfortable with this team. I had an emergency transfer plan and I had a non-urgent transfer plan. Everything was spelled out very nicely. I knew they weren’t going to push the limit. 

Meagan: Yes. 

Amy: I just had to tell myself that she didn’t have resuscitation equipment. She needed extra hands. When I went through the postpartum follow-ups, they were so wonderful. They come at one day. They come at three days. A lot of that was very therapeutic for me to talk about the why. I didn’t even realize at that time that she was born that it was one of the reasons. She really didn’t have anything with her. A lot of it was in her trunk because we weren’t planning to have the baby that quickly. 

I think I had this long, drawn-out early labor phase and that’s just how my body was in the past. In my first two other labor, I went from 4-10 with an epidural in an hour. I think my body does this pause until I relax and then I go real quick. That’s just how it has been with the other two. 

So yeah. I think if you have some parts that might– and it’s okay for parts to be traumatic. It can still be a beautiful birth if there are parts that don’t go perfectly as planned. I think that’s one of the things I had to work through a lot, but it was just still very healing. I just had to look at the why. That’s how I got through that part. 

I didn’t love sharing that part at first because I didn’t want people to say, “I told you so,” from some of my more medically-minded friends and colleagues. I think shoulder dystocia is scary, but I think after hearing some other birth stories, I feel like, some doctors aren’t even as skilled at handling dystocias as the midwives are or they jump to way more intense interventions because they can and midwives have to have the skills. 

Meagan: I just love that you did. I love that you did share that because it’s not your traditional– it’s what people fear when they have home birth of having to transfer and EMS. That’s what I noticed is that I love that you were like, “I had to break it down to the why and not let that make it be traumatizing.” 

She really had nothing, so she was only being the smartest midwife she could be in case this little baby needed help. She knew that this other midwife wasn’t close and couldn’t make it to her in time, so she got the help. I love that you pointed that out because really, most emergencies can be handled within an appropriate time. I know that there are always nuances, but I love that you are like, they got there and were like, “Are you good? Okay, bye.” 

Amy: I know. I mean, yeah. I always had a little fear of hemorrhaging even though I never had. I had a little fear of, I don’t know, other major things like a dystocia or malposition where I’m not going to be able to push baby out because in my past, I had it and I think it’s important to know that having an assisted delivery for my third, for my first VBAC, really cut my confidence down. 

Meagan: I’m sure. 

Amy: It really made me not believe in my body and I kept going, “Well, I really didn’t push the baby out myself last time,” because he really did jump to interventions really quickly for whatever reason. He pushed the time clock. So I kept going to my midwife like, “But I don’t really have the ‘proven pelvis’ because I really didn’t push that baby out myself. They helped him out.” I don’t know where I was going with that, but I think–

Meagan: Well, it placed some doubt. 

Amy: Yeah, it did place doubt. 

Meagan: It placed some doubt and that’s hard and then you went and totally– the proven pelvis thing, it’s like, no. You did. You’re amazing. 

Amy: We did it. Yeah. She came out really, really without too much effort. You could see the midwife assistant helped her arm out, but really, we got her out. 

Meagan: You did it. 

Amy: I want to say too that for anybody who is nervous about midwifery and their skills, it was her 7th or 8th catch ever by herself and her first dystocia. I asked her just last night, “Were you internally freaking out? Because you were very calm and confident.” She was like, “No, but you know. It was definitely my first dystocia.” I’m like, “Well, I’m almost glad you did it on your own because I hoped it built your confidence as a midwife.” 

Meagan: Exactly. 

Amy: If she had that situation. Again, I don’t want the whole story to be focused on that one moment and that one instance and be labeled with this shoulder dystocia, but I do think that it’s important for poeple who have a history of large babies to know that it doesn’t have to keep you from having a low-intervention birth or an out-of-hospital birth. You just have to trust yourself and do what you’re most comfortable with. 

It came down to me. This is where I felt safest and I knew that if I went to the hospital, in the past, one intervention always led to just another intervention that led to a more difficult delivery than it had to be and I just knew that walking into the hospital, I was just not going to have the opportunity to probably have no interventions unless I showed up crowning. I felt safest at home. I hired a team I felt safest with. If I could give any advice, it would be to just think about that and where you’re going to feel most comfortable and in control, safest, and hire a team that you feel 100% comfortable with. 

Meagan: Yes. Thank you for sharing. Thank you. Thank you. I do love all of it. I love every single detail. I love that you shared the ups and the downs. I noticed you were alone for a minute and then that’s what your body needed and then you kicked right back into gear. That is just amazing. 

I want to talk a little bit before we get going on cervical exams. Okay. So let’s talk about cervical exams. In the hospital, they are way more likely to perform them. Then out of the hospital, they don’t. I don’t want to make it sound like we are saying that out of the hospital is better than in the hospital at all. That’s just the way the system kind of goes in the hospitals. We have standard cervical exams. 

So cervical exams before labor, let’s talk a little bit about that. Are they necessary? That’s a big question. Do we have to start having cervical exams before we’re even in labor? Because we have so many providers and even out-of-hospital providers that will say, “Oh, let’s just check your cervix and see where it’s at,” or they’ll say, “Well, we’re getting to that 39-week mark. We’d better check your cervix and see if you’re going to be capable of having a VBAC.”

The question is are they necessary? No. They are not necessary. It does not tell us anything. It really doesn’t. All it does is help your curiosity and tell someone where you are on that day in that moment. That is not going to necessarily change anything to predict the future. It’s not going to predict the future. If you are 1 centimeter dilated and 40% effaced or something like that at your 39-week visit, that does not mean that your body is not going to do it and you’re not going to be able to have a VBAC. 

What does it help? Nothing, really. Maybe your curiosity. What does it hurt? Well, they can be uncomfortable. It can cause some prodromal labor if they are in there and they are too aggressive and it is stimulating things. It can hurt us emotionally because if we are getting this number and we are being told things at 39, 40, or 38 weeks even. We’ve had some people. That’s really, really hard to hear because then you start doubting yourself. It hurts us emotionally and places doubt. 

Are you needing a cervical exam before labor? No. Women of Strength, no. If you do not feel like you want one, you do not have to have one. Say no. Say, “Maybe next time.” And maybe next time you want one. Maybe next time, you are still like, “Maybe next time.” So that’s before labor. 

Now let’s talk about cervical exams in labor. You know, there are actually no real deep studies demonstrating that there are actually clinical benefits in routine exams before labor, but then in labor, they are doing it all of the time too and there’s not a ton of solid evidence that even tells us that it’s going to tell us anything but, again, what it is in that very moment. 

What can cervical exams in labor tell us? Well, it can tell us what we are in that very moment. It can give us an idea. It can appease our curiosity. It can tell a provider a station, a station of the baby whether how high or how low a baby is. It can help– and this is help, not tell exactly– a provider see where a baby is position-wise. But even then, you really have to be dilated enough. Your baby has to be low enough. Sometimes, the water, they can’t even tell through the bag of water if there is a bag of water and things like that. 

So yeas. It can help with the position, but it’s not going to always be sure exactly. Okay, so let’s see what else it can help with. Induction– if we are going in for an induction, it can help us know a base and a starting point and what method of induction may be appropriate at that time. Okay, so if there’s a medical reason or a desired reason for an induction, you may want to get a cervical exam to see what you’re going to do because they may want to place a Foley or you may be dilated enough and they may just start Pitocin. 

Or sometimes, from the mom’s standpoint, a cervical exam can sometimes be unofficial– again, it goes back to curiosity, but on their debate on an epidural. Maybe they are like, “I’m really, really tired, but if I’m past a 6, then I’ll keep going. If I’m a 3, I need a break.” Again, it’s a mental thing. But when would we maybe not? This is another thing. We have a lot of providers standardly every two hours, every two hours, putting their fingers in vaginas. Every two hours. 

Amy: No, thank you. 

Meagan: We are introducing things that we don’t need to be introducing like bacteria and the risk of infection. So when would you want to say, “Heck to the no?” When do we want to say, “Hell no”? I’m just going to say it. When do we want to say it? Well, we just kind of mentioned it. Maybe if your water has been broken for a long time or just broken at all. Maybe we don’t want to introduce that. Maybe we’ve been told in a previous exam that we’ve had a bulging bag because we can have an accidental rupture of membranes with a cervical exam. 

Not too much has changed. In your story, if you were to have gotten an exam further before they left, they would have been like, “Okay, well not much has changed, but let’s still check your cervix anyway.” But instead, they were like, “Not much has changed right now. It’s kind of slowed down. Why don’t we just take a break? We’ll leave. You hang.” Versus, “Well, let’s do a cervical exam.” If not much has changed, probably not much has changed. They don’t feel good, so if you’ve had a previous cervical exam that didn’t feel very good and not much has changed and it’s only been two hours, it’s probably still not going to feel super good. 

This is another thing. If one nurse came in two hours ago and now we have another nurse coming in, we probably don’t want to do that because guess what, you guys? They are subjective. Is that the right word? I don’t even know if that’s the right word. They’re not always accurate. My hand and your hand are different sizes. My fingers are different lengths and everything and everyone’s perspective is a little different. You may get a, “Oh, you’re at 5 centimeters,” and then you may get a, “Oh, you’re 3 centimeters.” Or, “Oh, you’re baby’s at 0 station,” or “Oh, you’re baby’s at +2 station.” It’s never a full-on guarantee. 

A big question is, “Can I say no to a cervical exam in labor?” Again, the answer is yes. You can say no. Never feel like you have to have a cervical exam. That doesn’t mean– maybe it’s changing from you don’t want one now and then maybe you want one later, but you do not have to have a cervical exam and there’s really not a ton that it really tells us what we’re going to be in three hours. It’s just not. It’s just not. 

So anyway, I’m going to get off my rant about cervical exams, but I don’t love them. I also didn’t have many. I did have some at my birth, but I didn’t have many. You know, I’ve been to births just like yours where we’ve never known how dilated. We fixate on this dilation number so hard and we don’t need to.

So, Women of Strength, your cervix does not need to be checked. It does not need to tell anybody any information. If you want the information, get it but just know that even when you get that information, that doesn’t necessarily mean that you’re going to be 5, 6, 7, 10 centimeters in the next hour or three hours. Look at Amy. She went from 4 to 10 or whatever. We don’t even know in this situation with this last birth, really. She went from chill labor to intense active labor to a baby out. We have no idea where she was and that’s okay. 

But do you want to know what I can tell you? She’s got a beautiful baby in her arms right now. 

Amy: I do think that you have to know yourself. I know people love to know the information, but I think I would have been really discouraged had I known maybe I was 4-5 when my team left after the first 12 hours, and then I think it would have been a huge mental block. Then your body can shut down. Who knows if labor would have started back up or kept going? 

Part of me goes, “Man, I’d love to know where I was just so I could piece it together and tell the story with the centimeters and just maybe help someone else,” but I’m also like, “I dilated to a 10 and we knew it was time to push because my body pushed.” I think the surrendering was what I needed personally and I think that route was the best for me. For some people, that would stress them out to not know, but I think for us it was helpful. 

Meagan: Yeah. 

Amy: I do love that there are options and I do think you need to advocate for that in the hospital because you do get pressured a lot to get checked. I will say that. 

Meagan: Yes, you do. 

Amy: For sure. We know that. 

Meagan: All right. We will let you guys go. I will get off my cervical exam rant and we will catch you next week. 

Amy: Thank you for having Juniper and I. We are so, so happy to share our story so 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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“Feel it to heal it.” 

Ali Levine is back with us today sharing her HBAC story! Ali was first with us on Episode 166 where she shared the details of her transformational VBAC. Ali and Meagan reflect on the growth they both have experienced since they last chatted. Ali is now a certified breathwork practitioner and intuitive stylist. She talks about how through regulating the breath, we can better surrender and allow our true selves to shine through. 

Ali experienced this firsthand as focused breath helped her stay calm through her baby’s shoulder dystocia and allowed her to surrender to the guidance of her midwife. She was able to achieve the home birth she knew she could have! 

Ali shares how important breathwork is in allowing us to release fear, anxiety, trauma, stress, or any other negativity that our bodies hold. And it’s a process! By giving our bodies lots of opportunities to breathe, relax, and release, we allow beautiful healing to take place. 

Additional Links

The VBAC Link Podcast Episode 166

Ali’s Website 

Awakening with Ali Podcast

Ali’s Breathwork App

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello everybody. You guys, it’s December. How are we at the end of 2023? I cannot believe it, but I am so excited to be kicking the month off with our friend, Ali. She has been with us before, so welcome, Ali. 

Ali: Thank you. 

Meagan: Yes, I’m so excited to have you on the show again. She shared her C-section and VBAC journey a while ago because she is Episode 166 and we are now at 264 so almost 100 episodes ago. 

Ali: Wow. 

Meagan: So crazy. She’s back today to share her HBAC story, but not just that amazing part, she’s also going to talk to us about breathwork and her journey to become certified as a breathwork practitioner. She is a breathwork practitioner, intuitive stylist, and transformation expert. 

What exactly is a breathwork practitioner and transformation expert? Can you tell us a little bit more about that? 

Ali: Yeah. Well, I’m just so excited to be back here with you. Can I just say when you said about 100 episodes, I had such a reflective moment as we were sitting here? I’m like, “Wow. 100 episodes.” Thinking about how much both of us have evolved and grown and shifted, I feel like that’s so important to start with because as mothers, I feel like we don’t necessarily get that time to reflect and look at our growth and look at our evolution. 

So much of doing that allows us to continue to move forward. I’ve learned so much in my journey. It’s not only the healing work around it but the true reflection and celebration of, “Wow. Look how far I’ve come.” Yeah. I first came to you guys. I was listening to the VBAC podcast. I was pregnant with Amelia almost five and a half years, almost six years ago. She’s five and a half. It’s crazy. I was listening to your podcast and I had my C-section with her. I started listening to The VBAC Podcast to start to understand what was possible and what I could do, then 2020 came and I had Arlee, my second daughter. 

I had my VBAC in the hospital and then as you said, moving forward into 2022 and having my son and my first HBAC which is a home birth. It’s so cool. You said about 100 episodes and it’s so cool. It’s like, “Wow.” Think about that and the time and evolution even with your podcast and what you guys were doing what you are doing now and when I met you guys and when we first connected, getting to share my story then and then coming here. 

So I just think it’s really cool to start with that first, right? The journey before we talk about what are these “titles” that we all have. I feel like it’s so much more important and so much juicer. You just feel it so much more when you hear, “Hey, yeah. Okay. This is what people call me, but really at the end of the day, what’s the journey? What’s the story?” That’s how we are going to support each other, help each other, and be of service. 

So hi, everyone. I’m Ali Levine. If you don’t know me, go back and listen to, of course, my other stories. I’m so excited to be here. A certified breathwork practitioner is someone who, of course, is certified in the work of breathwork. Breathwork is regulating your nervous system through different types of exercises. When people hear regulating their nervous system, some people don’t even know what that means. 

To break it down really simply, basically think about visually that you have almost this computer in the bottom of your body that is sitting like this hard drive. Think of your whole body as a computer and the hard drive is sitting basically at the bottom, kind of near your womb space and kind of near your stomach in the lower area, okay? It’s sitting there. It gets filled up consistently with files and junk and stories and limiting beliefs and people around us, family, friends, all of the things and our own things. It all fills up. 

Meagan: As it does every day. 

Ali: Every single day, every single moment. It’s just the way that life is. What happens is that system basically moves into a disregulated system. Speaking of birth, when we talk about having a baby and when our baby is first born, of course, they take their first breath when they actually enter this world earthside. If you look at your baby and you watch how they breathe, they breathe from their stomach to their chest deeply and out. That is a sign of a parasympathetic nervous system which is the true homeostasis of how we enter into this world. 

It is a rest and digest place. Most of us are not in that state anymore. We are in a sympathetic nervous system. So when we speak to breathwork, we are moving ourselves back from that reactionary state of that fight, flight, or freeze, that triggered state that happens continuously and moves us back into the flow of how we came into this world which is so perfect of course speaking to birth and what you talk about on the podcast. 

When you think about that and you think about that flow and how that feels in the body, and you start to come back to that rest, that’s what breathwork does at a very basic level. That’s what is means to regulate your nervous system. The basic benefits of breathwork are just allowing the nervousness to fall off– anxiety, depression, sadness, and stress. It gives you better sleep. It builds up your immune system. It builds up your gut health and all of these things because you are bringing more oxygen into the body and then you do it on a normal basis. 

We are all breathing, of course, because we have to breathe to be here on the planet, but we are not actually consciously breathing so what breathwork does and what it means is that not only regulating your nervous system, but you are allowing different types of breathwork exercises which is what I guide you in being certified in this work and trauma-informed. I take you through different exercises through your nose and through your mouth. Maybe if we have time, we will do a quick one so that people can experience it. 

Meagan: Yay!

There are different ways of doing it and there are all different types of breaths that will lead you. It can be anywhere from literally two minutes to an hour getting into a full meditation. When you do this practice over and over again, you start to notice that not only do you start to release everything that you are holding consciously or unconsciously, but you do start to notice the benefits that I spoke to. 

What I like to say is that I help people, especially mothers and women, shift from lower states of consciousness to higher states of consciousness. You go from that triggered state, that reactionary state into actual authenticity of who you are as a soul, more peace, more love, and more calm and you are able to show up better as a mother, as a partner, and all of the things that you do in your job or whatever it may be. That is where my heart is. 

When we say “practitioner”, some say “facilitator”. Some say “practitioner”. Practitioner for me speaks more to my soul because it is more about the practice, the art, and the modality, versus facilitating the space. Of course, I do both, but I feel like I allow and open that up. It’s where I shine and help my clients. 

The intuitive peace of styling as you know, when we first met, I had been a celebrity wardrobe stylist for many years and I rebranded after my motherhood journey and postpartum depression and all of the things I went through. The intuitive is more tapping into what I learned from my own journey of what really feels good on you versus the trends. What really feels good on the body because it’s all connected– mind, body, and soul. 

Even when we start the day, even if we are in our sweats as a busy mother, it’s being conscious of, “Maybe I don’t want to wear that gray t-shirt because I’m going to notice that my mood actually shifts.” Helping people get conscious in their closet and understand that there is a frequency to everything. Everything is energy so what you put on in and out is so important. Hence, intuitive stylist. 

And then of course, that brings us to transformation. The more you do this and embody this work and allow that surrender, you can move into actual transformation which is what I love to help people with because I’ve gone through my own transformations over and over again. 

Meagan: Yes. I love that so, so, so much. You had written in your bio, “You help your clients breathe through their closet to tap into the design of their soul and come home to themselves through the wardrobe of their dreams”. That’s so cool. 

Ali: Thank you. 

Meagan: I just love it. I just love it. I love it so much. Thank you so much for breaking it down and explaining because it’s like, “Okay, breathwork practitioner. What is that?” You know? Just  hearing you, I can hear your energy and I can just feel it. Oh, I could just feel it from you. I can see it. I mean, they can’t see you but I can see you. I can just see it and feel it. Oh, I’m so excited to dive into this episode. 

Review of the Week

Meagan: But of course, we have a Review of the Week, so I’m going to hurry and do that before we jump right in. Okay, it’s not a super long one, but it is by kchidster. It says, “Amazing. Thank you, thank you, thank you. This podcast was my saving grace. Could not have had my VBAC without these ladies and their stories of encouragement and wisdom. A must-listen to anyone wanting to TOLAC.” If you are new to this podcast, that is a trial of labor after a Cesarean. 

It says, “Keep up the great work. I thoroughly enjoy listening. Ladies, we can do hard things.” 

I could not agree more. Women of Strength, you can do hard things. There are sometimes things that sound impossible or feel impossible and like Ali was saying, maybe our compartment is on overdrive. We’ve got too much going on and we need to get things going and start working through our breathwork and finding ourselves again, but it is possible. It is 100% possible. 

Ali’s stories 

Meagan: Okay, darling. Oh my gosh, I mean, you just spoke for three minutes maybe and I’m like, “Ahh, let’s just keep hearing from you,” so I’m going to turn the time over. 

Ali: All right, cool. Well, thank you. I’m so excited to get to share this journey. So where do we want to begin? Should we start going back? 

Meagan: Your HBAC, yeah.

Ali: Okay, my HBAC. Yeah, okay. 

Meagan: Well, and if you want to re-highlight a little bit, if you want to hear the full story, episode 166 is the full episode, but why don’t you talk about like we were saying at the beginning, the journey through 100 episodes, but there was a journey before that too, so touch on all of the journey. 

Ali: Okay, cool. All right, well thank you. Yeah. I mean like you said, I love that review that came in of how you can do hard things. I think so much, especially as mothers or mothers-to-be, we can get so in our minds. We can get so in the limiting beliefs and like, “Oh, I can’t do that or I won’t be able to,” or we are told by someone that it won’t happen. It can’t happen. But guess what the most amazing thing is? We are divinely created this way so when we can get out of those limiting beliefs, when we can get out of the mind which is why breathwork is so, so powerful, we get into the wisdom of the body and we can actually listen and receive our body.

Then we recognize, “Oh, actually, I can do this and more,” which is why obviously, people who are listening to The VBAC Podcast are having these amazing VBACs. Same with my story, it was like, hey. I had a C-section five and a half years ago back in 2018 with my first daughter. It was quite a traumatic birth. 42 hours led to a C-section. I wanted to have a natural birth with a midwife at a birth center. It didn’t work out that way. She didn’t progress. 

You can go back and hear the whole story, but I didn’t progress. Didn’t happen. Fast forward and I had the C-section. Then after that happened, I went through a pretty heavy postpartum depression journey. After finding myself all over again, or a new version of Ali, and reinventing myself and finding that empowerment and that freedom and all of the work I had to do, meditation, affirmations, prayer, and all of that led me to breathwork. That was where my next journey began. 

Breathwork really started to change my life in how I showed up, how I viewed my body, how I viewed my story, my baby, and my motherhood journey. It went from being a very dark place to a very bright place and seeing that there was healing within that. There were lessons within that first birth. There were all of these things to learn. I think that’s important to say, Meagan, because I feel like I personally, and I’m sure many other mothers can agree, shamed myself and they guilt themselves through what I could have done, what I should have done. They play the victim mode.

I was blaming everybody around me– my parent, my friends, this person, that person. We can blame all we want and we can have all of this shame and this guilt, but it doesn’t actually do anything for us. It actually debilitates us from moving forward. So the more we heal that space and then also see it as, “I had lessons to learn here. There was growth here. There was evolution,” which is what I had to do in my own healing work and really move myself out of the victim to the victor in my life. Move myself out of the victim mode in saying, “I’m going to blame you. I’m going to blame you,” and take full responsibility because, at the end of the day, we have to be responsible for ourselves and say, “Okay. I chose to listen to stories. I chose to take on the noise that came to me,” instead of creating sacred boundaries and understanding that I do have the wisdom. I do have the knowing. 

So that’s what led me to you guys and listening to your podcast and then finding a chiropractor for my second pregnancy with my daughter to finding a doula who helped me advocate for myself and understand that I could ask those hard questions to help me fire my doctor who told me I couldn’t have my VBAC. I’m putting quotes because they love to tell you that you can’t do this. 

And then, of course, this is not medical advice, but advocate for yourself. Ask the question, “Why can’t I? What is it?” For me, it was literally just someone who saw me as “You had the C-section, you’re always going to be a C-section.” I wasn’t willing to say yes to that. I wanted a VBAC. I wanted to advocate for myself and luckily, in having those sacred boundaries and having the empowerment and healing I had done, I was then able to move into 2020 and have my second daughter and have a VBAC. 

During that time, obviously, we all know what went on in the world during 2020. It was a crazy, crazy, traumatic time to say the least. I was also living in California at the time so it was extra crazy. I now live in Tennessee, but I was living in California at the time. The fear, the limiting beliefs, and everything started coming back up for me. I thought all of the healing work I had done was handled. It wasn’t. It all bubbled back up when 2020 came. 

I say that because I think the healing journey also is an evolution of the continuous peeling back of the onion. We have to understand. We have to be willing to peel back the layers to continue to heal and feel and move through. 

So long story short, it was crazy at that time and everything was coming up. That’s where breathwork really, profoundly showed up in my life. I was struggling with meditation, my affirmations, and my mindfulness work because there was so much going on. I couldn’t get out of my head no matter what I did.

It was really frustrating to me. I was like, “Oh my gosh. I’ve done so much work. Why is this not working?” I surrendered to breathwork and I allowed myself to start to let my body show me what it needs to release. So when we speak to that, again, regulating the nervous system, I always tell my clients and anyone I come in contact with that I believe the nervous system doesn’t lie. The mind, the ego, and our personality love to tell us stories and give us different junk and the monkey mind will go on and on, but the body doesn’t lie. The body will tell you if you have a pain that comes up. The body will tell you if there is a sensation that is coming up. Something is going on. It’s speaking to you. 

The same thing with breathwork. When we regulate the nervous system, things come up whether it be emotions, breakdowns, feeling more intensity in the body, or whatever it is, it’s meant to be released. We’re not meant to hold it. Everything like you said before, gets junked up and it is meant to come up. 

The more I recognized when I was doing the breathwork when I was pregnant in 2020 and I would do it, I would have a breakdown, but I would move into another breakthrough. It kept happening and happening. 

Fast forward to having Arlee in the hospital and basically, she got stuck at the end during my VBAC after labor had gone well. All the things had gone well. She got stuck. I looked at my husband and I said, “I need my earbuds.” I put them in my ears and I basically started doing a whole fear release, breathwork, and meditation, and there she came. 

There is a lot more to it but of course, you guys can go back and listen. I bring that up because that was the beginning of the journey for me in understanding how much the body has that wisdom and that we can get so stuck in a moment and get triggered or freeze or fight and flight instead of just allowing and surrendering to what’s actually happening. 

That’s what then led to having my son at home in 2022. After having my daughter in such a crazy time and a world being told that a VBAC wouldn’t happen and it did, and then moving into more of my healing journey and becoming certified in breathwork because that moment solidified it for me to decide to get certified and learn the work and why it was so powerful and transformational. 

So then I continued on that journey. I started helping people breathe and then I got pregnant with my son. In 2022, I went to my husband and said, “I really want to have a home birth.” He was a little like, “Are you sure? Are you sure?” I was like, “Yes. I am sure. I had my VBAC. I know I can do it. I really want to.” It was something I always envisioned myself having, but again, I had many people come up in my life who did not want to see that going on or different things happening. 

I honestly had to make really sacred boundaries to the point where I didn’t share most of my birth and what I was doing with many people, even those very close to me. I had to decide this time was sacred for my immediate family– my daughters, my husband, and I– to go through this journey together whether someone respected it or understood it or not because it is our journey. I think it’s really important to understand that whether you’re newly pregnant or going to be pregnant or are in this journey of a VBAC, it really is your sacred space. 

Just like the sacred womb has your babe or babies, you need to also protect what’s coming in and out. Breathwork helped me to do that over and over again. Every time something would come up that would maybe trigger me or upset me, I’d allow myself to feel it so I could heal it and move through it, but then I’d also recognize, “Okay, but I can also create sacred boundaries around this and make sure that it doesn’t come up again because I’ve healed this and maybe it’s something else that someone else isn’t willing to heal or see the way I see.” 

We all have different journeys and of course, it’s out of love. It’s out of protection, but sometimes, again, the ego and that protection want to tell us you can’t do these things and then you don’t do the hard things. You don’t push through. You don’t move over to the next level and the next evolution which, for me, was allowing myself to go for this home birth at home. 

It was pretty wild because when I did go into labor with my son, I had two false starts at home. It was that prodromal labor that came in. I had that with Arlee, but not as intense as I had it with Abel here at home. It was so much so that my team came over both times because we were really, really sure and then it didn’t happen. 

I felt like even that, Meagan, was a true surrender for me. I started getting in my mind and in my head of, “Oh, am I really going to be able to do this? Why is this happening?” I really had to go back to the breath and go back to my practices and say, “Release that. Release what you think. Release what’s coming up from the other births. Release what you’re scared of. Release the fear. Trust in that you can do this. There is a reason that you have felt you wanted to do this from the beginning. Go back to your knowing. Go back to your intuition.” 

I had to really work on that space when he wasn’t actually coming and it was these false starts. And then I, of course, had my acupuncturist come the next day because I was like, “Okay. I need help to be relaxed.” Something I’ve learned so much in my journey too is that we are meant to have support, especially as mothers and especially when we’re pregnant. We’re meant to have a village around us who can see our vision and who can support our vision as safe and as best as possible. 

You find the people around you who can help you in these modalities and support you in healing and in relaxation, so I had my massage therapist come and really relax my body. I had my acupuncturist come to work on me and give me the needles not only to help stimulate natural labor, but just to relax the body so I could get deeper in my breath and deeper in my visualization and allow myself to be at peace versus in the monkey mind that was coming up because it was. 

I tell my clients all the time that just because I’m certified in this work, I’m still human. 

Meagan: Absolutely. Yeah. Really. I mean, I was a doula with my VBAC after two C-sections, but I didn’t think, “Oh. I’m having all of this back labor. I bet my baby is posterior.” It literally just went over my head. I was in my space and that’s why you have a team. 

Ali: Yeah. That’s why you have a team. That’s why you find the extra support and you invest in yourself and you say, “This is important” to be able to help me be able to go through what I’m going through because you’re not meant to do it alone. You’re really not. I know as mothers, we know we can do it all and we absolutely can, but it’s usually to our detriment. I say that over and over again. I can, but why should I if I can actually have support and I can actually lean into that and allow that to have more space for myself and to be able to show up better for my husband and for my kids, for my work, for my clients, and for all of the things that I do versus exhausting myself and then having nothing left and not being able to show up at all? Because then I’m not serving anyone nor serving myself. Right?

Meagan: Right. 

Ali: I say that because I needed to reach out and say that I needed to help my acupuncturist come and help me relax. I need to get the massage to let my body just chill. I need to go back to my chiropractor again during the week and let her work on my hips again. She was so funny. She was feeling me. She was like, “Oh my god.” We didn’t know what I was having this time. It was a surprise gender. She said, “The baby is so low. I just don’t know how the baby is not here.” I was like, “I don’t know.” She was like, “Seriously. Let go. Whatever you are holding, let go.”

I didn’t know what that was until I had the different people that I worked with help me move through and my doula sit with me and be like, “Okay, what is it?” A lot of it was birth processing. It was going back to Arlee’s birth and understanding that there was a journey there and that last moment where she did get stuck and what that felt like and what that looked like and that out-of-body experience that happened. Processing that and, “Okay, if this happens again in a different way, will you be able to move through this?” 

All of these things came up that needed to be seen. I think it’s important where we understand the difference between getting locked into the fear of what could happen versus the reality of the different things that can happen and seeing them so we can see them and release that fear. There is a big difference between creating the story and making it your own. It’s actually seeing something and allowing it to go because I think a lot of times between the motherhood community and then also, I see in the spiritual community from being in breathwork, there is a lot of bypassing that happens. It’s like, “Okay, now I see it but I’m just going to shift it.” 

It’s like, “No, no, no,  no, no.” We still have to experience a piece of it. We still have to heal it and realize what’s coming up. We don’t have to get stuck in it. It’s like I tell everybody. You are not your feelings. Feelings come up. They are meant to move through. They are meant to be felt and they are meant to be released. We are not meant to become them. When we become them and embody them, then it’s, “I have this issue. I have this diagnosis. I have this.” 

Meagan: Versus, “I feel.”

Ali: Exactly. It’s, “I feel this. I feel that. This is how I’m going to work to move through that or fix that or whatever it may be.” Of course, there are different extremes in that, but I think so many times where we get stuck whether it’s a basic issue or an extreme issue, we do add on to that because we are such good storytellers and we create these stories over and over again and then we start to believe them. 

I know in my postpartum depression journey, I kept telling myself so many things about my body that were wrong with it, and the next thing I knew, I had massive cystic acne. My body was inflaming and everybody was like, “It’s been months since you had your baby. What is going on?” Nobody could figure it out on the medical side. Then on the holistic side, it was like, “Let’s get to the root of the trauma that’s happening. What’s going on?” When we started doing that, my face started to heal. My body stopped inflaming and it was like, “Holy crap. I did this. I told myself all of these stories.” 

Your body and your cells are always listening and it literally manifested it which is why again, breathwork is so powerful because it is in the body and you release it out. You release the trauma. You release the emotions, the feelings, and everything that is stuck so you can move through. 

It’s a real understanding that it’s not about bypassing, but it’s also not about becoming it and embodying it. You want to embody what you actually want to have in versus what you’re afraid of. 

Meagan: Yeah. So many people in our community are afraid. We are afraid. I was afraid. 

Ali: So was I. 

Meagan: Right? Especially when I did have people saying. I had some big naysayers. Then to what you were saying when your doula was like, “Well, what’s going on? What do you need? What’s going on in there?” and your chiropractor. All I could think when I was in labor is what my provider had said to me years ago in the OR but I wasn’t saying that. 

Ali: Sure. 

Meagan: I was holding it down. Yeah. 

Ali: Yeah, exactly. Sometimes we can’t communicate what we’re holding. We just feel that we are holding which is why again, breathwork has been so transformational in my life and so many clients that I have worked with. They’ll say that to me. They’re like, “But I’m not holding anything.” We’ll do a breathwork session and they’re hysterical. They’re like, “I don’t even know why I’m crying.” 

Meagan: You released it. 

Ali: Right. You don’t have to put a story to it. You released it. Guess what? Later on, the mind is going to catch up and you will know why you are crying. But right now, it’s about the fact that you just allowed the release. You let it go so now you can flow and you can receive more. This is in every area of our lives, not just motherhood. It’s so obviously important when it comes to birth and the work and everything that we do because we do hold so much. Fear is something that does come up through all of this. I experienced it with my VBAC through my daughter, Arlee. Obviously, she got stuck. 

Now we’re going to go into the story of Abel. I said that I had the two false starts that were happening. I did a lot of work around that and then finally, I went into labor the next morning. This was something funny. I went into labor on September 11th and– this sounds terrible but it is just so true. I woke up in the morning and I looked at my husband and I said, “There’s no way I’m having a baby on September 11th. I’m not in labor.” 

Right? I mean. 

Meagan: Yeah. You’re like, “I don’t want to have a baby on September 11th. That’s not a great day that people remember.” 

Ali: Right, so I was like, “No way. It’s got to be false.” He was like, “What?” I was like, “I’m going back to sleep.” I put my heating pad literally up to a 10 and went back to sleep. I jumped up not even 20 minutes later bouncing like I was on a trampoline, but I wasn’t. I was like, “Oh, this is not a false start. This is not false.” I was really, really, feeling it. I was really in my mind. I was really in the adrenaline. Immediately, I had to take deep breaths and calm myself down. I got in the tub. I started doing my deep breathing. I started regulating myself and I started noticing, “Okay, yeah. No. This is the real deal. This is my third rodeo in this.” I knew my body. This was definitely it. 

My husband called. He was like, “Do you want me to call the midwife? Do you want me to call your doula?” I, of course, was hesitant because I was fearful that it wasn’t real even though I knew it was. I was still fearful because they had come twice already. I was like, “I don’t know. I don’t know.” Then when I was really feeling it, I was like, “No, no, no. You need to call. Yeah, no, no. You need to call.” 

I was clenching and doing the breaths like, “Okay. It’s getting intense.” She came over and she checked me. She was like, “This is the real deal. Baby is coming.” I was like, “Okay.” It was funny. She was so smart because she knew me and how I got in my head. I was like, “How far along am I?” She was like, “I’m not going to tell you. I’m going to Dustin and I’m going to tell the team,” but because I had the false starts before and I hadn’t gotten very far, she recognized. I was very grateful for that because that was a fear and a lock that kept happening. 

She was like, “I’m not going to tell you. I just want you to know that baby is on its way. You’re doing great and we’re going to just keep going.” Now, it’s funny because she told me, of course, weeks later when we processed our birth, “By the way, you were at a 10 right from the beginning.” 

Meagan: What?!

Ali: So I had apparently, from going back to sleep and the whole thing and everything, I had progressed so quickly but because I had psyched myself out and I say this because this is how powerful our minds are, ladies. We can psych ourselves out of something happening good or bad or indifferent and don’t know it until it’s actually happening. When she told me that weeks later, I was like, “Wait, what do you mean, Kelsey?” She was like, “No, you were at a full-blown at a 10, but you weren’t ready mind-wise. You were still up there and you hadn’t fully surrendered to your body yet. I wasn’t going to tell you because I didn’t want you to get stuck again.” I was like, “Wow.”

That was a whole other mind-blowing emoji. It was like, “Wait. This mind/body/soul connection. I already knew this was real, but this was a whole other level of connection like, “Wow. This is happening.” So then it honestly was several hours that I still had to go through deep labor to allow him to come down and come through even though I was fully progressed. He still had to make his way through. 

I was in my tub for quite some time. I moved into the birth tub after doing a lot of walking and birth ball work and a lot of holding myself in the hallway just stretching and trying to let myself let baby come down. We did some walks around the backyard and just more and more movement. We did a little bit on my bed of the side-lying because it was really about just letting him move down and move through. 

Then when he was getting closer, she was like, “All right. I think it’s time that we get into the birthtub. We can start getting ready to push when you’re ready.” You feel it naturally which also was a mind thing for me. I had to keep deep breathing and getting into my breath exercises because I started getting into the mind of, “Oh, do I feel the push? Do I push? Do I not push?” I feel like that’s all just something with the VBAC is that you’ve had a C-section so you don’t really know how to push and that was the thing I learned with Arlee, but then I still had to learn with Abel. It was like, “Oh. Okay. There’s more pushing here but it’s natural.” It’s when you feel it, not just push to push. 

That was also something that when I got more and more of the deep breathing and more and more of the surrender in the tub, I started feeling it. I was like, “Okay. I feel him.” She was like, “Okay. Whenever you feel him, go and push.” Or actually feel the baby because I didn’t know what I was having. She was like, “Push.” I kept pushing. 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 

She was like, “Push.” So I kept pushing and pushing. Then I guess at that point, she had the mirror in the tub and she could see he was coming, but she said that she knew something was going on because there was a little bit of turtling that was happening which is when the head starts to go back. Something was going on, so she said very calmly, “All right. We’re going to get you out of the tub. I know you want to be in the tub, but we’re going to get out of the tub.”

 

They put me on the couch in my living room that was there in the room because that’s where I was giving birth. She was like, “Okay. I’m going to put you on all fours and move you around. I need you to just let me move your body.” That was a whole other surrender for me of not being in control of what I should do and literally just allowing myself to be loose and let myself be moved and maneuvered how they needed to to help me bring the baby forward.

 

Fast forward, we did that for a little bit and then he crowned. That was at 7:30 that night. I had gone into labor at 10:00 AM that morning. It was a long time. It was a long progression. When he crowned, she saw more of the turtling, so I guess she then let my husband and my doula and everyone know, “Hey, if things become a little bit more intense, we may have to transfer. We’re not there yet, but I just want to make everybody aware of what’s happening.” Of course, without letting me know and keeping me calm which I very much appreciated.

 

She said, “Okay. We’re going to move you more and we’re going to readjust your legs.” They had put my left leg up on the couch to one side and my right leg down a little bit more kind of in a funky position. But I mean to spread me. She said that she needed to use her fingers almost like finger forceps to push down to let him push down further. So she was like, “Okay, we’re going to spread you so I can push down and put pressure.” You tell me, of course, if you’re comfortable, but I need to push down to give you more space to push through.

 

I just remembered in that moment, I started feeling the fear like you spoke to coming back up. It was like, “Oh my gosh. What’s going on? Why is he not here? His head is here. Holy crap. What’s happening?” I had to immediately let that go and say, “Okay.” I started praying. I started surrendering and I just started breathing so deeply and so loudly into my body and just saying, “Allow me to further surrender. Whatever this is, allow me to release it.”

 

As I did, then she said, “Okay. One more push.” I pushed and there he came. She said when I was doing that, and I couldn’t see because my head was down, she said that my other midwife was actually unlocking his shoulder that had gotten stuck with a dystocia.

 

She moved and unlocked on the left side and then he came right through.

 

Meagan: Wow.

 

Ali: Yeah. It was quite surreal when all that had played out and then there he was. She brought him over to me and even in that moment, I noticed how powerful the breath was then too because of course, for anyone who has had a home birth, knows that it’s all about them naturally taking their first breath. Of course, they have everything they need to help them, but they want them to do it naturally. That was another trusting moment for me too.

 

He was lying there and he was like, “Just start talking to him. Just start letting him know you are here. By the way, it was a boy. It was like, “Oh my god. It’s a boy.” I had two girls, you know. I was like, “Hi, baby. I’m your mama. I’m here. Come to me earthside,” and just speaking to him. He took his first breath, but even in that moment, it was remaining in that surrender and that trust of, “He’s here. He’s fine. He’s well and he’s going to naturally take his first breath and be here with you.”

 

So all of it was such a transformational experience. I recognize too, Meagan, when after having the reflection and meeting back up with my midwife, Kelsey, that wow. There was work, obviously, that I still needed to heal from, and the fact that he got stuck again. It wasn’t the same way that Arlee did, but still, there was that moment of getting stuck. Thank God I had a great team which is why you obviously check who your team is, who was able to recognize everything that was going on, make sure everything was safe, and there wasn’t an emergency, but I even think about that now and reflect telling you this story. I’m like, “Wow.” It makes me wonder what I was holding because I still am processing that.

 

Meagan: Yeah. That’s what is so crazy. You were talking about how you released, but then there is still stuff you hold onto, but you released. Sometimes you don’t know or you don’t recognize that you’re holding onto anything until you’re in the moment.

 

Ali: Oh yes. Oh yes.

 

Meagan: Right?

 

Ali: That’s where it all comes up. That’s the final test, am I really going to trust and go through it? The only way through is in and through. It’s like, am I really going to go in to allow this or am I going to come back to that comfort of like, “Oh, but I was fine here.” It’s like, no, you’ve got to take that next step. It’s really having faith and not seeing it but believing it.

 

Meagan: Absolutely. I feel like having faith and taking those steps is what brought your baby there.

 

Ali: Absolutely.

 

Meagan: At home, in the manner that he came. It’s hard. It’s really hard. We’re so vulnerable.

 

Ali: We’re so vulnerable.

 

Meagan: It’s really hard. What tips could you maybe give someone who tends to pull back maybe and not take the dive in?

 

Ali: Definitely. Absolutely. I think first off just really becoming clear with yourself. Knowing your own why of why you want something and what that looks like to you and understanding that of course, things can change, but overall, what is the why, and how are you going to allow yourself to move into that? You don’t have to figure out the how because really, once you figure out your why and your true heart-set like, “This is what I want to do,” and you trust it and you let the body receive that, the how figures itself out. Everything else will show up. I really believe that.

 

But you have to first understand why it is so important for me to do this. And then also, the trust. The trust is such an important piece moving from what you want because everything is based around that trust. If you don’t have that trust and that faith, then you are going to get stuck in the fear. You are going to get stuck in the stories and the limited beliefs and the people and the things that are said to you is going to combine onto you.

 

If you are someone who does that naturally, then create sacred boundaries from the get-go. Immediately, as soon as you are pregnant, and even me, I didn’t tell people my due date because I'm like, "It's a due date.” I’m so sick of people asking me, “When are you due?” I’ll let you know when the baby is here. Stop asking. People don’t realize that makes you so crazy because you are already like, “Why isn’t the baby here? What’s going on?” Then you go back and start tightening in your body.

 

If you need to create sacred boundaries and not give your due date to people that you know are going to continuously ask, then give them, “Okay. It’s around this month and it’s around this time.” Make sure they honor that and understand that. If you need to put certain people on mute, if you need to block certain people, you really need to think about your sacred space of how you’re going to set this up that you feel good going into it, and then as things come up, you see them. You see what triggers come up and you allow yourself to heal them, but you don’t white-knuckle your way through and get tense. You allow yourself to surrender more. You allow yourself to have more faith and more trust. There’s a reason why this vision is on your heart.

 

You, of course, understand that things can change and you need to be open to that as best as possible, but I just think that it’s such an important piece. That’s how we embody this. That’s what I speak to in breathwork is embodying the work. Understanding that it’s not just saying it, but it’s truly feeling it in your body and then doing everything from how the body feels.

 

Like I said before, your body always knows. We feel everything, so if your body feels that something is off because somebody tells you something and it doesn’t feel true to you that you’re projecting a limiting belief on you or a fear, but your body is saying, “No, that doesn’t feel good to me,” then listen to your body and trust yourself. Don’t listen to what somebody else is saying. Ask your body. Ask your soul. Is this still a yes from me? Is this still what I want or is this someone else’s projection? Listen to your body. Your body knows. It’s a divine channel. It is the messenger.

 

Meagan: Yes. I feel like so many times, okay. VBAC. Your heart—actually, I’m going to give you an example of a client of mine. She just called me the other day. She was like, “I had a baby.” She had a traumatic Cesarean. She was like, “From the get-go. I knew I wanted an out-of-hospital birth. That’s what I wanted.” She was like, “But now, all of a sudden, everything is making me question. I don’t know if I can commit to an out-of-hospital. Should I? Is it too dangerous?” She was spiraling and getting the monkey brain.

 

Ali: We do. We spiral.

 

Meagan: We go from branch to branch to branch. We just hop all over. That’s really, really difficult. I love that you said that. Something that you said earlier and you just said it again. I don’t know why, but it made me think of Frozen, the movie. “Conceal, don’t feel.” When we’re concealing things, we’re not feeling things. You said, “Feel so you can heal.” I just love that so much. Don’t conceal and not feel. Feel so that you can heal.

 

Ali: Feel it to heal it. That’s how you can shift it. I tell people when my clients will say to me, “Oh, this trigger came up so I guess I’m not healed.” I’m like, “No, no, no, no, no. This healing is an ever-evolving journey. This trigger came up to see what isn’t healed still, so now let’s work through that and move through that. Don’t shame yourself because that came up. We’re all human. We’re going to have things come up that are going to do that, but let’s feel it so we can heal it. Let’s not get stuck in it. Let’s not conceal it. Let’s not hide it. Let’s not pretend it’s there.”

 

We’ve been doing it for centuries and it’s not working by the way. Actually feel it so that we can heal it and trust our body. This is where then when we regulate our nervous system and we allow ourselves to actually feel to heal, then we actually recognize, “Oh, the body is telling me something. Oh, the body is saying, ‘I do want to do this at home.’ Oh, the body is saying, ‘I don’t believe what you are telling me. That’s your limiting belief. I know what I believe. I know what I feel.’”

 

I had tons of that. So many people say, “Oh, do you think you could do a VBAC? You had that crazy C-section. Oh, do you think you could do a home birth because you had a vacuum assist at the hospital?” All of the things, but it’s like, yes. You can. If you feel the wisdom in your body and you know, listen to your body. I ask my body everything now. Literally, when someone reaches out to do a podcast, I ask myself, “What does that feel like in the body? Do I want to do this? Do I not?” These are the sacred boundaries I speak to of you understanding your own wisdom. We all have it divinely within us, especially as mothers and mothers-to-be. We are divinely created not only to create but we are designed to feel in order to create.

 

So understand that it is something within you and no one can take it from you unless you give it away, so don’t give away your power.

 

Meagan: Don’t give away your power. I love that. Yes. It’s so weird how this sometimes on the podcast where they all connect, but the story last week where it was like, everybody was saying no. No, no, no, but she was like, “No. I feel this. I know I can do this.”

 

Ali: I know. I know.

 

Meagan: I know. Even in a very similar way, I felt it when I went to all of these providers. “No, but I deeply feel this. I do.”

 

Ali: That’s your inner wisdom. You know your intuition is saying, “Yes, yes, yes,” and you have to trust that over when someone tells you, “No,” because they don’t know what you’re feeling. Only you know what you’re feeling in your body and this is when we have to get out of the mind because the mind will tell us tricks all day long. The mind will tell us to conceal. It will try to protect us. It will give us all of these stories. Like you said, the monkey mind of moving around. We have to get into the body and understand that is where we find the wisdom.

 

So anyone, whether you do breathwork or not, find what works for you in your body that’s going to allow you to move into that space of being in the spiral and in the constant dysregulated system into a regulated system where I can receive the divine wisdom that is within me and I can have the faith and the trust to surrender to this process because guess what? If I can do it, you can do it.

 

Meagan: Right. Something else that you had said earlier and again, just touched on now that stands out to me is that it’s okay to serve ourselves with the people that we feel safe with and sometimes I feel like in our community, we put restrictions on ourselves like, “I don’t need to have a chiropractor. I don’t need to do that or I can’t do that.” I’ve heard people say, “I don’t want to be too selfish. I don’t want to have all of the people because I don’t want to be selfish,” especially because it’s financially daunting.

 

Ali: Sure. Of course.

 

Meagan: This is okay for you to do. Women of Strength, it’s okay for you to bring your village in.

 

Ali: Yes, and also too, that’s another limiting belief. “I can’t do this. I can’t afford this. I can’t.” That was such a shift for me even in the entrepreneur workspace of getting out of the “I can’t” and being like, “No, I can. I am worthy of this. I am abundant. I am creative.” When you move into that, you start to feel it and then your body starts to receive it.

 

What’s really cool too is that everything is energy so if we think about our emotions as energy that’s always flowing, then your mind doesn’t actually know the difference between if something is actually happening or it’s happened because this is how our mind gets so crazy which is why limiting beliefs come into play.

 

I say this because if you keep saying things like, “I am worthy. I am going to have this VBAC,” and you keep telling yourself it, your mind will start to believe it and then you already know it in the body, and guess what? Mind, body, and soul all start to sync up, and then now, things have shifted. It’s like, again, going back to the beginning of what we said, Meagan, don’t embody what you’re feeling. Embody what you want and what you already have that you know you are walking into. Make the shift. Trust in it and everything else will show up behind it, but you have to take the leap of faith.

 

Meagan: You have to. You have to. Oh my gosh. I feel like we could talk for hours. We probably just need to do another whole episode. But oh my gosh, okay. So a couple of exciting things. One, obviously you have some social media that everyone needs to check out, and then two, you have an app.

 

Ali: I do. I have my own app.

 

Meagan: You have an app!

 

Ali: I do. Thank you. Yes, I wanted everyone, especially mothers and women and even kids—I have a whole kids section. I wanted everyone to be able to use breathwork whether they go on a deep journey or they use it just for the basics in their lives to help them destress and get back to regulation.

 

It’s called Breathe and Be. B-R-E-A-T-H-E and then you can either type in and or the & and the letter B because it’s all about breathing and being in your being because I really believe that when we allow ourselves to get into our being and our knowing, we come home to ourselves through the breath and that is what I want for everyone, especially mothers. So yeah. Download it on Google Play or the App Store. You’ll find it and you’ll see it right there.

 

Meagan: It has a beautiful logo. It’s white and blue with a B.

 

Ali: It’s very calm.

 

Meagan: Yep. Yep.

 

Ali: It’s got everything. When you download it, there are a few free exercises that you can do just when you get into it and then I highly recommend subscribing for all access. I drop in all new intentions, all of my events I do online as well as in person if you are in Tennessee, affirmations, and all of the tools that I have used that have helped me on this wellness and this spiritual journey I’ve been on. I’m always dropping in new content to different breathwork exercises so like, the power of you, gratitude, helping you sleep, releasing anxiety, just all of the different ways of breathing that are going to help you regulate and shift out of these different states that we get into.

 

So please join me. I have a community. There are two where I can talk to you. We can connect and message.

 

Meagan: That’s what I was going to say. There’s a community. That’s something I love. You go on and it says, “Begin, breathe, community.” It’s like, sometimes we need that community. We need to have those people because sometimes, we may not have people in our circle who are our safe place.

 

Ali: Right. Right, and that is supportive and the safe place and the sacred place is so needed. If you need that and this episode gave you a tug on your heart and you want to check it out or you want to get deeper in the journey, please subscribe and join me. I would love to have you and help you.

 

And of course, you can work with me one-on-one. I do online sessions as well as virtual events, but I tell everyone that if you want to have Ali in your pocket, then download my app and check it out.

 

Meagan: Absolutely. We will make sure to have the links for social media, your app, and all of that in the show notes. If you guys want to make it really easy on yourselves, just scroll to the show notes. Click the link and you will have Ali in your pocket in a snap.

 

Ali: Awesome.

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

Petra joins us today from Modesto, California sharing her unmedicated, hospital VBA3C story! Petra learned and grew from each of her three C-section births which paved the way for her to manifest the birth of her dreams with her fourth. 

Though she had very little support around her, Petra stayed steady. She continued to prepare her heart, mind, and body for the physiological birth she knew she could have. She tuned out the negativity. She trusted the path she knew she was supposed to take. 

Petra was thrilled to experience labor when the time came. She knew what to do. Her education and preparation paid off. She labored hard at home and went to the hospital when it felt right. 

Two hours later, Petra was crying tears of joy with a sweet baby on her chest. Petra is forever changed by her empowering birth experience and has now dedicated her heart’s work to helping other women do the same. 

Additional Links

Petra’s Website

The VBAC Link Blog: VBAC After 3 C-sections

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello. I hope you guys had a wonderful Thanksgiving. We are back with another story for you. Today we have a VBAC-after-multiple-Cesareans story. In fact, it is a VBAC after three which is a little bit harder to find information on and to find support for. We have our friend, Petra– look, I almost did it. Petra. I asked her before the episode. Pay-tra? Petra? I had a neighbor, so in my head, it just went, “Pay-tra”. 

Anyway, hello, hello. Welcome. 

Petra: Thank you. I’m so happy to be here. 

Meagan: Yes, so happy. You are from California. Is that correct? 

Petra: I am, yes. 

Meagan: Was your VBAC after three C-sections in California? 

Petra: Yes. 

Meagan: I feel like especially when we have VBAMC, we have so many people writing in saying, “Where did this person go and where are they located? Because if they are in my area, I need to find that provider or I need to research.” It sucks, but we don’t get the support after multiple Cesareans more often than not. 

Of course, through your episode, feel free to share and name-blast anyone in a positive way of course. Send those names out to the audience because I’m sure that they will want to research your provider. 

Review of the Week

Okay, so as always, we have a quick review. This is by cve18 and it was actually written in 2020. It says, “Gave me courage. This podcast is everything I needed to switch to a supportive instead of a tolerant provider at 28 weeks pregnant. The education and information I have learned is immeasurable. I have been researching and discussing with my husband to get a doula and all of the things to help me get a successful VBAC in December. Thank you for all of the things and I know I will have done everything I could for my future VBAC.” 

Thank you so much for your review and as always, you guys, we are always loving your reviews. You can go to Google. You can go to Apple Podcasts. Wherever you can, drop us a review because it may be read on the next podcast. 

Petra’s Stories

I just want to tell people a little bit more about you. Guys, she is a birth doula and if you haven’t noticed on this podcast, we love doulas. She is a birth doula, a birth educator, an advocate for VBAC, and a birth coach who had the most transformative vaginal birth after three C-sections. She now works with women who are ready to strengthen their authenticity and help them not only become healthier mentally, but have the pregnancy, birth, and postpartum experience they’ve dreamt of without feeling the fear and or inhibit– Oh my gosh. How do I say the word? How do I say the word? 

Petra: Oh my gosh. I think I need to change that word. 

Meagan: Inhibitions. 

Petra: So they don’t feel—

Meagan: So they don’t feel– 

Petra: Inhibited. 

Meagan: Inhibited. Yeah. I couldn’t spit it out. Okay, and hold them back. Okay. We’re back on track. Okay. She wants to help women reclaim the power that they already possess. That right there, I just love that. Women of Strength, I want you to know this. You have the power. You already possess it. This is why I love this so much. You are reclaiming the power that you already possess so we can help break the cycle. Right? Let’s break the cycle that is no longer serving us. The cycles are no longer serving us. 

That introduction– I’m sorry. You wrote that. I just read what you wrote and apparently couldn’t even read what you wrote, but that is so powerful. So thank you. Thank you for writing that. 

Petra: Yeah, of course. I just feel like these are all barriers that I had. Going through each one of my pregnancies up until my VBAC and now in my support of clients that I have, it’s huge. It’s a huge barrier. So if it’s okay, I’m going to start placing you in my story. 

Meagan: Yes. Yes. 

Petra: Okay, so it all started. I was a teen mom. I had my daughter a month before I turned 17. I was 16. Obviously, it wasn’t planned but it happened and it was the best thing that ever happened to me. Even though I had zero support from family and a lot of people, I went on to– let’s just go straight to the labor. I was in labor for a couple of hours. I went to the hospital. I rushed there because that’s what I see in the movies. 

Meagan: Right. That’s what we’re taught. Even today, that’s what we’re told by our providers. You have contractions. Your water breaks. You come in. 

Petra: Yes. Exactly, so that’s what we did. I took a shower and rushed to the hospital. I got there. They stuck me on monitors and told me to stay in bed so that they could see the baby on the monitors and make sure baby is doing okay. I didn’t know any better. I didn’t educate myself. I was a teenager. I was so scared and I had no idea what to expect other than what I had seen in media, movies, and all of the stuff. 

I never really talked about what could happen with my mom or anything like that. I was just like, “I know what I’m doing.” I was that person. “I’ve got this. My body was made to do this. It will just know what to do.” Well, yes it does, but when you are in a hospital setting and they have certain policies or expectations for how your labor should go, it’s different. So yeah. 

I was hooked up to the monitors. I was there maybe 6 or 8 hours. I didn’t progress past a 4 for a couple of hours and they told me, “Okay, the baby’s heart is dipping. We’ve got to get to an emergency Cesarean.” 

Meagan: Whoa. 

Petra: I was like, “Whoa, what?” I was just so taken aback. I didn’t understand because it was like all of a sudden, everyone was rushing. I’m like, “What is happening?” She’s like, “Your baby is in distress. We have to take you to an emergency Cesarean.” I was like, “Okay,” because she said, “You don’t want your baby to die, right?” I was like, “Of course, not.” I mean, who wants their baby to die? Come on. That’s horrible language to give to somebody. 

Meagan: Yeah. Those words matter. 

Petra: Yes. Yes. Oh yeah. I mean, look. My daughter is 18 now and that’s ingrained in my brain forever. Anyway, I went back for the Cesarean and once we got in there, nothing was an emergency. Everything was slow. I was like, “Wasn’t this an emergency? Aren’t you guys in a hurry?” I could hear the doctors talking to each other as they were opening me up and everything. They were talking about, “Oh, now I’ll get to make my dinner, my dinner plans.” 

Meagan: They were saying that out loud? 

Petra: Yes. 

Meagan: Oh, I don’t like that. 

Petra: Yes. They were talking to each other. I was just like, “Am I really hearing this right now?” I was like, “Oh gosh.” 

So anyway, I was so drugged up. I was in this fog. They were like, “Here’s your baby.” I didn’t even know what was happening. They brought this baby to me wrapped up in a million blankets. All you could see was literally the little circle of her face. You couldn’t see any other body part of her. I was like, “Oh, okay.” They were like, “Oh, kiss your baby,” and brought her to my face. I was strapped down to the bed. It was horrible. 

I was like, “This sucks. This is weird. What? This is birth? I don’t like it.” But after I had my daughter, I was so obsessed with her once all of the drugs wore off. It was blissful in the sense that I just loved her completely. It was a hard postpartum recovery because you had a major abdominal surgery. I didn’t plan for any postpartum support. I was just flying by the seat of my pants. 

We had a nonexistent breastfeeding journey because I didn’t know what to do. I didn’t know who to call to get help but we just made it through. You know, you just get through it. 

I want to fast forward to my next birth. My daughter was about 8 years– no. Yeah. 8 years later– 10 years later. Oh my gosh, my brain. 10 years later, I was with my then-husband– well, now husband and we got pregnant. Then at my 20-week ultrasound, my doctor was like, “You have placenta previa. You have to have a C-section.”

I wanted to have a VBAC, but once she said that she was like, “It’s a non-negotiable. You cannot.” 

Meagan: At 20 weeks though?

Petra: Yes. Yes. She was like, “It’s fully covering your cervix. There’s nothing we can do. It’s not going to move.” I was like, “Well, okay.” In my head, I’m like, “Well, you know best. You’re the doctor.” I didn’t do my research. I didn’t realize that it could move and at the 20-week mark, that’s not really a good gauge for your placenta staying that way. 

So anyway, I did end up having her at 36 weeks. It was a planned Cesarean. 

Meagan: 36? 

Petra: Yes, because I had a little bit of spotting. It was literally a couple of drops of blood and the doctor was like, “Oh no. We need to have the C-section right now. This is an emergency.” It was crazy. I just felt like everything was a whirlwind and everything was telling me, “I had to. I had to.” There was no other choice given to me and no other option. 

I just believed in the medical system so much because I have a lot of family that is in the medical system. Anyway, we did it and then for my third baby, so going on to my next daughter, this was four years later. 

She was a planned Cesarean because my doctor said, “We don’t support VBAC. We have a VBAC ban at this hospital. We won’t. We’ll turn you away.” I was just like, “What?” I just was so confused at all of this language being thrown at me. So she was like, “This is the safest route for you. Your uterus could rupture. Your baby could die.” All of the language is horrible to tell a mom who– of course, you don’t want your baby to die or anything bad to happen to them. 

Meagan: You’ve been told now twice about emergencies and that your baby could die. 

Petra: Yes. 

Meagan: Ugh, I don’t like that. 

Petra: Right. You know, talking to my husband, he was like, “Well, if the doctor says it’s the safest route, I guess.” So we did have a planned Cesarean at 39 weeks. But you know, with that pregnancy, I felt like I was ready to give birth at the end. I was like, “Oh my gosh. I feel so good. I feel like I could really have her. We had already scheduled the C-section and my husband was like, “Well, let’s just do it. We know what to expect.” I was like, “I guess.” 

Everybody in my family was like, “I think that is safest for you. That’s probably the best option.” Nobody really even has C-sections in my family. Everybody gave birth vaginally so they hear C-section and they’re like, “Well, you can’t,” because they heard the “once a C-section, always a C-section.” 

We just had her. It’s rough. Every C-section I had, I felt so disconnected from my babies. The breastfeeding journey was hard or nonexistent and I just felt broken. I was like, “What is wrong with my body? Why can’t I do this?” It felt so heartbreaking because you’re a woman and your body is made to give birth so when doctors say, “No, your body can’t,” you’re like, “Wait, what?” You feel like you should trust them because they see birth so often. 

After that birth experience, we decided we wanted to have one more baby. I told my husband, “Absolutely not do I want to have another C-section.” I said, “I don’t care what it takes. I’m going to prepare my mind and body and I’m doing this.” Because we also were going to have the babies two years apart, so I was like, “I don’t want to be running after a toddler and having a major abdominal surgery.” 

Meagan: Right. 

Petra: Once I started diving into the VBAC world, I found your podcast and was binging it like crazy. 

Meagan: Oh. 

Petra: It was so helpful hearing all of the positive stories of women succeeding in their VBAC goal. I hate to even put it that way because of course, we all want to have that VBAC if we are planning for it, but if you don’t have it, it’s not that you fail so I hate even putting that language towards it. It’s just nice hearing those stories where they did it. 

I listened to all of those stories and I tried to find providers. This was before I was even pregnant. I couldn’t. First off, obviously, I started with my OB who delivered my other two babies. She was like, “Absolutely not. This is dangerous. You could die. Your baby could die. Your uterus can rupture.” All the words. All the words. 

I was just like, “Oh my gosh. Here we go again,” but this time, I was educating myself. I was going full force into what I wanted to accomplish and that was my VBAC. Once we did get pregnant, I started calling midwives and doctors in the area. I called my local ICAN group and I got in touch with the ICAN leader. She referred me to all of the providers in my area and outside of my area that supported VBAC after three C-sections. 

After that, I found nobody supportive in my area. But I knew–

Meagan: But they were on the list or they were just in your area? 

Petra: Yeah. After talking to my husband and discussing our options, we decided that it was not in our best interest to have to drive 4-6 hours outside of where we live because we have three other children. 

Meagan: Right, the logistics. 

Petra: Yes, work and at the time, we had just moved. We moved into this home where our rent was now three times what we were used to. It was a little tight and before this, I didn’t know about Be Her Village. I am all up in Be Her Village’s world now. 

Meagan: Oh my gosh. I love Be Her Village. 

Petra: Me too. 

Meagan: I love Kaitlin and her crew. Oh my gosh. 

Petra: Yes. I tell all of my clients and everybody. I shout it from the mountaintops, “Check out Be Her Village. If you want support, go to them. Go to them. Go to them.” Anyway, I wish I would have known about them back then. We are there now. 

We decided that we were just going to do what we could with what we had. I switched providers. I think I was about 30 weeks by the time I was able to switch insurances because I had to switch insurances and I wanted to switch to Kaiser. In my area, it’s Kaiser Modesto. I knew they were supportive of vaginal birth after two C-sections so I was like, “Oh, okay. That’s only one less than I had and maybe it will be supportive.” 

I went forward with that. I went to my first doctor’s appointment and I told the lady, “I’m having a VBAC,” and she was like, “Absolutely not. That is ridiculous.” I was like, “Well, I’m doing this. I understand your concern. I already know what you’re going to say because I’ve heard it all before. I’m planning to do this, so this is what I’m doing.” She was like, “We need to schedule your C-section. I have to do it.” I was like, “I’m not going to show up. You can schedule it all you want, but I’m not going to go.” 

Meagan: You have to do it. 

Petra: Yes. 

Meagan: Have to. 

Petra: All of the have-to’s. After that, I had another appointment with her and she said the same thing, “Let’s schedule your C-section,” right when I walked it. I was just like, “No. I already told you last time that I’m not going to show up. You can schedule it but I’m not going to go in.” She said, “Well, now I have to refer you to the maternal-fetal medicine doctor.” I was like, “Why?” She was like, “Because you’re high risk and you’re planning to do a high-risk thing, so I have to give you to them.” I was like, “Okay, that’s fine.”

So I went after that. I met with him and he told me all of the same things. I said, “I totally understand. I respect your opinion, but I’m still going to do what I’m going to do and nobody’s going to sway my mind. I’m planning this and it’s going to happen.” He was like, “Okay. It seems like you have your mind made up. I told you the risks and that’s all I can do.” I was like, “Okay.” 

Literally after that, I saw a different doctor at every single appointment, and at every single appointment I went to, they all told me the same thing even though I told them what I was doing. It was the same and everything. 

It felt defeating in a sense. 

Meagan: I’m thinking too if you continue to hear it time after time after time after time, I feel like some self-doubt can start creeping in and being like, “Well, okay. Everyone is saying I shouldn’t do this. Should I be doing this? Is this the right choice? Am I being selfish?” All of those questions, right? 

Petra: Oh yeah. That’s exactly what crept into my mind after every appointment. My husband was working at the time. He wasn’t able to come to appointments with me which was fine. But I would call him after every appointment and I would cry. I would tell him, “Am I making the right decision? I feel in my heart I am, but it’s hard when somebody keeps telling you no, no, no, no, no.” He was like, “If you feel like it’s right, I support you and you’re doing the right thing. Who gives a crap what they say?” He’s like, “They’re nobody.” I was just like, “I know.” 

Once I started working on my mindset, I really dove into mindset work and started working on it literally daily. 

Meagan: You have to almost though. 

Petra: Yes. I was preparing my mind to be okay with the decision that I was making because those doubts crept in and I had to really sit with myself and ask myself, “Okay. What is the worst thing that could happen? What is the best thing that could happen?” I had to really sit with each of those and decide which one I could live with. In my mind, I couldn’t sit with living with the, “What if?” 

Meagan: The what if? 

Petra: What if I did do it? What if I did succeed but I’ll never know because I didn’t try? I had to sit with my husband and talk to him about the risks and everything and make sure that we were both on board. I feel like if you’re going forward with this type of decision that most people are going to say is dumb, is scary, is irresponsible, then you have to make sure that you have a support system that supports you 100%. 

I felt very confident in my husband’s support. He was like, “If you feel confident in this decision, I trust your judgment.” That to me, was everything because we are a team. We created this baby together. I want to make decisions about this baby together. Of course, ultimately, I’m going to do what I’m going to do and he knows that. When I set my mind to something, it’s going to happen. So yeah, we made the decision collectively and at first, I told a couple of people what I was doing like family and friends and then a couple of them were like, “You should just have a C-section. You’ve already had three. Don’t you have a zipper that they can just zip and unzip?” 

Meagan: Okay, why do people think that? My husband said the same thing. He said, “Why can’t we just go unzip you?” I’m like, “I am not a pair of jeans!”

Petra: Yes. Yes. It was– oh my gosh. 

Meagan: I get it. 

Petra: It was so crazy. I was just like, “This is my body. It’s not just a toy or a backpack that you can unzip. It’s a major surgery.” 

Meagan: Exactly. Yep. 

Petra: It’s a major surgery that affects you not only physically, your physical body, but your mentality, your spirituality, and everything. Everything. I stopped telling people what I was doing. I only told a handful of people that I knew would support me 100% and then I stopped telling anybody because I did not want to continue to hear all of the negative language that was feeding into my brain. If it did come in, that negative talk or whatever, I just blocked it out. I said, “Nope. I don’t want to hear it. I don’t want to hear it.” 

I feel like that really helped. That really helped. 

Meagan: It’s actually really healthy. It’s okay to do that. I did something very similar where I was like, “I love you and you’re my people every day, but right now, you’re not my person.” That’s okay. I might have to accept that. I still love them, but they’re not my people when it comes to talking about birth and having the support that I need. 

Petra: Yeah. Yeah, definitely. 

Meagan: That included some of my family members and that was really hard. Oh yeah. I felt that too because I wanted to share this journey with them, but since I knew that they were not going to be supportive, I was like, “You know what? I’m just going to do it and then afterward, I’ll go, ‘Hey, look at what I did!’”

I literally visualized my birth. This was one thing that I felt was pivotal. I would sit in quiet and calm and I would literally visualize every single part of my birth from start to finish. The labor, the pushing, and bringing my baby earthside. I would envision what it would smell like, what it would look like, who would be around me, and what it would feel like. The emotions I would experience once my baby came out and I was holding him on my chest. 

It makes me emotional thinking about it. 

Meagan: It’s okay. We were crying on last week’s episode too. 

Petra: It was so transformational for me because it wasn’t just the fact that I gave birth vaginally. It was the fact that I believed in myself. I advocated for myself. I stood up for myself for what I believed in and as a recovering people-pleaser– I am a self-proclaimed recovering people-pleaser. I don’t like to go against the grain. I don’t like people to be upset with me. I don’t like them to not like me. That was really, really hard but you know what?

Meagan: Because you were doing all of those things– going against the grain, not pleasing people, not doing what they said, and maybe even shutting people out. 

Petra: Yeah. Yeah. It was really hard. I’m a very open and honest person, so like you said, shutting people out was hard because I wanted to share this beautiful journey with them. 

Fast forward to when I hired a doula because I researched all of the things and on one of your blog posts, it says, “How You Can Be Successful in Having a VBAC” and one of the things was to hire a doula. Yes. Get that support team. 

Meagan: Absolutely. 

Petra: Build your support team. So that’s what I did. I hired a doula and she had never supported anybody with any VBACs but she was totally on board. She was like, “I’m totally with you. Let’s do this.” I felt really confident in my support system that I had on board. 

Let’s fast forward to labor. I had prodromal labor and it lasted from Friday night until I went to my next 40-week appointment which was on that Monday. I had prodromal labor for a couple of days.

Meagan: That’s exhausting. 

Petra: It is exhausting. I tried really hard to just get through it. I didn’t want any interventions. That was my plan. I wanted to just go unmedicated and make sure nothing was introduced that didn’t need to be introduced. So I went to my doctor’s appointment. She was like, “Oh, are you okay if I check you?” I was like, “I guess so.” 

She was like, “Well, you’re 2 centimeters. I can do a membrane sweep.” I was so tired. I originally didn’t want that, but I was like, “Go ahead and do it.” Looking back, I wouldn’t do it again, but at the time, plans can change. 

Meagan: Right. Plans can change. Yes. 

Petra: Yeah. So anyway, after that, oh my gosh. It was on. I was in full-blown labor after that. It was incredible. I was so excited and looking forward to my labor. I couldn’t wait. I couldn’t wait to be in labor because I knew I was going to do this amazing thing. I was in labor and I was like, “Oh my gosh. I’m excited.” My husband was like, “You’re so weird.” 

It was painful. I had back labor which I wasn’t expecting. That was intense. I even felt it through my thighs which I wasn’t expecting either. I literally needed hip squeezes through every single contraction. But it felt manageable. I felt like I could handle it. I felt powerful through it. Between every contraction, I was smiling. I was laughing. I was having great conversations with everybody around me. I labored at my home and my family ended up coming. My mom, my brother, my sister. My nephew was there and my kids were there. Obviously, my husband was there too and it was beautiful. 

It wasn’t planned that way. The plan was to labor at home, but all of my family coming that way was not planned and it was perfect. They were helping me. They were doing hip squeezes on me. They were talking to me between contractions and it just felt so blissful. It felt right. It felt perfect. I labored like that. 9 AM started the active labor and then by about 5-6:00 PM, it was mentioned, “Hey, should we go to the hospital?” We never talked about it beforehand when I wanted to go, but people kept asking, “Do you want to go?” It was pretty intense. I hit transition and I knew that because I was shaking when I was sitting on the toilet. Dilation station. 

Meagan: It’s a real station. It does exist. 

Petra: Mhmm. I agree. Yes. Yes. After that, we headed to the hospital. I think it was 6:00 PM and then everything becomes a blur. We got to the hospital and immediately went up. They were like, “You can’t be in active labor.” I was talking and laughing. They were like, “Okay, can we check you?” I was like, “Okay.” I can’t remember what they said. I was either 9 or 10 centimeters. They were like, “Oh my gosh. How are you this far along?” 

Meagan: and chatting. 

Petra: Yeah. It was perfect. I was in the zone. Everything felt perfect. They got me into a room and we started doing different positions to try to help my back labor. At one point, they offered to break my water because I guess I had a bulging bag. At first, I didn’t want that, but of course, in the moment, I was like, “I don’t care, if you need to.” I was trying to focus on the task at hand. They did end up breaking my water and after that, everything was insanely intense. The contractions were more intense. They felt closer together and by 9:00 PM, I was like, “I need to push or I need to do something.” 

I just felt like I couldn’t get comfortable anymore. I was like, “I’m going to start pushing.” I started pushing and they brought everybody in quickly. I was like, “Oh my gosh. Everybody is rushing in.” Then I pushed five times they said, and he flew out.

Meagan: Oh, so everyone was seeing something and they were like, “Oh, this baby is coming.” 

Petra: Yes. Yes. I remember that they did bring the mirror in. They brought the mirror in real quick so I could see. I guess they were thinking it might take a little bit longer and I needed encouragement but anyway, no. It was really fast. I pulled him up out of me and onto my chest. It was like I literally manifested that birth because that’s literally how I dreamt about it happening, literally. 

Meagan: Baby coming out, just flying out. 

Petra: Yeah. Yeah. No, it was perfect. After that, you have that oxytocin dump and I felt like I was in a dream. I was just so happy. I cried. I laughed. I was thanking God. I was like, “Oh my gosh.” It was so emotional and so beautiful. You know, the recovery is like night and day. I was up and walking, going to the bathroom and I didn’t have an IV. I didn’t have an epidural. I didn’t have anything on board so I was able to just move and I was discharged less than 24 hours later. 

Meagan: That’s the best. It’s so nice when it can just be quick and you go home and can be in your space. Acclimate together. 

Petra: Mhmm. 

Meagan: So when they got there, I mean you were that progressed. You were really calm. Things were happening. Did anyone say, “Hey, we need to have the OB come in and talk to you,” or were they actually supportive? Because through this whole prenatal, you’ve been hounded as, “No, no, no. Why would you do such a thing?” I was just curious. Did they seem more supportive? 

Petra: Oh yeah. I didn’t touch on that, but yeah. When I went in there and especially after they checked me, they were like, “Oh my gosh. Let’s do this. Let’s have a baby.” They were all excited. It was no doctor I had ever seen. It was a traveling OB so I don’t even know where he was from but he was there on-call and then there was a student doctor. I don’t know what he was but he was a student. He was actually the one who was there that helped bring my baby to my chest alongside my midwife. So yeah. There was a midwife there and then that training OB, they were together right there. Everybody was super supportive. 

My nurses were amazing. I will never forget her name. Her name was Brita. She was like, “I’m so proud of you. You’re doing amazing.” She was so incredible. Of course, my doula was amazing too. She was helping me through everything and had all of the things with her that helped with lavender scents, keeping the lights dimmer, and just keeping that atmosphere calm and cool. My husband was there too. He’s cool as a cucumber anyway. He’s so go with the flow and afterward, we talked about it and he was like, “I was ready once those doctors were right there checking you. I was ready to jump in and be like, ‘She’s having her VBAC!’ but I didn’t have to say anything. Everybody was so supportive and so sweet to you.” 

Meagan: Good. 

Petra: Then afterward, it was almost like I was a celebrity. Nurses were bringing other nurses in and they were like, “She was only here for two hours and she had her baby and she had three C-sections.” Yeah. It was amazing. 

Meagan: Do you know what you did? You changed their mental perspective. You changed a whole bunch of people’s mental perspectives. Think about what you did for the student. VBAC after multiple C-sections, especially three, isn’t widely studied because it’s not happening. 

Petra: Right. 

Meagan: So for that provider to come and start right in the school world and training and be like, “Oh, actually I saw that happen and it happened really well and it was okay. Baby was okay. It is possible,” then maybe, just maybe– I don’t know about that provider. Some providers that are in training don’t even go to OB land, right? They are going to some other specialty and that is just their clinical, but hopefully, it will help some other future Woman of Strength who is going in and wanting that whether that be him or her or someone that they talked to, just changing the perspective. Look at what you have done. How amazing. 

You didn’t just have a VBAC after three C-sections, right? 

Petra: No, it doesn’t just feel like that. It feels like so much more. Honestly, I’m forever changed by this experience. 

Meagan: Absolutely. I understand that. 

Petra: It helped me. And honestly, I feel like even if I did have a C-section, I planned for it if I did end up having one. I had a plan set aside. I didn’t put any energy towards it, but I had that plan just in case so I could have my preferences honored in that situation, but it helped educate me. I am so educated now. It threw me into the birth world. I had always been obsessed with birth, but I didn’t know where I fit in. I went to school and was going to become a labor and delivery nurse, but once I got into the classes and everything, I was like, “This is not for me. This is not where I belong.” It just didn’t feel right. 

I never knew about doulas. Once I had this experience, I was like, “I know where I belong.” This work sets such a fire off inside of me. Oh my gosh. I am supporting a couple of VBAC after two C-section clients right now. We are preparing for their birth and it’s so exciting to me. I’ve never been so excited about work ever in my life until I hit this point. It’s so amazing to see somebody switch mentally from being fearful to feeling empowered. It’s not that I’m giving them that power. We all have that power inside of us. It’s just somewhere along the way, it’s been dimmed. I’m there to help them find that again. It feels so good when somebody is so confident in themselves and makes that transformation. 

No matter how their birth unfolds, they can feel good about it because they know that they are educated. They know what they plan for. It’s not the fact that the plan goes exactly how you planned it. It’s the fact that they educated themselves enough to be able to advocate for what they do or don’t want. 

Meagan: Yes. 

Petra: That’s huge. 

Meagan: Yes. I mean, I can relate on so many levels. It’s crazy how the things you are saying, I’m like, “Oh my gosh. That was me. That was me.” I wanted to be a L&D nurse. I wanted to do that. I didn’t even start the classes. I didn’t even get to that. This is so bad to admit. I was like, “That’s way too much math. Nope. I’m not doing that. No.” Then I had my second C-section and I wanted a VBAC. I was like, “Ugh.” I wasn’t in a place where I was mad necessarily. I wasn’t happy that I had a second C-section, but I wanted more. I wanted to support. I felt that desire. I felt that burning in my body that was like, “I want to help people.” 

Just hearing you talk, I’m like, “That was me.” That was me in 2014. I can just feel your energy so much and so will your clients. You’re going to change your clients’ lives. Like you said, no matter what the outcome is, they’re going to feel supported and loved and educated along the way and that is powerful. 

Petra: Yes. Yes, exactly. That’s what I’m here for. I feel like I’m here to just help be their cheerleader. You can do anything if you set your mind to it. I know that sounds so cliche. 

Meagan: I know, but it’s true. 

Petra: Yeah. Yeah. It just makes me feel so good to know that I can help in any kind of way. I’ve always been this helper anyway. I’ve done in-home CNA work so my heart is in service. That’s where I feel the best, so yeah. It’s just amazing. I feel like also, the most important thing is just trusting yourself. Trust yourself to make the decision and not that it necessarily has to be the right decision to what everybody says is the right decision, but whatever feels right to you and staying true to yourself. 

We see all of these people on social media and it’s easy to get caught up in what they’re doing and it’s staying authentic to ourselves and bringing that into your journey because not everybody’s journey is going to be the same. I feel like that’s so important to showcase, so yeah. 

Meagan: It is. Yes. I love that so, so, so much. I wanted to quickly talk a little bit about VBAC bans and multiple Cesareans, just what to do if you are in a situation like this. I feel like you touched on all of these things that you’ve done and I just love your journey. I love your journey so much. If you’re running into a VBAC ban, and one of the things that you did too not necessarily for this purpose, get in contact with your local ICAN groups. See what information they have on local hospitals and their policies and see what they can do to help. Write a letter to the hospital. Write a letter to the state’s medical board. I know that sounds crazy, but we are the ones who are going to be able to change this future.

Doulas, we’re loving. We’re supporting. We’re educating, but then also as VBAC parents ourselves, we have– I don’t want to say a duty, but we have this power to start making a change by not letting every single provider bully you into something you know in your heart is not correct. To continue to reclaim that power and stop letting that light be dimmed as you were saying earlier, right? 

Petra: Exactly. 

Meagan: Let’s light up the world. Let’s light up the world. We have to light ourselves up first. We have to be fully lit before we can help others light. 

Petra: Yeah. I just want to touch on something real quick. The VBAC ban drives me insane. 

Meagan: Me too. 

Petra: They say they don’t want to do it because they can’t support an emergency situation for a VBAC, but what if a person goes in there in labor and she needs an emergency or if it’s a true emergency situation and they can’t give her a C-section? I’m sorry. That just doesn’t sit well with me. I would go to a different hospital completely. 

Meagan: I know. I mean, ACOG recommends that VBAC is a great option for women and they can have it at any hospital location that is a level 1 facility or higher which is pretty much any hospital. Me too. I have such feelings about it. Such feelings. 

If you are a VBAC multiple Cesarean, check out our VBAC after multiple Cesareans blog. We’ll make sure to attach it here in the show notes and it will go over some of the studies. What’s hard is after two Cesareans, we don’t really have a ton of really solid, hardcore evidence showing that your chances of rupture really do increase this much because it’s not happening. It’s not being offered. Look at how many providers shot you down. I’m a VBAC after two Cesareans and I went to 12 providers before I found the right provider for me. They didn’t all necessarily say, “Absolutely not,” but they didn’t necessarily say, “Yeah. Go for it,” either. They weren’t cheering me on. It was, “Well, you can try,” or “Well, if you were my wife, I probably wouldn’t suggest it, but I’m not their wife so sure. Go ahead.”

It’s so annoying that we don’t have this information, but it is possible and you are living proof. 

Petra: Yes, definitely. 

Meagan: Oh, well thank you so much for being here and sharing your stories. 

Petra: Of course. Of course. I would be so happy if this touches just one person and it helps anybody. 

Meagan: It will. 

Petra: I would love to share my story with anybody. Anybody, feel free to connect with me. I just love talking about anything birth and VBAC. That is my heart's work. 

Meagan: Yes, well tell people where they can find you. 

Petra: Yes. I am on Instagram at Birthing Come True. The name comes from my birth coming true and also my website is birthingcometrue.com. If you basically type that in anywhere, you’ll find me. Yeah. 

Meagan: Awesome. Thank you so much. 

Petra: Of course. Thank you for having me. I’m so happy to be there. 

Meagan: Absolutely. 

Closing

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

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“It’s very fitting that this is going to come out just before Thanksgiving because I feel very, very fortunate.”

Becky’s two babies were both posterior and asynclitic. They weighed exactly the same at birth, but their deliveries were very different. Becky shares her sweet experience going from skepticism around home birth to fully embracing all that it has to offer. 

Her first birth included residual trauma which made for a very difficult postpartum period. Her second birth was full of safety, peace, and healing which left Becky feeling so joyful, so strong, and so thankful. 

Happy Thanksgiving week to all of our listeners. We are thankful for your stories. We are thankful for your love for us and for each other within our VBAC Link community. Your commitment to healing, education, and better birth experiences lifts us all and makes the birth world a better place. We are thankful for YOU, Women of Strength! 

With love, 

The VBAC Link Team

Additional Links

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello. Welcome to The VBAC Link. You guys, this is my first episode back from taking a really big break through the summer. You guys have still had episodes, but I recorded up through May right before my kids went to school and then took the summer off so I could have fun and spend time with them. I’ve got a middle schooler who went back to school today for the first time in middle school. It was bittersweet then I’ve got a fourth grader and a second grader. 

So they are back to school today and I figured, “All right, let’s get back to school today.” We’ve got Rebecca with us. Welcome, Rebecca. 

Becky: Hi. 

Meagan: Hi. Thank you so much for being here with us today. Rebecca is from Seattle, correct? The suburbs of Seattle?

Becky: East side, yeah. 

Meagan: She is going to be sharing her VBAC story with us today. Her VBAC– we were just talking about this before we pressed record. It has a lot of things. We’ve got– okay. Do you want me to name it or do you want to go through it? 

Becky: I can name it. There was a late-term transfer to home birth with a sort of faux dual care that ended up not being dual care just before I went into labor and pushed on my back and a posterior and asynclitic baby. 

Meagan: Yes. Right there, posterior and asynclitic– those two together are like, whoa. It’s awesome because a lot of the time, that is a reason for a C-section. Asynclitic or posterior, but when we have an asynclitic and posterior baby, that definitely adds some things so I’m excited for you to be sharing your story with us today. 

Okay, so her name is Rebecca but do you like to go by Becky? 

Becky: Yeah, actually you can call me Becky. That’s fine. 

Meagan: Okay, yeah. Becky. I was going to say as I was reading through your form, I remembered seeing Becky. Yeah. Becky is a music teacher from little babies all the way to my oldest, middle schooler age. Let’s see. You do voice and Music Together and composing and all of the things. So music is definitely really, really close to your heart. I love that in your bio thing that you gave me, you talked about singing in your C-section, right? 

Becky: Yeah, yeah. 

Meagan: And how healing that was. 

Becky: Yeah, I think it is really important just as an idea for someone to have if it works for you because it definitely was very helpful for me. 

Meagan: Yeah. I love that. Well, I can’t wait to hear your story and more of the things that help. I think sometimes too when we have unplanned C-sections, or even if we are preparing for VBAC but go in for a C-section, it’s always nice to have some of those tips to say, “Okay, I can try this to see if it helps me stay calm or brings me peace.” 

Review of the Week

Awesome, well we have a Review of the Week as always and then we will get into Becky’s story. This is from postpartummama on Apple Podcasts and it says, “A surprisingly and valuable postpartum resource.” I love that because we are not a postpartum podcast, right? But there is a lot. We were just talking about it two seconds ago about things we can do during our birth to help it be a better experience. When it’s a better experience, it helps with our postpartum experience. 

She says, “Once again, I found myself listening to episode after episode of this podcast. It is truly an invaluable resource for anyone preparing for birth or healing from a traumatic birth. Julie and Meagan approach topics that are often hard to discuss and they do so without judgment creating a community of acceptance during a season of life that can often feel alienating and overwhelming.” 

That just gave me the chills. She is not wrong. This journey can sometimes feel so lonely. I know I felt lonely during my experience prepping for my VBAC. 

It says, “I listened to this podcast while preparing for my VBAC and although my VBAC was successful, it was also traumatic. Now six months postpartum, I’m listening to each and every episode again and in doing so, I’m processing my second traumatic birth experience at my speed. It’s helping me mentally and emotionally heal from everything that happened and lessening my fear of childbirth. Thank you, Julie and Meagan, for–” Oh, I just lost it. Hold on. I moved it. 

“Thank you, Julie and Meagan, for dedicating your time to educating women in such an approachable way. I can’t recommend your podcast enough.” 

Wow, postpartummama, this was back in 2021 so a couple of years ago and that just makes me feel so happy. I don’t think we’ve ever had a review that has talked about how it’s truly helped them in the postpartum stage so I love hearing that. I love that she also talked about that she had her VBAC but it wasn’t necessarily all sunshine and butterflies. It had some trauma involved. 

I think it’s important to talk about that and realize that all C-sections aren’t traumatic and all VBACs aren’t sunshine and butterflies. Julie and I, in the past, have talked about that. We recognize that and I hope, postpartummama, that you have found your recovery and that maybe you are still with us today and listening to your review. But I hope that you have found that peace and recovery through your postpartum journey. 

As always, if you want to leave us a review, we never reject a review. You can leave it on any podcast platform so thank you so much. 

Becky’s Stories

Meagan: Okay, Becky. Again, thank you so much for being here with us today. 

Becky: Thank you. 

Meagan:  Yes. 

Becky: So I’ll just jump in, I guess. Yeah?

Meagan: Just jump in wherever you feel that you want to start. 

Becky: Okay, so I’ll start with the C-section. I was in New York at the time and I felt very committed to having a vaginal, unmedicated birth. I was with a midwife practice. It was three midwives who had birthing privileges, I guess is the term, at a hospital in midtown. 

Everything was really normal and healthy with my pregnancy. I got to 41 weeks and they asked if I wanted a membrane sweep. I said, “Yeah. Let’s go for it.” So two days after the membrane sweep, I think I lost my mucus plug or something and then two days after that, we went to a restaurant in the evening. We were walking back to our apartment and I started to feel low cramping which I now know is contractions. At the time I didn’t know. I feel like nobody tells you that it feels like cramps. It does. 

Meagan: Yeah. And it can. It can start just like little period cramps or maybe you even feel like you have to go to the bathroom like bowel cramps. 

Becky: Yeah. Uh-huh. The bowel cramps come later. 

Meagan: Right? Posterior babies. 

Becky: Exactly. We got back and I was keeping an eye out for the timing. I saw that they were very irregular. I knew enough that it kind of hinted towards a posterior baby but I was like, “Whatever, we’re good.” The midwives said to try to get some sleep. 

It’s not that it was so uncomfortable at that point I couldn’t sleep, but it’s happening. It’s exciting. So I really didn’t sleep. My husband didn’t really sleep much either. We called the doula. She came around at 5:00 AM or something like that and I started to feel pushy. I knew that that is also a symptom of a posterior baby but also, my mom had quick labors so I was like, “Mmm, I don’t know.” 

It was also a Monday morning, so we decided, “Let’s drive to the hospital,” because it was in Midtown. When we got there, I was only 3 centimeters. We went to a hotel nearby. We got a hotel room for one night and I labored there. Things started to get intense there. I mostly liked the shower. Actually, my midwife because she came to the hospital but since I wasn’t admitted, she was just kind of waiting for me because she didn’t have other patients at the hospital. 

She actually came to the hotel room and did a check there. 

Meagan: Really? 

Becky: Yeah, to see so that I could skip triage. 

Meagan: Wow. 

Becky: I hear that is very unusual. She went above and beyond and I was a 7 at that point or something. 

Meagan: Oh, wow. 

Becky: I skipped that when we went to triage originally, the midwife had me lay on my back with my legs hanging down. I have learned that is Walcher’s. 

Meagan: Walcher’s, yeah. At 3 centimeters, she did that? 

Becky: Yes. 

Meagan: Okay. 

Becky: After that, the contractions stopped. It was easy. I could walk again and everything felt fine. I was like, “This is 3 centimeters with a not-posterior baby versus a posterior baby. It makes quite a big difference.” But she went right back. 

Anyways, when we went back to the hospital, it was supposed to be intermittent monitoring. I was moving a lot and with the movements I was doing, they couldn’t get a clean, 20-minute read. The nurse was very nice. She kept trying to get it, but it kept getting interrupted so it was really continuous monitoring. 

At a certain point, I started to feel like, “This is not happening.” I started to feel like I couldn’t do this. They were like, “You’re doing it. You’re doing it.” I was on my back and the midwife said, “Why don’t I try to direct pushing for you?” She said that she could see the hair. The energy in the room was like, “You’re doing it.” I felt like, “I am not.” 

Then, the energy in the room shifted because the midwife felt the ear. She felt the baby’s ear and she said the baby was asynclitic. From then on, the contractions were so close together. I couldn’t get rest in between. I had done some pushing that seemed to be doing something, but I was getting tired because we hadn’t slept. I also hadn’t eaten because I had thrown up what I tried to eat. 

Meagan: Oh, yeah. 

Becky: It was everything. Eventually, it was back-to-back contractions. Somebody suggested, “Would you like to try an epidural?” Although I was wanting an unmedicated birth, I was like, “Yeah. I think I need to rest. I can’t.” I could feel like I wasn’t able to push anymore. 

Meagan: Well, and if you have an asynclitic baby too, a lot of the time we have to get baby up and reset. Sometimes it can be really hard unmedicated when you are so tired and when time has been going. It’s nice to maybe get an epidural and let your positions and rest to really allow that baby to try and reset. 

Becky: Yeah. Yeah. So I slept after I got the epidural and then when I woke up– my husband later told me that I was only asleep for an hour but I woke up and it was dark already. We had gotten there in the morning. It was late October, so it wasn’t that late, but it was probably 5:30 or something. 

So they were like, “Okay, let’s try pushing now.” I was like, “Um, what? What do I push and how and also, why?” I didn’t have any connection. I didn’t understand how I could possibly push. I was like, “Is this it?” It was clear from their faces that no, it wasn’t it. It was not it. 

I don’t know. We tried other things, but eventually, because of the continuous monitoring, they were getting the heart rate and it was starting to look not as good. It was the situation where it was like, “It’s okay, but the OB/GYN on call might not be okay with this.” We could try Pitocin, but the midwife was like, “I don’t know what Pitocin is going to do for you because your contractions are already really close. It could likely make the heart decelerations worse.” 

It was like we could continue going as we were going or we could start to talk about C-sections. At that point, I was just like, “Yeah.” We didn’t see any other option. We didn’t see any other solution. 

Meagan: Baby wasn’t turning. 

Becky: No, baby wasn’t turning. I mean, yeah. So we got ready for the C-section. They gave me some anti-nausea medication. I was like, “I already feel like I’m going to throw up.” They were like, “It’s okay. This will help,” but they gave me the medication and I immediately threw it up. They gave it intravenously. 

We went into the operating room and I asked them if I could sing during the surgery. The reason for this was that I had another weird medical situation where my husband actually suggested singing because I was breathing so shallowly and I was so anxious about it. It really slowed down my breathing and just made me feel so much calmer. 

I guess, I don’t think I had thought about it in advance, but once C-section became a reality, I was like, “I’m going to sing.” 

Meagan: Do it, yeah. 

Becky: They were like, “Yes, absolutely.” The energy in the room felt like it was a party. Everybody knew each other. They liked working together and they were like, “Now our patient is singing for us? This is great.” The C-section was really quick. I did not feel that way. I did not feel like it was a party, but I was like, “This is calming myself, so I’m going to keep going.” 

She came out pretty quickly and she cried quickly, but I guess after the fact, it was not a gentle Cesarean because of all of the things. She was off in the corner for a long time and her APGAR scores were good. She was healthy and I was very thankful that I was singing so she could hear my voice, but it felt like a long, long time before she came onto my chest. 

Even when she did come onto my chest, the feeling was sort of fear and like, “Um, hi. How are you? Who are you?” 

Meagan: A bit of a disconnect. 

Becky: Yes. Part of the reason why I had wanted an unmedicated birth was that I was interested and excited about the hormone cocktail that they talked about. This was certainly not that. But we went into the recovery room and the midwife and the doula were with us. They were like, “Do you want to try breastfeeding?” I was like, “Oh.” I had prepared for the breast crawl. I had prepared for the natural things so I did not know how to do it. I didn’t know how to do it. 

So I was like, “Okay. Go, baby.” She did not know how to do it. So she did not latch. The midwife helped me, but she didn’t latch and then she was getting sleepy so it was like, “Okay, we’ll try it later.” A nurse or something said, “Oh, we’ve got to take the baby for some regular checks of some kind.” So they took the baby. My doula left. My husband and I were left in this room and there were other people in this recovery room. It started to be again, a long time without my baby who had just exited my body. 

I was like, “What’s going on?” I really felt like screaming. I felt like screaming like a crazy person, “Where’s my baby? Where’s my baby?” 

Meagan: Getting anxious, yeah. 

Becky: What stopped me was that there were other people in the room and I was afraid of scaring them. That also feels not good that I was not free but also good that I wasn’t screaming like a crazy person. I had my husband go find her and she was just chilling out with a nurse. They were just waiting for my room to be ready so it was just sort of a logistical thing that they were like, “Oh, her room’s not ready. They’re going to wheel her in. We’ll just wheel the baby straight to the room with her.” 

Meagan: Why not just keep her with her? 

Becky: There was no reason for the separation other than that was the reason. Breastfeeding was very difficult. She did not latch. I did not have good lactation support at the hospital and all of the people that came around were like, “No tongue tie, no lip tie.” Spoiler alert, she had a tongue and a lip tie. 

Breastfeeding has a happy ending. We got the tongue tie and lip tie revision and she latched by two weeks. We had to do triple feeding. That was rough, but she was breastfeeding by the time she was two weeks and I breastfed her until she was two. By then, she was only doing it at night, but that had a happy ending. 

I did have a posttraumatic stress disorder really not even from the C-section, I think, but from that postpartum period and specifically from the separation. I struggled, actually, with saying that it was traumatic because it’s like, “Well, everybody was healthy and everything was fine.” I was treated with respect. There were no stories of doctors or nurses being snarky to me or whatever but it was just the idea of being separated is still really sad at this point. 

Now, I can think of it, but for a long time– at first, I would ruminate on it, and then after a while, if my brain started to wander towards the topic, it would be like, “No, no, no, no, no. Let’s go over here and think of something different.” My brain wouldn’t let me think about the postpartum time. 

Meagan: Yeah. 

Becky: But therapy is good. I highly recommend it. I went to the Motherhood Center. They specialize in pregnancy and postpartum things. 

Meagan: Awesome. 

Becky: Anyways, I had a lot of trouble listening to people’s birth stories. Even with friends, if they shared their birth stories, they were like, “Oh, and then I was pushing.” I was like, “You didn’t even do any of the things that I did. I felt like I had prepared so much for this and some people had done no prep or were just doing it. It was very difficult for me to hear birth stories. 

So what made me know that I felt ready for another baby was that I was interested in listening to The VBAC Link. I wanted to test out the waters and see if listening to a birth story felt acceptable because before, it was like, “No. I can’t do this.” And it did. 

But I was like, “I’m just going to stick to The VBAC Link. That’s safe.” I wanted to listen to repeat C-sections to successful VBACs to HBACs and all of that, but it felt comfortable to listen to them so I knew I was ready. 

Meagan: Oh, that warms my heart. 

Becky: Yeah. 

Meagan: That warms my heart to know that The VBAC Link could be a safe space for you. It’s not even something that you’re going to do, but you’re listening. You’re willing to go in and you’re listening and you’re like, “Okay. I can do this.” 

All of these people and all of these Women of Strength who are telling these stories put power in your pocket. 

Becky: Yes. It felt good to listen to it and yeah. 

Meagan: And now you’re one of them. 

Becky: Now, I’m one of them. It’s so surreal to be telling this story and also to be hearing your voice and seeing you because I’m so accustomed to hearing your voice and I’m like, “Oh, that’s what she looks like.” 

Meagan: Oh, that’s what she looks like. I’m a hot mess all of the time. 

Becky: Not at all. Not at all. 

So we moved to the Seattle area during the pandemic. I felt strongly that I wanted a birth center birth because I was at a hospital. First of all, I didn’t get the lactation support that I wanted and then you were there and kind of trapped, I felt. I said, “Let’s do the birth center because it will be a little bit higher chances of VBAC, but you still have more medical support of some kind.” 

I quickly learned after reaching out to the birth centers that in Washington state, birth centers cannot do VBACs unless they are birth centers attached to a hospital. So I was like, “All right. Do I want to look into home birth?” It felt like that was two notches of crunchy granola beyond where I was. I’m fairly crunchy granola but I felt like that was just a little bit beyond there. 

I actually interviewed a home birth midwife and the way she put it was like, “If this happens, you go to the hospital. If this happens, you go to the hospital. If this happens, you go to the hospital.” I sort of felt like there was an additional set of policies that you had to meet. The reason I was interested in out-of-hospital is that I was not interested in being tied down by all of the policies, right? 

Meagan: Right, right. 

Becky: So I was like, “No, no, no.” There was one birth center attached to a hospital 20 minutes away. I was like, “All right. The decision is made. I’ll go there.” I went there and it is really a hospital. You go to a hospital and it is in a hospital. Yes, there are midwives. 

Meagan: It’s similar to what you had the first time. 

Becky: Yes. It’s similar to what I had the first time. It was just in a hospital. I was like, “All right, I guess.” The midwives were nice. The nurses were nice. I was like, “All right. This is my only option.” So I was going and I got a really, really great doula who they recommended. Part of the reason the doula was so great– I mean, I guess all doulas do this maybe, but she encourages you to do video chats or calls in addition to the regular meet-ups. That was really good because it helped me to feel really close to her. 

Meagan: Yeah, really personal. 

Becky: Yeah, emotionally connected. So anyway, things were going fine again. It was a perfectly normal pregnancy except that I got COVID during it. The hospital was a little bit conservative about wanting more checks. I was like, “All right. That’s not great, but okay.” 

Then at one appointment, they were like, “Okay, now you’ve got to set up your appointment with the OB/GYN just as a VBAC consult. It looks like the doctor you’re seeing is going to recommend not a VBAC. You can just ignore that, but she’s going to recommend not a VBAC because your VBAC score is 69.5 and I know that doctor only recommends that if your VBAC score is 70 or higher.”

I was like, “What? The VBAC Calculator? Are they still using the VBAC Calculator?” I was saying, “Please tell me that at least you are using the version that does not use race.” 

Meagan: The updated version. 

Becky: They were like, “Well, no. This one is the older version.” I was like, “This hospital is so behind that they are even using the non-updated version which is racist.” It just sort of was a wake-up call like, “What policies am I going to be privy to that I’m not asked about?” because I was just like, “This is my choice and they are midwives so they’re going to be good.” 

But this is a hospital and there are policies and you have to abide by them or you have to put up a fight. My husband and I are both not prepared for that kind of thing. We just want to go with the flow. 

Meagan: Well, and what makes me laugh is– okay. Okay, this might sound really rude. I’m not trying to shame anybody who uses The VBAC Calculator. If that’s your thing, that’s your thing. But who in the hell pulls up a random number like that and is like, “No.” Like, what? And it’s 1%? Anyway, I don’t like The VBAC Calculator. Again, not shaming anyone who uses it or chooses to. I personally don’t like it and I just don’t love when they are telling people, “No” based on something that they personally came up with themselves, not something the evidence shows. 

Becky: Exactly, exactly. I didn’t even want to go to this appointment because I didn’t want somebody telling me, “I don’t think you should get a VBAC.” I just didn’t want that in the air. I had done the research. I know that it’s safe. You know? Let’s not do this. 

Meagan: You’ve done the research and you are there making the choice to do that. You are looking for support. It’s not that they can’t educate you along the way. They should be on both ends. 

Becky: Yes, exactly. 

Meagan: But they shouldn’t be deterring you based on a made-up number. 

Becky: Yes. Yes. I talked to my doula at length about it. She really recommended taking this because I was like, “Should I be considering a home birth again? This doesn’t feel good. This doesn’t feel good anymore.” She was like, “Why don’t you take this?” There is a VBAC class with Sharon Musa that everybody has been recommending across the board. She’s local to the Seattle area. 

So I was like, “Okay.” I kept hearing people recommending it so I was like, “Let’s just do it.” I took this class and it was very helpful going into all of the specifics about the risks and the benefits of everything and what is the risk. Not like, “You should do this or you should do that,” but “This is the actual level of risk. It is comparable to x, y, z. What are you comfortable with?” 

Meagan: What risk are you comfortable with taking? 

Becky: Yeah. I really appreciated that because it was put in such plain terms. But I was also like, “I know that even though this is clear to me now, but also, what is the risk with home birth VBAC versus hospital VBAC?” The truth is there just isn’t data for that because not enough people have home births and not enough people have home birth VBACs. I was like, “All right. This isn’t helping my decision really.” 

But she did recommend looking into the hospital VBAC statistics. I was like, “How do you do that?” I tried to talk to the midwife about it. You can’t really get hard numbers. You can just put it in Google. I forget what it was, but there was some outside source from Washington State or something. It’s probably the same in every state that gives a percentage of people who do VBACs in the hospital versus C-sections. 

I looked at the hospital where I was planning to go. The percentage, I kid you not, was below 20% for VBAC. It was below 20%. I was like, “This number has to be including people who are choosing to do a repeat C-section. It can’t be that low.” The national average is supposed to be 60-70% or even higher than that, right? I asked my doula about it. She looked at the statistics and where I had gotten it. She said, “No. The way they phrased it is for people who go for a TOLAC and get their VBAC.” 

I was like, “That is an insane statistic. I don’t want to be a part of that.” She recommended two other hospitals that had better statistics, but the better statistics, one was 28% and that was closer, and one was in Seattle which was 54%. That was the highest it gets. I called that hospital up. You couldn’t get a midwife because, at that point, I was 32 weeks or something. I could go and just have an OB/GYN and you’re still probably in a better spot because you’re probably going to a place that has better policies, but it still felt like I liked the midwife care. 

Also, 54% still does not feel pretty good. 

Meagan: I know. I know. When the overall success rate is between 60-80% and upwards, when you’re getting these lower numbers, you’re like, “Ah, I don’t love that. 50% is half a chance.” 

Becky: Yeah. Yeah. So I was like, “You know what?” I originally reached out to home birth midwives. There was one that looked really good, but she said that I was outside of their range. 

Meagan: Zone? 

Becky: Yeah, their zone. I learned that my doula had worked with them in the past. I said, “Why don’t I reach out to them again?” My doula has an in with them. I felt like my doula was the key. She knew everybody. Maybe things are different. Maybe they don’t have enough people around that due date. Sure enough, I don’t know if it was the fact that they just didn’t have anybody for that time or if they knew my doula and felt good about it, but they said, “Yes.”

I interviewed them and I felt much better about home birth with them. It didn’t feel like now there were more policies, it felt like she knew what she was talking about. She talked about dehiscences which I hadn’t even known about before somehow. I felt really emotionally safe with her. I think that’s something that people don’t talk about, but one of the reasons I chose my doula was that I felt very comfortable crying with her. I’m a crier. I cry a lot and there are times when I’m around people and I cry and it feels blocked and shameful almost. It just feels bad and there are people when I cry around them that it feels cathartic. 

So I felt like, “Yeah. Let’s do it.” My husband was not on board with home birth at first, but he was like, “You know, your emotional health is really important too.” 

Meagan: I love that he recognized that. 

Becky: Yeah. Yeah. I mean he had been there during postpartum for the first one and witnessed first hand so he really knew. But no, actually I skipped the dual care part. I liked her but I still felt really like, “Home birth, this is not me.” I was looking around on your website at the blogs and whatever and I came across the term “dual care”. I had never heard about it before and I was like, “Oh my gosh, this is it.” Suddenly, home birth felt comfortable to me with the idea of dual care that if something happens, you just transfer to your regular doctor. 

The home birth midwife was on board. I went to what turned out to be my last appointment with the midwives at the hospital. It sounded like they were giving tacit acceptance. They were like, “We can’t do that because health insurance is not going to cover two appointments. We can’t turn anybody away and technically, if you don’t tell us that you’re transferring care, you’re still our patient.” It sounded like this was faux dual care that I would just go to my home birth appointments. I was already 34 weeks at that point. It sounded like I was just going to be able to do it. 

What I did was I would call them after hours to reschedule my appointment with the hospital midwives, but then when they called me back to reschedule, I would not pick up so then it just would never get rescheduled. Okay. 

It went like that. The appointments were great. When I missed my 39-week with the hospital midwives, I had three messages from them. This time, two of them were from one of the midwives. It wasn’t just the receptionist, okay? I started to feel really– it was like, “We know what’s going on.” They were like, “The jig is up.” 

I started to feel really guilty about it and just uncomfortable with lying. I was essentially lying. I talked to my doula about it. I had a really long nap and I was supposed to call her during then, but I called her after the nap. We decided that I was just going to fully transfer care. It felt better than lying. I would call the next day which was Monday but oops, no. The next day is Labor Day so we won’t call then. We’ll call on Tuesday. 

But I did not get a chance because, at 3:15 AM, I woke up with a little wetness. I was like, “That is not my water breaking,” because, with my first, it was a very dramatic, movie-like gush. I went to the bathroom and I smelled it and it was not pee, but I was like, “Nope. It was probably really diluted pee. This is not my water breaking. This is not it. Nope, nope, nope.” 

Then I lost some mucus plug and I was like, “Okay, yes. That was mucus plug.” With my first, it was two days later that I went into labor so that was a more comfortable timeline for me. My daughter was starting her new class at school the next day on Tuesday. I was like, “Nope, it’s not happening now.” I just kept saying, “No, I just have to poop. This cramping is because I have to poop. I haven’t pooped in two days. That’s all it is.” 

My husband was like, “Maybe I should call the doula.” I was like, “No, it’s the middle of the night. You can text her, but this is not it.” 

Meagan: You don’t need to call. 

Becky: It was a good thing I was in such denial because had I not been, I would have suspected a posterior baby. But because I was in serious denial, I was like, “No, no, just no.” Things started to pick up. Eventually, we did call the doula. I did the Miles Circuit and it was too intense already. When the doula came, it was like, you know when a horse is whinnying and they are really anxious about something or panicked and whoever is helping the horse is like, “Whoa, whoa, whoa” and calms the horse down? That is what my doula did. 

Everything took it down a notch. Everything was much calmer. We started filling up the birthtub. Things were getting really intense really quickly. The midwife arrived and she asked if I wanted to be checked. I said, “Yes.” I was already at 8 centimeters. I was very glad that felt good. 

Meagan: I bet, yeah. 

Becky: I got in the tub, but in the tub, it felt like I couldn’t hang onto anything. It was hard to get a hold on anything. I learned after the fact that I started pushing there. They kept saying I was roaring, but they kept saying, “You’re wasting that energy up and you need to send that energy down.” 

Meagan: So you’re bringing it up but not sinking into it. 

Becky: Yes. Yes. I was sort of like, “What does that mean?” I was told that roaring is good, but I learned that they were right. It’s not so much that I was sending it up, it’s that I was shying away from down there. I was like, “No, everything is crazy down there.” They said, “Why don’t you come? We’ll do some directed pushing.” At that point, I was like, “No!” because that’s what happened in the first one. 

My doula was like, “No, no, no. Don’t worry. You are already much farther than the first one. This is a different birth.” I had affirmations up on the walls everywhere. She reminded me of one of them. 

So anyway, we started to do and it was clear that on my back, I was able to push better. Now, this goes against everything I had been taught about pushing and that people talk about pelvic dynamics and everything. I had been getting pelvic floor therapy and my thing with that was releasing. I needed to release. Whenever she did the internal release, I was on my back with my knees out. 

That was the position where I was doing my most effective pushing because I had inadvertently trained my body that this is the position in which you release. That’s what you need to do to push. So just for any of you who are getting pelvic floor therapy and getting internal releases, try to do it maybe in a position where you want to push. 

After a while, the assistant midwife was like, “Do you want to try knees together?” I was like, “Knees together? I know what that means! That means it’s late.” But still, even knees together just weren’t as good as knees apart. Something about it with my knees apart on my back was where I had the power to push. 

I felt the baby’s head at one point. I was pushing and it was getting there. It was taking a long time, but it was getting there. The assistant midwife started taking the heart rate of the baby.

Meagan: With the Doppler? 

Becky: Doppler, yes. I sort of clocked that it was varying widely. She told me after the fact that it was totally normal. She was not worried but I was clocking that and I was like, “This should be over soon.” I asked my midwife, I was like, “Can this be the last one?” as if she had the power to grant that to me. She was sort of like, “Maybe.” I was thinking to myself, “Yes. It has to be.” So I did it. This has to be the last one. I pushed and the head came out. I felt either the ring of fire or tearing. 

He came out and they said, “Now, wait before the rest.” She told me to breathe or exhale or something. 

Meagan: Like a little blow? 

Becky: I pushed for 3 hours when the hospital had a limit at 2. She was worried that there would be shoulder dystocia, but there wasn’t. He came out very easily after the head. He was just immediately on my chest. He was just immediately on my chest. I kept saying, “You’re here.” I had the hormone cocktail that I wanted. It was so serene and beautiful. It was everything I had hoped for. We had that totally uninterrupted golden hour. Totally uninterrupted. It was 10:20 in the morning. It was the day before school started so you could hear kids playing outside. It was really golden. The sun was coming through the window. It was so beautiful.

Then I was like, “Huh. Your head is very oddly shaped.” They were like, “Yeah. He was posterior and asynclitic,” exactly like my first but totally because of a different location and a different support team, it’s like they always say, “Location and your team are so important,” but they are really, really so important. 

Meagan: Crucial. 

Becky: Not only that, but he weighed the exact same amount. They were both 8 pounds, 4 ounces. 

Meagan: So on your op reports if you have seen them, what was your exact diagnosis on why you had a C-section? Was it failure to progress? 

Becky: It was failure to progress, yeah. 

Meagan: Okay, that’s what I was figuring. 

Becky: But it was really failure to descend because she was never down far enough. 

Meagan: Yeah, and you made it to 10 centimeters. 

Becky: Oh yeah, I was at 10 centimeters for a long time. 

Meagan: Failure to progress, yeah. So failure to descend due to a less-ideal position. It may be the way your babies need to come through your pelvis. 

Becky: Maybe. 

Meagan: Sometimes baby need to come through in a wonky, less-typical position to get out. I truly believe after knowing what I know now that all of my babies had to come through my pelvis posterior. Every single one. I thought I was going to have a baby the other direction because of all of the contraction pain. 

Becky: It’s like, I would just love to feel an anterior baby and compare. It seems like it must be so much easier. 

Meagan: Me too. I am with you. I am with you. I am with you. Yeah. Posterior, yeah. It is definitely a little bit different, but you had a C-section for positioning, but then you turned around and had the same position, same pounds and everything, and did it vaginally. 

Becky: Not only that, he also had a lip tie, but he did latch after that first latch. I also just want to give another shoutout to home birth because my assistant midwife was six months postpartum and she knew about previous difficulty with breastfeeding. She had her pump in her car and she said, “Would you like me to pump a few ounces for you?” I was like, “Yeah.” 

She found a clean, glass jar and pumped 2 ounces in there and left it in our fridge for us. 

Meagan: Oh my gosh. 

Becky: That just can’t happen at a hospital birth. Kindness like that– obviously, kindness means a lot to you, but in those first postpartum times, it’s just amplified. I’ll always remember that. Yeah. I had all of the support I needed and more. I really hope everybody who wants this has it like me. It’s very fitting that this is going to come out just before Thanksgiving because I feel very, very fortunate. 

Meagan: Thankful. 

Becky: Yeah. 

Meagan: Oh, I’m all teary, my eyes and nose and I have the chills. I’m so happy for you. I’m so happy for you. 

Becky: Thank you. Yes. 

Meagan: Huge congrats. 

Becky: Thank you. 

Meagan: Thank you so much for sharing this story with us today. 

Becky: Thank you for giving me the opportunity. I hope somebody has something that they take from it. I feel like there are so many random bits and bobs that could be helpful. 

Meagan: Absolutely. 

Closing

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

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Dr. Nathan Fox is a practicing OB/GYN and Maternal Fetal Medicine provider in New York City. Two of his children were also VBAC babies! He joins Meagan on the podcast today where they discuss topics in depth to help listeners make more informed decisions about their VBACs. 

Topics today include where to find evidence-based information, how to interpret it, the risks of uterine rupture, VBAC and COVID-19, induction, scar thickness, due dates, and third-trimester ultrasounds. 

Additional Links

Healthful Woman Website

MFM, High-Risk Pregnancy New York City Website

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello. You guys, it’s November. How are we at the end of 2023? It is crazy how fast this year has gone. We have a special guest today. It’s Dr. Nathan S. Fox. He is so amazing to come on today to talk to us about a couple of topics that I don’t know if we’ve actually ever talked about on the podcast. 

We’re going to be talking about scar thickness. We’re going to talk about third-trimester ultrasounds. We’re going to be talking a little bit about COVID and is it really best to induce at 39 weeks? We’ve had COVID. What does it mean with our placenta? We know we’ve been hearing it out there where our placentas are not doing well. So you guys, get ready. Buckle up. It’s going to be great. 

I want to tell you a little bit about Nathan Fox first. He is a board-certified OB/GYN and he is also certified in MFM which is Maternal Fetal Medicine. In his clinic, he sees a lot of higher risk and unique situations. He did his residency at Mount Sinai. He has an amazing podcast that really dials in on helping people know the evidence and then also understanding the evidence in English because if you are like me, you’ll know that it is kind of hard to break down some of these studies sometimes and it’s hard to understand what the evidence is even saying and then how to apply it. 

He has this podcast and it is Healthful Woman. We are going to make sure that it is linked. You guys, he has so many incredible guests on there talking about a wide range of things. It’s not VBAC-specific, but it definitely has a wide range of topics and things that you’re probably going to love. Definitely check that out. We’ll have it in the show notes. Dr. Fox, seriously, we are so grateful for you today. We can’t wait to have you on. We’ll be right back. 

Dr. Nathan Fox

Meagan: All right, I need to pull up those questions really fast. There are a lot. Literally, we do not have to get to all of them. 

Dr. Fox: I’ll come back if you want. Don’t worry about it. 

Meagan: Yeah, we’ll have to do a part two. You are so sweet to take the time out of your busy life, I’m sure. 

Dr. Fox: We are mission-aligned as they say in the fancy world. It’s about getting good education, and good information out to people so they don’t have to hear crazy stuff on the World Wide Web and get terrified. 

Meagan: Right. That’s why we started this podcast even just to share stories of people who are having VBACs so people can hear and learn through those VBACs and also know it is an option and it is possible. 

I have a question. You said before we started recording that you have two VBAC babies. 

Dr. Fox: Yeah. 

Meagan: How was that journey as an OB and MFM? Was your wife getting information that you were like, “Wait, that’s not true,” or were you like, “Actually, we need to think about this”? How was that journey as someone in the field?

Dr. Fox: Full disclosure, I was getting into the field. I have four kids. My first two are twins and they were born when I was a medical student so I knew very little. I guess more than nothing, but closer to nothing than where I am now. They were born by C-section. Both of them were breech. Thank God, both of them did great. All was well. 

With the next one, my wife was pregnant when I was a second to third-year resident in OB/GYN. For most of her pregnancy, I was a second-year, then she was born a month after I became– not even. She was born July 17th so 16 days after starting my third year. 

Meagan: Right after, yeah. 

Dr. Fox: I knew a little bit more then. That was our first VBAC. Then my fourth was born when I was an MFM fellow. I like to say that I had kids in all of my points in training. Honestly, we didn’t think much about VBAC in terms of being this grand decision and conversation. I would say mostly because the OB my wife was seeing was on board with it and didn’t make it into a big deal and she was delivering at a hospital at Mount Sinai where I trained and where I now practice where VBAC is commonly done. There was a conversation about it. It wasn’t like we were blind to it, but it was part of the normal culture in that hospital on the labor floor so we didn’t think much about it. 

My wife said, “Why would I want a repeat C-section if I can try and do it vaginally?” It worked out fine, thank God for both of them. The third was also actually a forceps. We’re like a textbook of obstetrics, my wife. But yeah. It wasn’t dramatic. Let’s put it that way, the VBAC process.

Meagan: Wow. Yeah. I love hearing about it that it was just a thing. It didn’t have to be a big deal. She was just going in and wanted to have a baby. She didn’t want to have a C-section.

Dr. Fox: Yeah, again, I think it is something that should be discussed. People should understand and not even everyone understands that it is a thing meaning people don’t even realize why you wouldn’t. 

Meagan: Why you would not, yeah. 

Dr. Fox: There is risk, but ultimately, if it is an option, the risk of a VBAC– again, in the right person– is not markedly higher than the risk of a C-section. So it’s a conversation. Which risk would you prefer or which risk would you least prefer? So that conversation was very straightforward. “Would you want a repeat C-section? Would you want a VBAC?” She was like, “I want a VBAC.” Fine, so that was done. It wasn’t like she had to meet with an attorney to go over everything and sign a waiver or anything like that which sometimes happens. 

Meagan: Yeah. I love hearing that. Well, I am so excited that you are here with us today. I know that we have so many questions to dive into. They’re kind of all over the place. With the first one, I think a lot of our community members– we have a Facebook community, a forum, and one of the most common posts in there is looking for a provider that is supportive because they were with a provider and then they found out that the provider that was seemingly supportive is not supportive anymore. 

It all seems to focus around things with evidence-based information and they’re getting all of the different things. One of the questions is why is it so hard to find evidence-based information on VBAC, VBAMC, and uterine rupture– because we have some providers that are saying you have a 60% chance of uterine rupture and then some saying you have a 0.4-1% chance. Those are very dramatic numbers. The range of answers is just so wide. I’m just wondering why do you think it’s so hard and where can we find this information. Where would you suggest our listeners go? Let’s talk about your podcast being one of those places. It’s not just VBAC-specific. Your podcast isn’t VBAC-specific but it’s very, very good at a whole, wide range. 

But yeah, can we talk about where to find evidence-based information about birth in general but especially about VBAC?

 

Dr. Fox: I mean, yeah. That’s really the million-dollar question. I think that both the problem and solution are essentially that we have access to all of the information that’s ever been available ever. There was a great Simpson’s thing where Homer Simpson said, “Beer. The cause of and the solution to all of my problems.” 

Information is the same way. On the one hand, it is unbelievable how much information we have access to and that’s a great thing. It’s not hidden. It’s not only amongst the elite that have the information. Everyone can have the same information so that’s the good part. The bad part is it’s very difficult to sift through all of that information and find a) what’s correct or b) what’s applicable to me. 

So for example, let’s say I’m someone who has a prior C-section and I have a friend who is also someone who has a prior C-section, but one of us has a prior low transverse C-section and one of us has a prior classical C-section. How do we know that we have different percent risks? It’s a high level in a certain sense. So sometimes the websites or the podcasts or whatever will spell it out for you and explain it very clearly, but other times, you just get a list like, “Okay, the risk is this, this, this, and this.” You can’t really apply it appropriately. 

One of the things we try to do in our podcasts is to be much more user-friendly and to really explain it and what would apply to you, what wouldn’t in certain situations, and what questions to ask, but I would say for people trying to find information, usually it’s a shotgun approach. You Google something and find a website then find a list. 

You have to be very cautious and make sure that this applies to me and my unique circumstances. Hopefully, you have a doctor or a midwife who can help you with that. You might not. It’s possible that you may not. The other part is sometimes, it’s hard to interpret data. Understanding medical literature is a science. It’s something that we train to do. We practice it. 

I do a weekly journal club with the OB/GYN residents. This is the top of the food chain. These are the smartest of the smart. They got into a great undergraduate. They got into medical school. They got into residency. These are really, really smart people. It’s not always intuitive when you read a study or several studies on how to interpret it and apply what is and isn’t applicable. It’s very difficult stuff. I would say don’t be dismayed if you are not understanding the information out there or seeing such variation because you are in the same boat as all of us. It’s hard. It’s hard to get the right information out there. 

Meagan: It is. Yeah. Even when I’m reading through studies or things, it’s even hard for me to just understand what it’s saying and what the relevance is of it and all of it, so yeah. It’s really hard. I think what you said, “Don’t be dismayed,” it can be really frustrating when we’re out there and we’re like, “Okay, I have a special scar or not a normal low, transverse incision. What does this mean for me? What does this mean for my future? What does this mean for right now?” It’s really hard.

I think you nailed it where one friend can have this and one friend can have this. You can both have similarities in your risks, but they also don’t apply because there are other things going on in addition. 

Dr. Fox: There are facts like what is the truth? What is the true fact? There are always some brackets around those numbers because different studies will find different things. Let’s say one study finds 1% and one study finds 4%. Is it 1? Is it 4? Is it the average of the two? Is it a range from 1-4? There are some nuances in that. 

But then there is also trying to sift through the interpretation of the fact. A lot of that is why sometimes you’ll see different doctors feel differently about something. For example, let’s say the risk of uterine rupture is– let’s just do very rounded, broad numbers. Don’t hold me to it. Let’s say the risk of uterine rupture is 1% and if you’ve had two C-sections, let’s say it’s 2%. Let’s say those are the true numbers and you can argue about those. Those are the numbers. 

I could describe those very differently. I could say to somebody, “All right, you’ve had one C-section. Your risk of rupture is 1%. You’ve had two. It’s a little bit higher. You need to know that it’s now 2%. Maybe your chance of a successful VBAC is a little bit lower.” Okay. I could say it that way or I could say, “Whoa, your risk of uterine rupture where the baby could die is doubled.” Right? 

Meagan: Yeah. That just gave me the chills. 

Dr. Fox: That’s the same number. I’ve said the same thing in two very different ways. One person hears it and says, “It doesn’t sound like a big deal. My doctor said it’s fine.” Another person said, “My doctor said that my baby is going to die.”

Meagan: Doubled and die, yeah. 

Dr. Fox: It’s understandable because the doctors and midwives, people who are pregnant are all humans. Humans are complicated beings. We have emotions. We have fears. We have experiences. We have anxieties. We have all of these things that come into our heads and it colors how we view risk and how we describe it to other people. 

So I would say that another lesson is when you are getting information, try to differentiate the numbers and the hard facts from the interpretation of the number or the feeling about the number. That’s why you always have to be very cautious when someone says increased, higher, or doubled. That’s a relative risk, right? The risk of something is increased. Well, by how much? Is it increased a lot or a little? If the number was very, very low, is it still very, very low but a little bit higher?

I always give people an example. If I walk across the street, there’s a certain chance that someone moving a piano is going to fall on my head. If I look up every time I cross the street, I’m going to lower that risk but it doesn’t matter. The risk is so low to begin with that it doesn’t have any practical application to me. It’s sort of the same thing. You can talk about something increasing or decreasing your risk, but if the risk is still very, very low anyway, it may not matter to the person practically. 

Trying to get that from a provider is sometimes difficult because they may not know themselves the actual numbers. They may just know increased or doubled or this. They may be so colored by it that they have a hard time talking about it just as numbers or vice versa. They might just give you hard numbers and you want to know how they feel about it and they’re not giving it to you. It is hard, but that’s one thing to try to think about or differentiate. 

Meagan: I love that. I love that. 

Okay, this can be a very political topic. 

Dr. Fox: Oh, all right. You’re not going to mention Trump. Are we going to talk about Trump?

Meagan: We are not talking about Trump. 

Dr. Fox: Everyone in New York talks about Trump. We like him. We hate him. We hate him. We like him. It’s all we talk about. 

Meagan: I bet. I bet in New York, it’s really hot. Maybe in New York, this is even a hot topic but we’re going to talk a little bit about COVID-19. 

Dr. Fox: Oh okay. 

Meagan: We have a lot of moms who had babies during COVID-19. It was a really hard time for everyone involved. Giving birth as a provider, as a nurse, and everybody in life. This whole world of ours. 

Dr. Fox: It was unpleasant. 

Meagan: It was and that’s putting it nicely, I think, in a lot of ways. 

Dr. Fox: I still have scars on my face from wearing my N-95 for six straight months. 

Meagan: I bet. I bet. It is. It was a very traumatic time. 

Dr. Fox: Yeah. 

Meagan: We’re interested to see if you felt like COVID-19 had an impact on the C-section rate and if you saw more inductions happening and things like that. But right now, we have a lot of our moms being told even today, that if they had COVID-19 during their pregnancy from the time of conception to the end, they have to give birth by 39 weeks. 

Dr. Fox: By 39 weeks or after? 

Meagan: By 39 weeks. What they’re being told is that their placentas will just crap out. They’re just done. So it can be really hard in the VBAC community when they’re being told this and then we may have a provider who doesn’t want to induce. 

Dr. Fox: Yeah, yeah. For sure. 

Meagan: We have providers all over the world who are not comfortable inducing. We have VBAC moms who are like, “I want to have a VBAC. I had COVID when I was 20 weeks. I’m fine. All is well, but now I have to have a baby at 39 weeks. Here I am and my body’s not doing it.” 

Dr. Fox: Yeah. There is a lot there to unpack. No, it’s okay. You’re throwing fastballs at me. I like it. You’re throwing heat. I’m ready. I knew it was coming. 

Whether COVID increases the risk of things like the placenta crapping out so to speak is itself a controversial question. The data on that is mixed. It seems that there are some people who COVID has a negative impact on their placenta that manifests as the baby is not growing well. It can manifest as the baby getting preeclampsia. The worst-case scenario is that it can manifest as a stillbirth. However, you wouldn’t expect the stillbirth to come out of nowhere. You would expect there to be multiple things leading up to it like the baby not growing well, the blood pressure going up, the fluid dropping, and a lot of things instead of a sudden stillbirth. 

Meagan: Right, warning signs. 

Dr. Fox: Now, that is different from someone with COVID who is in the midst of a very severe COVID infection. That is very dangerous to the mother and potentially the baby but we’re talking about someone who got COVID and recovered or someone who just found out they had COVID and are fine, that type of thing. A) the data is questionable and B) what to do about it is also questionable. 

Let’s say you’re over the age of 35. You also have a slightly increased risk of all of those things if you had IVF. There is a whole list of things that put you at increased risk of your placenta crapping out so to speak and what to do about it is also more of a philosophical question than a hard-data question. Whether someone has to be delivered– I wouldn’t say before but usually at 39 weeks– because they had COVID, I’m not doing that personally in my practice. We do follow up and do an ultrasound to make sure the baby is growing well, but if someone had COVID at 20 weeks and is otherwise doing well later in pregnancy, we don’t say they need to be induced at a certain point. That’s not something I’m doing. 

I’m not aware of anybody in professional societies like ACOG, American College of OB/GYN, or the Society for Maternal Medicine who actually recommended that or advocated that, but again, some individual doctors are very uncomfortable with any risk. I think the other part of this that is really coloring a lot of these discussions nowadays is there was a study called the ARRIVE trial that got published a few years ago. It’s a very, very good study. The study was essentially designed to test if inducing everybody– these are low-risk, first-time pregnant moms. The lowest, lowest risk whether inducing everybody at 39 weeks improved outcomes or worsened outcomes. The outcome they really looked at was the death of the baby. It did not have any impact on that in either direction. 

What they also learned was that the rate of C-sections did not go up by getting induced. That was the biggest, I don’t want to say surprised because medically, we actually thought that would happen, but in the community, that was a surprise because everyone was always told that if you get induced, you have an increased risk of C-section so the study did not show that. It showed a slightly lower risk of getting higher blood pressure which makes sense because the longer you are pregnant, the more it goes. 

The way I look at that study is if I want to induce someone or if a patient wants to be induced at 39 weeks, there’s an upside. There’s a downside, but the downside does not include an increased risk of C-section. The downside could be longer labor. It takes more time. It’s not as pleasant. Okay, fine. That’s how I look at the study. 

Some people took the study and interpreted it to say, “Since there’s no risk of C-section, you should induce everyone at 39 weeks. That’s the optimal thing to do.” 

Meagan: And it’s happening a lot.

Dr. Fox: Yes. There are definitely people interpreting it. I don’t think it’s an unreasonable interpretation because you could say, “Listen, if I’m delivering you, there’s no chance for a stillbirth in the next two weeks,” I get it. But I don’t think it’s the only interpretation and it’s also a very impractical interpretation because if you induce someone, the amount of time they are in the labor room is on average 18 hours. 12-24 hours they are in a labor room. A common labor on their own, the average is let’s say 6-12 hours or something like that. So if you induce everyone, you need twice as many labor rooms. I don’t think every hospital in the country plans to double their labor floor so now, you just can’t do it practically. 

This is a very, very long answer to your question. I think what’s happened is that you have a new risk factor which is COVID which is very prevalent. Everybody got COVID basically at some point and you have a new fact that inducing at 39 weeks does not seem to increase the risk of C-section so there are some people concluding, “Well, I have a risk factor, and inducing at 39 weeks isn’t ‘bad’ so I’m going to affirmatively recommend it on everybody.” That’s tough. I don’t usually recommend it. If they want it, I think it’s an option but I think that that’s again, hard to know when you sign up with somebody who has provided prenatal care what their philosophy is. 

These are questions you probably want to ask very, very early on in prenatal care. Again, the things that really matter. So for example, if it very much matters to you not to have an episiotomy, you should ask very early, “Do you perform routine episiotomies?” Most OBs these days will say no, but if your OB says, “Yeah. I do them on everybody,” and you don’t want that, get the hell out. Switch. 

Meagan: Yeah. It’s probably not your provider. 

Dr. Fox: Yeah, and again, if it doesn’t matter to you, then don’t ask that question. Or for example, let’s talk specifically about VBAC. Very early on, just ask, “What are your thoughts on VBAC?” They’re not going to lie to you. They’re going to tell you. If they don’t tell you, you’re going to be able to tell right away. If they say, “VBAC is awesome. I love it. I love it when I can help someone with a VBAC. It’s so satisfying. It’s rewarding. There are some risks and we can talk about that. I think it’s great.” Versus they could tell you, “I don’t do them.” Or they say, “Yeah, I’m okay with that but I don’t know.” They’re telling you. They’re telling you that it’s okay, but they’re clearly not a fan of it. 

Meagan: They’re not gungho about it. 

Dr. Fox: Or the question is if they’re gung-ho, you can say, “What’s the culture in your hospital like?” So if they say, “I’m gung-ho, but the labor nurses think it’s a stupid thing to do and the hospital is trying to get us to stop doing it because they have a lawsuit and this,” you may have a great doctor or midwife but they may be practicing in a place that isn’t supportive. That’s also an issue. 

Again, I guess there are some people who would lie to you because they “want your business”, but most OBs aren’t like that because if they don’t want to do it, it’s because a) they think it’s wrong, b) they sort of thing it’s okay, but they don’t want to get into a lawsuit, or c) they’re just afraid. So why would they want to hide that from you? It’s the opposite. They would want to tell you upfront. I think if you ask very blunt questions very early, they will tell you. If you have a provider who is uncomfortable, you don’t want to be with them for your VBAC. It’s not a good match. 

Meagan: We talk to our community members about that a lot. Don’t just say, “Do you support VBAC, yes or no?” It’s, “How do you feel about VBAC?” I love the question of, “What is the culture in your labor and delivery unit?” I love, love that. 

Dr. Fox: Usually, this is a good time when open-ended questions are best.

Meagan: Yep, yeah. 

Dr. Fox: Let them talk. Let them cook. They will tell you their thoughts and you can read it very quickly. 

Meagan: Their body language, yeah. 

So circling back to this whole induction thing by 39 weeks, you’re saying that there’s not really any organization that is hard-core supporting this evidence for someone who has had COVID has to have a baby by 39 weeks. 

Dr. Fox: I have not heard that of anybody. Usually, if someone said that, it usually wouldn’t be by 39 weeks. It’s a big thing not to induce people before 39 weeks unless there is a very good reason. 

Meagan: Yeah, and that’s what they’re doing. They’re inducing at 39 weeks or as soon as possible after but I don’t know that anyone is recommending that specifically because of COVID. Again, I’m sure there’s someone who might but I don’t know. Personally, what I would do is if they had COVID, again, I would just check that everything is okay with the placenta. Usually, in later pregnancy, it’s just with an ultrasound and then if everything is fine, I wouldn’t. 

If there is a concern, then it would be based on the concern. There are people who I recommend to get induced at 39 weeks but there is a reason and COVID has not been one of them. 

Meagan: Okay, that’s so good to know. We kind of dabbled into the ARRIVE trial. Can we talk about the 40-week mark? We have seen ever since ARRIVE came out that things have moved up. It’s like 40 weeks is really 39 weeks. 41 weeks is 40. 

Dr. Fox: 39 is the new 40? 

Meagan: 39 is the new 40, yes. It seems to be happening, not everywhere, but it’s happening. We talk about uterine rupture after 40 weeks. Our original 40-week, here we are, we know ACOG suggests or supports going past it, but can we talk about the risk of uterine rupture the further into pregnancy that we go?

Dr. Fox: So there are two risks. Part of the reason for the shift going earlier is not because of the risk of uterine rupture. It’s more of the risk of stillbirth. As you get more pregnant, if you look at just for the baby- I don’t want to say this and be recorded but forget about the mom. 

Meagan: Let’s not think about the mom. 

Dr. Fox: For this question, we’re going to forget about the mom. Mother first, baby second but for this question, you’re just looking at the health of the baby and you look at the timing of delivery. Generally, things get better and better for the baby as you get closer to 39 weeks meaning your baby born at 37 does better than at 36 weeks. A baby born at 38 does better than 37 and at 39 does generally better than 38. 

Once you hit 39, it plateaus and then it starts to diminish meaning that the optimal time for a baby is sometime between 39-41 weeks. As you get past that, it goes down. Part of that is because of stuff after birth like meconium or this and some of it is because some of these babies unfortunately will have stillbirths inside. That’s very, very rare and I’m not saying this to scare anybody, but it happens. As you go past your due date further and further, the risk seems to go up. 

With that said, is it worth inducing because of that? Generally, for a typical, low-risk, healthy person, the difference between 39-41 weeks is very minuscule in terms of the baby. So I don’t typically tell people that if you are low risk, then you need to be induced at 39 or 40. I tell people that 39-41 seems to be very similar for the baby or have very, very slight differences and I leave it to people’s preferences. 

If there’s someone who wants to get the hell out of pregnancy as soon as possible because they are uncomfortable and they have family coming in town or whatever it might be or they are worried about stillbirth, fine. We can go closer to 39 weeks versus if there’s someone who really wants to go into labor on their own, then you wait towards 41 weeks. 

After 41 weeks, the risk really starts going up so there are people who– I don’t really let them– I am okay with them staying past 41 weeks, but generally when we get to 42, pretty much everyone recommends inducing at 42 weeks and pretty much at 41. That’s all because of the baby. 

Now, in that conversation for someone with VBAC, there is a second risk on top of that which is okay, that’s for the baby, but what about for uterine rupture? So there doesn’t seem to be a huge difference between 39, 40, or 41 weeks for uterine rupture. It’s slightly higher if the baby is bigger and it’s slightly higher if you induce. 

So you’re sort of balancing, is it better to induce and have a slightly smaller baby or is it better to wait and go into labor on your own and have a slightly bigger baby also knowing that if you don’t go into labor on your own, now I’m inducing with a slightly bigger baby? That’s part of the risk that you may end up in a situation that is worse. And that again, there isn’t a right or a wrong answer. It’s a conversation. For people whose doctors or midwives won’t induce them, out of principle, the hospital won’t allow it, they won’t allow it, then yeah. You wait as long as they will let you until it’s unsafe for the baby and hope to go into labor on your own. 

In our practice, we do induce people with a prior C-section. It’s a conversation. There are risks that are discussed. They decide, “Is it better to do it earlier? Is it better to do it later?” That’s again, a conversation based on taking on all of the risks. The risk of inducing, probably ballpark adds another 1% so if your risk was 1%, it probably makes it 2%. Again, I could tell you that makes it doubled or I could tell you it makes it 2%. But you know, it increases a little bit. Not so much if they’ve had prior vaginal deliveries. That’s more so if they’ve never had a vaginal delivery. 

The risk of waiting an extra two weeks is also probably less than 1%. These are very small numbers and I don’t want to say pick your poison because neither is really poison, but whichever is sort of more palatable, that’s the one you’ll do. But again, you have to have someone where both options are on the table and for some people, the option to induce is not on the table. 

Meagan: So for someone who is really worried about uterine rupture, going to 41 weeks and maybe not getting induced or trying to go into spontaneous labor at 41 weeks, we shouldn’t be feeling that we have passed that 41 weeks so our chance of uterine rupture just skyrocketed. 

Dr. Fox: No. The chance of uterine rupture doesn’t really go up markedly the more pregnant you get. If you get induced, it goes up a little bit. You have a risk to the baby of waiting.

Meagan: Or a bigger baby. 

Dr. Fox: But the rupture risk is not markedly changed by your gestational age of delivery. Maybe there are slight differences, but nothing crazy. 

Meagan: Okay, that’s good to know for the audience because they ask that a lot. 

Dr. Fox: Right. But a lot of people or some of the doctors want a “controlled setting”. It also depends on what the situation is. Again, I practice in an area where people can usually get to the hospital very quickly if they go into labor. But if you are practicing somewhere where someone has– I actually just had someone. She actually was 2 hours away. She comes to our practice because we are a high-risk practice and she doesn’t want to go somewhere local, fine. She is someone who has two prior C-sections and this. That does play into this because she’s not someone who when she goes into labor is going to be monitored right away. She’s 2-3 hours. 

Meagan: She’s far away. 

Dr. Fox: Yeah, so that is sometimes a factor in these discussions. What you do about it depends but that may be a reason that someone might prefer to have you induced rather than going into labor on your own if they are worried about time to get to the hospital or something like that. Again, usually not relevant for me but sometimes. 

Meagan: More of a controlled setting.

Dr. Fox: Yeah. 

Meagan: You have a lot of knowledge in imaging and testing and all of these things. We’re going to take a little bit of a turn from due dates and all of those things and talk about tests that happen during pregnancy. This is kind of something that comes up a lot. We’ve got early, middle, and late tests that are happening. A couple that is happening in the early stages is genetic testing. It’s becoming a lot more popular and a lot of people are wondering, does this impact my chance of VBAC at all? Does this increase my chance of Cesarean? Can genetic testing impact the mode of birth? 

Is there anything that you feel that our community should know about that early-on test ritual? 

Dr. Fox: It shouldn’t. It really shouldn’t impact anything about the mode of birth. For genetic testing, fortunately, if you get to the point where you are 10, 11, 12, 13 weeks when this is done whether it’s a blood test or an ultrasound, if it’s a screening test or an invasive test like an amnio, again, fortunately, high 90% of people have a baby with no genetic issues whatsoever, thank God. We are very fortunate. 

For the few people who unfortunately have a baby with one of those genetic conditions, genetic screening and testing is information. It’s just to find out before birth. Now obviously, some people get results and choose to terminate pregnancies. Other people get results and choose not to terminate pregnancies. It’s just information they want before birth. That’s also another political discussion, obviously. 

But ultimately, at the end of the day, none of that really impacts the mode of delivery. Occasionally, it impacts the timing of delivery. Sometimes with certain genetic things if there are associated anomalies, then occasionally. So I don’t think it really impacts. It would have to be a very rare case where genetic testing would then somehow preclude someone from a VBAC. 

Meagan: That they would have to have a C-section. 

Dr. Fox: Again, if it precludes someone from having a VBAC, it would also preclude someone from having a vaginal delivery with their first delivery. There are some abnormalities in babies where they are better off being born by C-section but then it has nothing to do with VBAC. That’s just the case. But they are also pretty unusual. Even babies with certain abnormalities can usually be born vaginally safely. But occasionally, there are some that they shouldn’t. But again, not specific to VBAC. That’s just anybody. So yeah. I think if they want to know more about their baby’s genetics, they should do it. They should feel comfortable and if for some reason, they don’t want to know, fine. That’s okay, too but it should not impact VBAC. 

Genetics is the most complicated part of all of prenatal care for patients, for doctors, for everybody. We have 6 hours of podcasting on this and it’s just scratching the surface because it’s complex. It is growing. It’s expanding. So definitely try to get educated on that, but the short answer, it should not affect VBAC. 

Meagan: Yeah, it’s seeming like it’s growing. 

Dr. Fox: Huge, huge. 

Meagan: It’s a popular topic. 

Dr. Fox: We know nothing more about labor than we did 100 years ago, but we know a bajillion times more about genetic testing than we did 100 years ago.

Meagan: Well, and if anyone wants to find out more about genetic testing, then we will make sure to link your podcast or one of the episodes and they can filter through. 

Dr. Fox: Definitely, they’re free. 

Meagan: Okay, so another one, and this is usually done through ultrasound, is the scar thickness. 

Dr. Fox: Mmm, yeah. 

Meagan: What is the evidence? What do you have to say about the scar thickness? We have some providers that are like, “Ope, it’s too thin. You cannot, will not, absolutely will rupture.” They are making very big comments like that. 

Dr. Fox: I just did a consultation for someone on this two days ago. Well, today is Tuesday. Friday, three days ago, whatever it was. Here’s the issue. When you have a C-section, you’re essentially cutting open the uterus, taking out the baby, taking out the placenta, and sewing it back together. If the uterus healed perfectly, exactly the same as before you cut it open, then fine. You don’t have a risk of uterine rupture any more than anyone else in the world who is having a baby. 

But when you cut things open and sew them back together, we know that the integrity of that tissue is always diminished compared to before. That’s true in every part of the body. So when you’re laboring, you are contracting and squeezing and all of that stuff, there is a chance that it would open up. Fortunately, we’ve learned that for people who have this low transverse type of incision, while that is true, the risk of it is pretty low– 1% or less. There are times when it is higher like if you make a different type of incision on them. 

So the question is are there ways to further quantify this risk or to find who is that 1%? Can we predict who that 1% is or is it just pure luck? So someone came up with an idea that, “All right. If I look at the area of the scar where I made the incision and sewed it together either before pregnancy or during pregnancy and I measure it, I can measure the thickness of the muscle.” You’re taking a muscle and sewing it back together. If it’s very thick, the implication is that it’s stronger whereas if it is very thin, the implication is that it’s weaker. 

I would say that is probably true that the thicker it is, the stronger it is and the thinner it is, the weaker it is, but the question is how do you use that practically? Right? Is there a cutoff where I could say, “Okay, if it’s this thickness or greater, the risk of rupture is less than 1% whereas if it’s this thickness and thinner, the risk is more than 1%. It’s 2%. It’s 5%. It’s 10%. It’s 50%.” The problem is that we’ve never been able to identify a good cutoff meaning let’s say a lot of people use 2 or 3 millimeters. Under that number, it is a higher risk. If it’s over that number, it’s a lower risk. 

The problem with that is that there are enough people whose uteruses rupture despite being over 3 millimeters and there are enough people who don’t rupture despite being under 3 millimeters that it doesn’t seem to be any practical or useful cutoff. Most of the studies that have looked at– for example, there is a study where they said, “All right, I’m going to take 1000 women or whatever the number was who have had a prior C-section, and in half of them, I’m going to measure the thickness and do this exercise where if it’s this thick, I will have them VBAC or if it’s this thick, I won’t have them VBAC. And then the other 500, I’m not going to even measure. I’m not going to look.” If you look at those two groups, neither one did better. It sort of indicates that this exercise of measuring the thickness of the incision doesn’t seem to be fruitful. 

I’m sure there is somebody on Earth who you measure the thickness, you see it’s then, you don’t have them VBAC, and you save them a bad outcome, but there are also probably a lot of people who you then said couldn’t VBAC when they would have a perfectly fine VBAC. So the short answer is that nobody knows. There isn’t one standard and that is something that some people use in their practice and some people don’t. In our practice, we don’t formally measure the thickness and make decisions about it. If we see something that looks remarkably unusual, then we have a discussion about it. It depends on your circumstances, but we don’t do that ourselves. 

There are those that do it. Whether they are helping the world or harming the world, I have no idea. Nobody knows. That’s the problem. 

Now, there’s a different situation where you measure the thickness before pregnancy. 

Meagan: That’s what I was just going to ask. Is there a situation where, “Okay. We’re done. We’re not even pregnant and we measure.” 

Dr. Fox: That is something that is an emerging field of research. We do that on certain people who have had multiple C-sections. It’s not often because I want to know if they should VBAC or not. It’s usually if I’m worried about something called a Cesarean scar pregnancy where their pregnancy implants there or if they’re at risk of uterine rupture during pregnancy. There are different cutoffs used. You have to have a very specific test called a saline sonohysterogram where we squirt water into your uterus and measure the thickness of the scar. 

What to do about it, you need surgery to repair that and then what do those people do in pregnancy? This is definitely not standardized and different people do it differently ranging from not doing it at all to doing it very religiously. You still don’t know what is the optimal method for this. Again, we don’t do this test on everybody who has had a C-section between pregnancies. We do it on certain people, but a lot of it is about planning for the pregnancy more than deciding about VBAC or not is what I would say. 

Meagan: If they can or cannot. Okay, that is good to know. And then in the same area, we have some people talking about adhesions. We get adhesions after we have C-sections. If we have really dense adhesions and we’re having issues, does our risk– and we’re seeing this on these ultrasounds– of rupture go up with adhesions? 

Dr. Fox: Adhesions are generally scar tissue in your belly. That’s either between the uterus and other parts of your belly or between layers of your abdominal wall. Number one, we don’t think that they have any impact on the risk of rupture. They make a C-section harder on your surgeon but we don’t usually see them on ultrasound. That’s actually not correct. 

Meagan: People are saying that they are told that. 

Dr. Fox: Adhesion just means that two things are stuck together. 

Meagan: It’s just scar tissue, right? 

Dr. Fox: Yeah. It’s hard to tell if two things are stuck together versus just sitting next to each other on ultrasound. If I showed you a picture of my hands together, you would have no way of knowing if they are superglued together or not unless I tried to pull them apart. 

So it’s the same thing. On ultrasound, we rarely– sometimes, you’ll see that the uterus is tilted in a really weird way and you know it must be scarred or this or that. That’s also prepregnancy. During pregnancy, your uterus grows very, very large and you can’t typically tell who is and who is not going to have scar tissue. It does not usually impact VBAC. 

Also, you rarely have a lot of scar tissue after only one or two C-sections. Usually, it’s if you’ve had three or four or five and we’re not doing VBACs on people who have had three, four, or five C-sections and no vaginal births and so it doesn’t really come into play practically. 

Meagan: Okay, yeah. That’s good to know because people are being told that in these scar thickness visits that, “Oh, and you have a lot of adhesions so your chance of rupture is increased.” 

Dr. Fox: Listen, I don’t have the skill myself to recognize adhesions on ultrasound. I’m not sure if anyone does. I’m not sure if they’re telling people that because maybe– I guess the only way you would know is say someone has had two prior C-sections and they want a VBAC and the person who did their second C-section saw a lot of scar tissue from their first C-section, then they would say, “Listen, I did your second C-section. It’s a mess in there. You’re not a good candidate for VBAC because if you needed an emergency C-section in labor, it would take a long time to do it.” That is a very reasonable discussion to say, “Listen, part of doing your VBAC is having the capability of doing an emergency C-section if it goes wrong or if something bad happens or there is a concern over that.” 

If you know in advance, I can’t do a C-section easily, then it makes it more difficult. For example, that happened to someone who we know has scar tissue, or let’s say someone who had multiple surgeries. Let’s say someone had a tummy tuck which has a lot of scar tissue or they have Crohn’s disease and they had three other surgeries. Let’s say because of the size of the person themselves if they are much larger, then it is harder to do a C-section quickly, then that is a very reasonable concern over VBAC. Listen, if the VBAC goes well, great. But if I have to do a C-section in labor and I have to do it quickly, I can’t do it quickly. 

That’s sort of the reason why hospitals don’t have VBACs because they’re like, “Listen, we don’t have an anesthesiologist 24/7. If you need a C-section, I need 30-60 minutes to get a team in place. That may not be safe.” That’s one of the reasons why smaller community hospitals don’t allow VBACs. It’s not because they’re mean. It’s because they don’t have the proper staffing to address an emergency. 

Now, anybody can have emergency labor, so it’s a problem for everyone, but it’s more common that if you have a prior C-section, then you may have to do something emergently. 

Meagan: Okay, and one of the last and most famous ultrasounds in our community is the third-trimester ultrasound to check baby’s size. In our community, we have a lot of people doubting their body’s ability to give birth because they are told that their babies are too large or their pelvis is too small. La dee dah, we could go on for a long time about that, or that their fluid is too low. We’re getting these third-trimester ultrasounds. One, the question is, is it absolutely necessary? Can someone turn it down? Is it a bad idea to turn it down? And two, if they’re told, “You’re baby is too large. Your fluid is too low,” is it possible to increase their fluid somehow? Is it really possible to know exactly how big that baby is? 

Dr: Fox: To answer that question fully, we need more than the 5 minutes that we have left. I can come back, but the short answer is whether it’s a good idea or not to have that ultrasound is debatable. In our practice, we do it but we have a higher-risk population typically. And I am pretty confident that we interpret the results appropriately. The issue isn’t so much the ultrasound. It’s the interpretation of it. 

Low fluid is a legitimate concern and that’s a concern for the health of the baby because low fluid could indicate a non-functioning placenta or as we said earlier, that your placenta is crapping out. That could be a sign of that. That’s real. That’s legit. 

If the baby is measuring too small, most of them are fine, but the concern is maybe it means that your placenta is crapping out. The baby being too big, there are two issues with that. One is that, especially with big babies, they are less accurate. With smaller babies, we tend to be more accurate. Bigger babies, we tend to be more inaccurate. We may be right that the baby is big, but how big, we’re not that precise. 

And what to do about that. Like you said, most people having a baby can deliver a big baby and everyone’s going to be fine. But yes, there are risks that go up as the baby gets bigger. There is a risk of injury to the baby. There is a risk of injury to the mother and there is a risk of uterine rupture because a) the baby is bigger and b) the labor is likely going to be longer and more difficult which increases the risk. 

Now, whether that should be used as a criterion to prohibit VBAC, again, is debatable. There isn’t a perfect answer to this. I would be less comfortable managing a VBAC if the estimated weight of the baby is 10 pounds over 8 pounds. Do I have to be so uncomfortable that I wouldn’t allow it? It depends on the circumstances, obviously. 

It is a legitimate concern that the baby is measuring big, but again, how confident are we? Those are difficult details. Our ability to assess the size of the pelvis is even worse because the pelvis changes in labor. It’s part of our assessment, but we have the humility to know that we are frequently wrong about that. It’s tough. Listen, if someone had a prior C-section and their story is, “I pushed for 4 hours and this 6-pound baby didn’t come out and they did a C-section,” then in the next pregnancy, I’m estimating a 10-pound baby and the pelvis does not feel so great and the baby is very high, I’m certainly a lot less gungho about it than if they said the opposite. “I pushed for 4 hours for a 10-pound baby,” in the next pregnancy, the pelvis feels really roomy and great and the baby is measuring 6 pounds. 

That’s legitimate. I could be wrong, but that’s information that might be helpful to me. But again, this has to be individualized. There isn’t a perfect answer to this. I wish we could be more scientific. People have tried a lot of different things. There used to be routine X-rays and to see the size of the pelvis and the size of the baby’s head. It didn’t help. The baby’s head changes shape in labor and the pelvis changes shape in labor so we are not precise with this, unfortunately. 

Meagan: No, I love that you said it’s all unique. We’re all individuals. We’re all different and even from one baby to another, we need to remember that it’s always different. 

Dr. Fox: Yeah. Yeah. 

Meagan: Well, I know that we could dive into so much more. There are so many topics, but I really wanted to just thank you so much for taking the time today. I know you’ve got quite the schedule and spent this hour with us answering these questions. 

Dr. Fox: My pleasure. Thank you for inviting me. Thanks for doing what you’re doing. I think it’s great and hopefully, we can continue getting people better information and making good choices. 

Meagan: Yes. We will make sure to link everything to your podcast and your website so people can read more about you. In New York, people can find you. Sometimes, it can be that VBAC people are looking for doctors all of the time. 

Dr. Fox: If you are in New York City, at our practice, we do VBACs so come on over. If we don’t think it’s a good idea, we’ll tell you but if it’s a good idea, we’re on board. 

Meagan: And you do VBAC after two C-sections, you said? 

Dr. Fox: We do. It depends on the exact circumstances, but we don’t prohibit it because of two C-sections. Obviously, there are some people in that category who think it is a better idea than others, but it’s not a hard rule or anything like that. 

Meagan: Okay, good to know. Okay, well thank you so much. Have a wonderful day. 

Dr. Fox: You too. Thank you very much, I appreciate it.

Meagan: Okay, bye. 

Closing

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