The VBAC Link

Crystal Nightingale is The Mama Coach. Her mission is “to guide families through every stage of their parenting journey by providing evidence-informed education infused with nonjudgmental support, compassion, and empathy.” Crystal chats with Meagan today about some of the many resources available to women who are in the postpartum stages of motherhood. 

While we spend a lot of time preparing for our births, we sometimes don’t know how to really prepare for postpartum. Crystal talks about how to recognize postpartum depression, preparing for going back to work, tips on birth control after a baby, and lactation advice. 

We are so thankful for the work Crystal does to help families thrive with their new babies!

Additional Links

Crystal’s Website - The Mama Coach

Postpartum Support International

The Lactation Network

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello you guys. You are listening to The VBAC Link and I am with my friend today, Crystal. Crystal Nightingale is with The Mama Coach. Right? I’m saying that correctly. She’s amazing. I feel like we connected on social media and I just madly fell in love with her. I feel like I could talk to her for hours postpartum and just the journey of what things look like after we have our babies. 

It’s a topic that we don’t talk about enough in today’s world and honestly, it’s a topic that isn’t focused on. It’s not only not talked about, but it’s not focused on, in my opinion, enough. We have babies and are told to come back six weeks later but a whole load of things happen in that six-week period. There are things from recovering from birth and sometimes we have different types of birth. Maybe we had an easy birth and that’s super great, but sometimes we have a C-section or a vaginal or an assisted vaginal and we have extra tearing. Maybe we’re having a really hard lactation journey and feeding our babies emotionally. There is so much that is packed into postpartum and we just don’t put enough focus on it, in my opinion, in the medical world. 

So today’s episode is with Crystal and she’s going to be talking more about postpartum. What does it look like? What to expect? All of the things. We’re diving deep into it. We’re going to be talking about baby blues and postpartum and mood disorders and hormonal dips and lactation and when it’s okay to not be okay and when it’s okay to ask for help. Just all of the things, so stick with us today. It’s going to be a really, really great episode learning more about what to expect in that postpartum experience. 

Review of the Week

We have a Review of the Week as usual. Just a reminder if you guys have not had a chance to leave a review, we would love for you to do so. You can do that on Apple Podcasts. You can do that– I actually don’t know if you can do it on Spotify but we are on Spotify. You can do it on Google. Just Google “The VBAC Link”. Find us and leave a review there. Wherever you leave a review, we would just love it and you never know, it might be read next on the podcast. 

Today’s review is actually from Google and it’s from Elizabeth Garcia. She says, “As a birth doula and mom, I am always referring clients for information to The VBAC Link. For incredible VBAC stories to lift my VBAC clients up and make them know that there are others who have successfully VBAC’d and for advice, information, and statistics, I always turn to The VBAC Link.”

Thank you, Elizabeth or Beth, if you go by Beth, for your sweet review. Again, as always, we love your reviews and would appreciate them on any platform that you want to leave them on. 

Crystal Nightingale

Meagan: Okay, cute Crystal. Hi. Welcome to the show. 

Crystal: Hi Meagan. Thanks for having me. I’m excited to be here. 

Meagan: Oh my gosh. I’m excited for you to be here. Like I was saying in the intro, you probably know more than I do. We don’t talk about this. There are so many things that I didn’t even know about in postpartum, how our hormones shift and what to look for and I’ve had three kids. Truly, I have not even been informed and I have had three kids so I’m really excited to dive into this with you today. 

Crystal: Yes, awesome. I know. Like you said, we have all of this attention during the pregnancy and we have all of these appointments and all of this kind of stuff, all of this information and resources, but then when you have your baby, it’s like, “Okay, bye. Take care of yourself and your baby. Make sure you sleep.” 

Meagan: Yeah. Make sure you sleep. You’re like, “How do I do that again when I have a baby waking up every 2-4 hours?” 

Crystal: Yeah and then most women don’t have their first postpartum appointment until six weeks and it’s like, oh my gosh. Where is the support for those first six weeks or even beyond? Because postpartum doesn’t last just six weeks. I’ve read somewhere– I can’t state the source because I don’t remember, but it can last up to a year after giving birth. The way I look at it is, okay. You’ve been pregnant for about 9-10 months or so and all of that time, your hormones were increasing and your body was changing. In my opinion, it will take at least that long to fully recover as well. 

Meagan: Absolutely. It’s kind of interesting that you say that because with my first, my oldest daughter who just turned 12. I’m thinking of when this episode is coming out. She’ll be 12 in a week. 

Crystal: Oh my gosh. 

Meagan: I know. It’s so crazy to me. But I was 11 months postpartum with her. I had gone back to work when she was 3 months old. I had been working and things were pretty good, then I had some struggle with my lactation with my supply and was doing things to try and get it back. I just felt a shift in my whole self. I went in at 11 months postop because my husband was like, “I think you should talk to somebody.” I didn’t really know anyone to talk to so I just went to my OB. My OB said, “You have postpartum depression.” I said, “No, I don’t. I am really far out from postpartum now,” because, in my head, almost a year was really far out. 

He said, “No. You have postpartum depression. This is postpartum depression.” I literally looked at him and my jaw opened and I said, “I think you’re crazy.” He said, “Nope. This is postpartum depression.” We talked about it and I was like, “What?” So I called my husband and I said, “Hon, even though I am almost a year, he said I could still have this. I have this. These are the things we talked about on how to work through it.” I just could not in my mind believe him. I really could not believe that I had postpartum depression. 

I think one, I didn’t want to admit it. We have a negative stigma around the word “depression”.

Crystal: There’s a stigma, yeah. 

Meagan: With just depression, it’s like, “No, no. I’m not depressed. Don’t say that. Don’t put that diagnosis on me.” Truly, I was scared of that and didn’t want to admit it, but then I was like, “No. I am not a few months after birth. I am almost a year out.” So it’s interesting that you just said that because I was actually told that at 11 months postpartum. 

Crystal: Yeah. It’s crazy. Like I said, with all of the hormones running rampant during pregnancy, then it’s the same afterward. There’s a hormonal shift right after delivery, during breastfeeding, and if you stop breastfeeding, there’s a hormonal shift as well. Then going back to work has all of these different emotions. It’s just an emotional rollercoaster. 

Meagan: It really is. I think that is what was happening. I was shifting a little bit within my milk and then I was maybe deciding on not working, then there was a lot of pressure on where my daughter was. There was so much going on. I had those hormonal shifts, but I didn’t realize they were happening. I didn’t recognize them. 

So yeah. Let’s just dive into that. Postpartum– things to expect as a postpartum mom both physically and emotionally. What are things that we could just automatically expect to happen? 

Crystal: All the emotions. 

Meagan: All the emotions. 

Crystal: There is a big drop of estrogen after you deliver and that increases prolactin hormones which help with milk supply and then there is just the initial recovery. So if you delivered vaginally, you may or may not have had any tears and there are different degrees of tears. I know you are more familiar with that kind of stuff and how to prevent it with perineal massage and things like that. 

It’s funny because some people think, “Oh, I’m going to have a big baby,” or whatever they tell you that your baby is going to be big or small, but there is a misconception that if your baby is big, then you’re going to tear. You’re just going to tear, but some women don’t tear and they have 10 pounds but other women tear and they have a 6-pound baby. 

Meagan: Yep. 

Crystal: It can happen to anyone. It doesn’t matter how big or small your baby is. That’s the immediate recovery from any tears. Of course, you want to to sitz baths. They have the dermaplast spray to help with pain and things like that. Bleeding, if you had a C-section, you will still bleed. Maybe not as long as a vaginal delivery, but bleeding can last anywhere from a few weeks up to 8 weeks so that’s totally normal. Some women are like, “Oh my gosh. Why am I bleeding still?” It’s totally normal for all of that. 

Meagan: Yeah. The wound of our placenta, we have that on our uterus so we can bleed. We can bleed shorter sometimes or longer sometimes. 

Crystal: Right. Yeah, and it is a wound which is why it’s not recommended to have any sexual intercourse until at least six weeks. Even when your doctor “clears you”, you still may not be ready. You’re exhausted. You feel touched out, so it’s totally okay to be open with your partner on how you’re feeling in regards to that, but you definitely want to wait at least six weeks for sexual intercourse. And then of course, have a plan for birth control because you are most likely more fertile right after you’ve given birth. 

Speaking of breastfeeding, there is a family planning method called Lactational Amenorrhea Method and there are three criteria to this. You should be less than six months postpartum. You should be exclusively breastfeeding and not have started your period. With those three combined, you can usually use exclusive breastfeeding as a type of birth control. It’s just crazy. You do have to be exclusively breastfeeding though. That’s the really big key thing. If you’re giving bottles here and there, I believe the CDC I think it was said, “If you’re exclusively breastfeeding and not going more than four hours in between feedings, it’s a good family planning method.”

Meagan: I’ve never even heard of this. When I saw it on the list, I was like, “What is that?” I had no idea. 

Crystal: Yeah. Yeah, it’s crazy. It’s just because while you’re breastfeeding, a particular hormone is lower than usual. It suppresses ovulation and that’s why a lot of women who are exclusively breastfeeding don’t even have their periods until months down the line. 

Meagan: Yeah, we had a question like that on one of the Thursday questions. When is it normal for people to have their period return? I’m like, “It really just depends. It totally depends.” 

Crystal: Yeah. Yeah. It could be a couple of months after birth, or like I said, if you are exclusively breastfeeding, it could take a little bit longer. 

Meagan: Yeah, so talking about hormones and all of this, I have been blown away to see recently that we have providers– if you’re in Utah anyway, this is happening– that literally right after birth, they are saying, “Hey, we can put your Mirena IUD in right now.”

 

Crystal: Oh my gosh. 

Meagan: What?! My mind was blown. I was like, “Hold on.” They left and I was like, “Let’s talk about this. Let’s talk about placing a Mirena IUD the second you have your baby.” 

Crystal: I know. 

Meagan: What? No. I mean, for me, I was passionate about it because my IUD was actually placed too early with my second. My cervix hadn’t completely “hardened”. It hadn’t recovered completely and so it was too soft. It ended up floating up and protruding through my uterus going towards my lung. 

Crystal: Oh my gosh. 

Meagan: I was specifically told, “It’s because you got it too early.” I’m like, okay. So that was one thing. But hormonally, why are we giving birth control hours and days after we have a baby? So that is something that is happening. Have you ever seen that?

 

Crystal: That is so crazy to me too, yeah. I have. I have. 

Meagan: Like what? 

Crystal: Yeah. Literally right after the placenta is expelled–

Meagan: “Well, let’s place your IUD right now.” 

Crystal: Yeah, we’ll just place it. I’m like, first of all, that’s a big wound. Why are you putting something in there? It needs to recover and two, like you said, the hormone stuff. I mean, yes. Mirena or progestin-only birth control is the recommended birth control to use if you are breastfeeding, but still, this is a very vulnerable time. 

Meagan: Very. 

Crystal: I say, if you can, wait until you establish your milk supply so that way you have an abundant, well-established supply because you may experience a dip in your milk supply with any type of birth control. It will be easier to bounce back if your milk supply is established. Make sure you are knowledgeable and know what to do and you are informed and educated on it, but yes. I have seen that many, many, many times. I cringe when I see it. I’m like, “Oh my gosh.” But you know, what can you do? The OB offers it. Moms feel like, “Oh yeah. Let’s just do it. Might as well,” but they are not given all of the facts and are not informed. It’s so crazy.

Meagan: I know. I just couldn’t believe it. I could not believe it when I saw that. Also too, we want to know who we are and where we are. We’re already dealing with so many hormonal shifts emotionally and then getting breastfeeding established and things like that. Why are we adding? I don’t know. It wasn’t my thing, but I was just shocked to see that. I was shocked to see that that was happening. 

Like you said, it can impact the milk supply. By the way, listeners, Crystal is also with The Lactation Network, our sponsor, which is super exciting to find out about. She is really skilled in lactation and things like that. Is that something that can impact our milk before we even establish our milk?

Crystal: Yeah, it can. I can’t say always, right? But yes. I’ve definitely seen it impacted. It can take a little bit longer for milk supply to be established if you’ve got the Mirena or started the birth control early on. Like I said, the recommended hormonal birth control is something with progestin-only or progesterone only and no estrogen. But I have seen some women’s milk supply impacted by the recommended one. I always say, of course, birth control, yes, is there and it’s good but if you do plan to breastfeed, at least know that it may be impacted. Be educated on how you can, I guess, counteract that dip. Frequent and effective removal of milk, staying hydrated, having good nutrition, and eating lots of leafy greens and protein and iron are going to help with that. 

Meagan: I agree. If we can’t get it in through food and nutrients, it’s okay to supplement and get vitamins and things like that. We highly suggest Needed but getting the nutrients your body needs and understanding that you’re going through a lot so if you can’t eat that, supplement with that so your body can still have those nutrients. 

Crystal: Yeah, for sure. I mean, we are recovering ourselves as well as trying to take care of a new baby and maybe even breastfeeding that baby if you’re planning to breastfeed so for sure. You lose some blood during delivery whether it’s vaginal or C-section and you know, maybe there’s even a complication where you hemorrhaged so now you’ve lost a lot of blood and you need some iron supplements. So a prenatal vitamin for sure especially if you’re breastfeeding and then like you said, if you’re unable to eat– most of us, at least I can speak for myself, don’t get all of the nutrients that I need through food. 

Meagan: We don’t. We don’t. It’s so hard. 

Crystal: It is. It’s very hard. Either you’re on one side of the spectrum. You’re either famished because you’re breastfeeding and you want to eat all of the time or you have a lack of appetite. I always recommend for moms if they have a loss of appetite, maybe do a smoothie or a protein shake or something like that. Little snacks throughout the day or a protein bar, nuts, seeds, and things like that. 

A lack of appetite is a sign of postpartum depression or a postpartum mood disorder. Baby blues versus postpartum depression is pretty similar. Baby blues is basically a temporary, short feeling of that initial postpartum period where you’re exhausted. You’re stressed. You’re anxious. “Am I doing this right for my baby? Is my baby getting enough? I’m tired. Oh my gosh. We’ve got a new routine going on.” Those are baby blues. It’s short, maybe a week or two and you’re able to move on. But if it lasts longer than that and includes other signs such as a lack of appetite, excessive worrying, lack of sleep– I mean, of course. New mothers are already sleep-deprived but if you are just so–

Meagan: Really unable. 

Crystal: Unable and you can’t sleep even when the baby is sleeping, then those are definitely signs of postpartum depression and you for sure want to reach out to your OB at the least or whatever psychiatric resources your insurance plan has, you want to reach out to them. Of course, online there is a lot of stuff and resources for that. Like you said, it can show up at 11 months postpartum so always be aware of that. 

And then for the partners, just make sure that they are aware of those things because they may see it first before you realize it yourself. 

Meagan: Yeah. Exactly. That’s what I was just going to say. Yeah, at 11 months is when I really willingly addressed it and recognized it deeper myself, but looking back, I think that it started way further. It just kept getting deeper so going back to baby blues, maybe I was like, “Oh, these are baby blues.” Nursing was really hard for me. I didn’t have the opportunity to have as skilled of an IBCLC. As we know, insurance doesn’t cover that a lot. We were young and didn’t have the best jobs in the world so we didn’t really have things like The Lactation Network to work with our insurance and support. 

Crystal: Right. Right. You couldn’t afford it.

Meagan: So it was really just trying to figure it out. I had the IBCLC in the hospital and things like that, but not on a deeper level so that was really hard for me. Then it was the stress of work and the thought of how I was going to juggle it all. Then it was back to work. Then I was really struggling when my mother-in-law accidentally spilled over my hard-work-pumped milk for my baby for that day. If I look back at all of the things, I actually had a lot of these signs, but I didn’t really chalk it up to anything other than, “I’m a new mom.” I think that’s where we can go wrong. There are so many times where it’s like, “Of course I’m tired. I have a baby that wakes up every couple of hours. Of course I’m sore. It’s because I just had a C-section. Of course I’m this. Of course I’m stressed,” but like you said, if this is continuing, that’s where we need to reach out. 

Crystal: Yeah, and there are a lot of resources out there. Like I said, the first thing would be to reach out to your own provider whether it’s your general practitioner or your OB. Someone who can point you in the right direction or give you some of the resources for that. 

Yeah, so speaking of that, our own maternal struggles, also the partner struggles. I talk to dads and a lot of the time, they’re like, “Oh my god, I feel bad. She’s trying so hard and I’m trying to do what I can.” It’s stressful for the partners as well. 

Meagan: Absolutely. 

Crystal: Seeing your other half struggle because they really want to breastfeed or struggling with postpartum depression. Partners will ask me, “How can I help?” so I give them tips like, okay. If mom is breastfeeding or doing newborn care or anything like that, try to make the meal for her. Help with the other kids or say, “Hey, why don’t you go take a bath?” because as moms, we just neglect ourselves. I always say, “Make sure she has snacks.” Of course, water and food are probably the biggest things especially immediately postpartum for recovery for ourselves and to nourish our body so we can nourish the baby. 

But yeah, we should acknowledge that and like I said, obviously, I can’t speak for all moms, but for me, I didn’t realize and acknowledge all of the things that my partner was doing. The partners can also experience some postpartum anxiety and postpartum depression. 

Meagan: They really can. I was just going to say that I didn’t have the mental space to recognize what my husband was and wasn’t doing and where he was emotionally. It wasn’t until I wanted to VBAC with my second, my VBAC after two C-sections, that I realized that he had some trauma and some things that he had been dealing with based on things that he had said. It was like, “Oh, okay.” So it’s kind of interesting, but I wasn’t in that space because I was so focused on my baby that I couldn’t even focus on myself or my husband. 

Crystal: Of course. Right, yeah. Yeah. As mothers, it’s instinctual. Of course, we have our baby. We have to protect it and we have to do everything for it but then also we neglect ourselves and inadvertently everyone else around us. But it’s good to acknowledge and even just a “thank you” to the partner like, “Hey, I’m so sorry. I’m just really tired. Blah blah blah. Thank you for what you’re doing and supporting our family.” 

Meagan: And coming up with a plan. I think communication is really big and it’s really hard for us to say, “I’m not okay,” but it’s okay to not be okay or feel okay. There would be times where I would just be tearful. I didn’t even know why. He would be like, “What’s wrong?” I would be like, “I don’t know. I don’t know. I don’t have anything where I can say this or that.” It got to the point where you have to communicate and say, “I’m not okay” or “I need help today” or “What can I do for you today? I’m feeling really good. You seem like you’re stressed. What can I do for you today?” Right? It’s hard because again, we’re not in that space. We’re already taking care of a baby. We can’t take care of another human, but they are taking care of the other kids and the dinners and they’re still trying to help so sometimes just asking, “Hey, I’m doing good today. I’m just doing a quick check-in. How are you? If you’re not okay, how can I help you?” or “Hey, “I’m not doing well today. Is there any way I can get help with this?” Or if they can’t do it because they are tapped out, talk about it. 

Come up with a plan. Maybe it’s lactation help. Maybe it’s going to a therapist. Maybe it’s having a cleaner come in and clean your house because looking at it is creating anxiety for everything that’s going on. We don’t want a dirty house with a new baby and all of these things. So communicating and really having that full openness is going to impact our postpartum and the way things are with our spouse and our loved ones. 

Crystal: Yes. I totally agree. Communication is key. I really believe that preparing for the postpartum period before we get there is key too. 

Meagan: 100%. 

Crystal: Yes. That well-known saying, “It takes a village,” I say, try to start forming your village before you deliver. Look up different mom groups if you don’t have family. Of course, family and friends that are near you will be the best because you feel more comfortable asking. It’s pretty hard for us to ask for help. 

Meagan: It is. 

Crystal: But it should hopefully be easier with family and close friends so if you can establish that village beforehand before it gets really bad, then you have those resources already. Or, like I said, if you don’t have family or friends close by– like for me, I was in the military and I had my second baby while I was away from all of my family– try to find resources in your county or your community or even online mom groups like The VBAC Link and support groups like that where you can even just vent and type out, “I’m so tired.” Whatever you are feeling, there are just so many supportive women, not only women but supportive people out there who are willing to be an ear or try to put you in the right direction or even point out things like, “Hey, it sounds like you maybe need to reach out to somebody. Please do,” and this kind of stuff. 

Meagan: Absolutely. We've been talking about that a lot lately how we’re doing so much to prep for the birth and during pregnancy and all of these things, but then we do forget about the postpartum and really, during our prep for birth, we also need to be prepping for that postpartum period. 

Crystal: For sure. 

Meagan: That includes finding your village and getting a meal train organized. Truly, meal trains are amazing. If you want to breastfeed or whatever, I would think even if you are not planning on breastfeeding, it’s good to talk to a lactation consultant. Get in touch with The Lactation Network beforehand. Understand your resources and your groups. PSI, postpartum support international, is really great. Resources as well– being familiar with those pages, going and looking at those professionals, understanding, and having a relationship so it doesn’t come to five weeks postpartum and think you need help but now it feels really overwhelming to find that village. 

Crystal: Yes. Right, right. 

Meagan: Right? It’s very overwhelming so if we can just have our village in play, then they’re available. We have them on our list. “Oh, here’s my lactation help. Here’s my postpartum help. Here’s my favorite group to vent and get it out because I know I’m going to be validated and feel love in this group.” 

Crystal: Yes.

Meagan: Whatever it may be, do it beforehand. Do it before. 

Crystal: Yes, yes. I wish I did that before too with my older kids because like you were saying earlier, we were young. I didn’t know. I was naive. I was 20 and I’m just like, “Okay. I don’t know what I’m doing.”

Meagan: I’m just going to have a baby. That’s what people do. They show up and have babies then they go off. They know how to nurse and they know how to help. They understand what is going on with their body and how to recover and get those nutrients and fuel our brains. No. Guess what? I didn’t know any of that, you guys. 

Crystal: I didn’t either. I did not either. 

Meagan: I wish I did. I wish I did and that’s why we’re here talking to you today. Even if it’s baby number two and you didn’t do it with your first, it’s not too late to create your village beforehand for birth and postpartum. 

Crystal: Totally. 

Meagan: Those might be two different villages, just fyi. 

Crystal: True. That’s a good point. Yeah. Yeah, for sure. 

Speaking of postpartum, parents need to also keep in mind that things can change. We have our birth plan. Okay, we’re going to breastfeed. We’re just going to pump or however you choose to feed your baby but unfortunately, things can happen that are unexpected things. Complications or issues with milk supply or baby not even wanting to take a bottle, having a bottle refusal or breast strike so just being flexible and like you said, knowing where you can turn to for help like, “Okay. I’m having this issue. I’m going to reach out to my lactation consultant” or “I need some extra help with meals or cleaning.” Like you said, now that I know everything that I know, I wish somebody would have told me– you know how we do our birth registry– that we don’t need a lot of those things that we put on there. 

What we need are meal trains and if you have family or friends, someone who can take turns once a week to come in and cool a meal for you or just help you clean up or even a postpartum doula. 

Meagan: Yes. 

Crystal: Money for that would be great. Way back when, we didn’t have all of this different equipment for the babies and we did just fine without it. 

Meagan: Yep. Yep. Yeah. There are so many details to figure out. If you really think about it, it’s why it makes so much sense to do it beforehand because we’re tired. We’re sore. We’re recovering. We’re overwhelmed already. You guys, I don’t know. This is my personality. If I’m overwhelmed, I’ll just ignore it. I’m like, “I’ll just get to it later.” Then it never happens and I suffer because I never did it. 

Crystal: Yep, exactly. 

Meagan: Honestly, you guys, if it’s overwhelming– say that right now you’re listening and you’re 3 months postpartum and you’re like, “Oh gosh. Yep. Everything these guys are saying, I need help,” delegate. That’s okay. Tell someone. Tell your mom or your friend, “Hey. I need help. This is where I’m at. Is there any way you can help me find these resources?” 

In the show notes below, we are going to have some resources. We’ll have The Mama Coach. We’ll have The Lactation Network. We’re going to have PSI. We’re going to make it easy for you right here too, but it’s okay to delegate and say, “Hey, I’m not in a space that I can find this.” Wish you woulda, shoulda, coulda, you can’t go back and dwell on it. Let’s get help now. Delegate someone to find you or even send them this resource and say, “Can you reach out to these links?” 

Crystal: Yeah, because that’s a lot of time too going through these different resources and contacting them or navigating their websites to find the specific information you need. It takes a lot of time and the next thing you know, an hour goes by and you’re like, “Oh my gosh, I could have taken a nap. Now the baby’s up.”

Meagan: Exactly, yeah. Send them this podcast. There will be all of the links in the show notes for all of the things that we are talking about including nutrients that your body needs and resources so we can hopefully try to make it easier for you. 

Crystal: Yes, for sure. Yes. As a Mama Coach, we have Mama Coaches all around the U.S. and even all around the world. Most of us do provide postpartum hourly care similar to a postpartum doula. We could do it even virtually, virtual postpartum care. If you need help with how to birth your newborn or just with help around the house. If you need someone to watch your baby while you take a nap, the Mama Coach has a lot of services as well. Like you said, it will be in the show notes but definitely reach out. 

If I can’t help you, I can definitely point you in the right direction or connect you with another Mama Coach or resource, whatever that can hopefully help support you. 

Meagan: Yeah. Do you know what I wish I had you for? Helping me know how to return to work. 

Crystal: Ah, yes. That’s a big one. 

Meagan: It was a really big, daunting task. I remember just trying to look online, how to figure out, what a good schedule is, if I wanted to pump, what a good schedule for pumping was based off of my specific work schedule, and things like that. 

Crystal: Yeah. 

Meagan: I know you guys can help with that. Just a few tips that you can give our listeners if they are planning on returning to work. 

Crystal: Yes. I always say to try to start planning for your return to work at least a month before you plan to return to work. If you are breastfeeding, say you are postpartum and going along, you are exclusively breastfeeding and now you’re going back to work, if you’re going to be bottle feeding, don’t wait until the last minute to introduce a bottle. There have been a lot of babies who have refused the bottle and just want the breast so for sure, you don’t have to give them a bottle every time, but I always say that at least once a week or so starting off a month prior to going back to work, start to introduce it if you haven’t already. 

Yes, definitely you need a plan because there is that separation anxiety too. You’ve just been home with your baby for 6 weeks, 8 weeks, 3 months, 6 months. You’ve been home taking care of your baby and now you have to pass him or her off to either a daycare provider or a family member or your husband. The husbands do a lot of stuff, but of course, as a mother, we just are that nurturing type and it’s like, “Okay. Are you going to take care of the baby as well as I do?” 

Meagan: Yeah. I wanted to micromanage my husband. I was like, “I know you’re going to do it great.” I kind of was that way with everyone. “I know you’re going to do a really good job, but you’re not me.” It’s so hard. 

Crystal: Exactly. It’s just different. It’s definitely hard. There is that separation anxiety so prepare mentally too. Like you said, open communication with whoever is going to be the caregiver while you are away for work whether it’s your partner, a family member, a friend, or a daycare provider, be open with them. “Hey, I am breastfeeding and bottle feeding. Paced bottle feeding. Can we talk about that? If you don’t know how to do it, I can send you a video on how to do it.” If they are starting solids, what kinds of foods? There are a lot of different things so you definitely need to come up with a plan. I think that the biggest thing is coming up with a plan and being flexible because you just never know what your baby is going to want to take. 

Meagan: I know. 

Crystal: I’ve heard of babies not even eating while they are away from their mom and then they are nursing all throughout the night and now moms are tired and they have to go to work tired. It is a lot so I mean, I think the few tips I have is to get prepared at least a month in advance and open communication with whoever the caregiver is going to be. Reach out for help. 

Meagan: And reach out for help. Absolutely. Women of Strength, it’s okay to reach out for help. It’s okay to feel like you need help. We don’t want you to have to feel like you need help. We want you to be prepared and feel confident along the way, but it’s more likely to need help than to not need help so know that if you do need help, you’re not alone. There are a ton of amazing resources that just want to do nothing but help you. 

Crystal: Yes, definitely. 

Meagan: Awesome. Well, thank you so much. We’ll definitely have to have you on again. I know that we have just brushed the surface. 

Crystal: Yes. No, I would love to be on here again. Thank you for having me. I love this platform. You guys give a great amount of information and resources and things like that, so thank you for having this platform. 

Meagan: Yes, 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.

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

The chances of having vasa previa in a spontaneous pregnancy is about 1 in 2500. Our friend, Jessica, shares her experience with vasa previa during her first pregnancy which led to a scheduled Cesarean. While Jessica’s Cesarean experience was difficult and traumatic, she knows it is what her intuition was telling her to do. Meagan gives important advice about listening to that intuition with every pregnancy.

When the anatomy scan results showed that Jessica’s second pregnancy was completely normal, she went all in to achieve the HBAC she deeply desired. Jessica didn’t expect her birth to be so painfully intense and wildly fast as it was, but now she says that she “would love to do it again!” 

Additional Links

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello you guys. This is Meagan and today I am recording in a very different spot. Normally, I am in my office at my home, but today, I am recording from my car. We have our friend, Jessica, and she is from California. She is going to be sharing her HBAC story with you guys today. If you don’t know what HBAC is, if you’re new to all of the terms, it’s a home birth after a Cesarean. 

She has a unique situation with her first C-section so I am excited to talk a little bit about that and have her share more information and then with her home birth, it was precipitous. Jessica, was it a planned home birth? Remind me, or was it so precipitous that it ended up being a home birth? 

Jessica: It was definitely planned. 

Meagan: Definitely planned. 

Review of the Week 

Meagan: She will be sharing that story but of course, we have a Review of the Week. This review is by Ashley and it’s actually on our doula course. So birth workers, if you’re listening, if you didn’t know, we have a birth worker course to become certified in VBAC. It says, “TOLAC/VBAC should be treated just like any other birthing person, but there is a certain preparation and information that needs to be offered to them. Your course covered that. The value is held in your careful recognition of how best to support our client who is doing a TOLAC. I cannot praise you two enough for the fear-release activity. Honestly, it is something I can apply to even myself before and after birth and even in life in general. Thank you for that. It has already helped me with three of my VBAC clients.” 

That is so awesome. That is one of the biggest things we do in our course. We do a fear release. If you didn’t know, listeners, a fear release is so impactful really processing your past births and working through any trauma. Even if you don’t recognize it as trauma, it may resonate as trauma so working through those fear-release activities is super amazing. 

Jessica’s Stories 

Meagan: Cute Jessica, thanks for joining me from my car today. I kind of had a crazy day where my husband got thrown into coaching another team and we had soccer tryouts. As we are recording right now, it’s actually May so we are in the thick of soccer tryouts and all of the chaos of the last week of school. I ended up being at the soccer field so that’s why I am coming from my car. 

So yeah, Jessica, I’d love to turn the time over to you to share your beautiful story. 

Jessica: Yes. Thank you. Thank you so much for having me. I’m very excited. 

I’ll just get to it. Basically, I got pregnant with my first son and he was due in July of 2020, well actually, the beginning of August. He was a COVID baby. My husband didn’t get to go to any appointments with me. But that was supposed to be at a birth center. I watched The Business of Being Born. I got down that rabbit hole. We decided we wanted to be at a birth center. 

Everything was fine, then I had my anatomy scan and they found vasa previa. I had never heard of it. I never really even considered something being– you know, you worry about something being wrong with your baby. You never think about you having something wrong. 

So we were very shocked and all I remember was the sonographer saying, “It’s detrimental to your baby.” That was very devastating because I had no idea what that meant. I had to wait to get a referral to see a specialist. It was, I think, 4-6 weeks away. In that timeframe, I had to basically just sit and wait and not know what was going to happen. 

I joined a Facebook group, did research in the meantime, and I realized, “Holy crap. This is a big deal.” I went to the specialist and they said, “Yeah. You have vasa previa but it could still move.” I left with no answers. It didn’t feel any better hearing that. 

So basically vasa previa is you know, you have your placenta and your umbilical cord. It was explained to me that typically with a placenta and an umbilical cord, the umbilical cord is like a tree trunk. But when you have vasa previa, it’s like tree roots. So basically it’s an unprotected umbilical cord and vessels that could potentially be ruptured with a vaginal birth. 

Meagan: Yeah. They’re very exposed. 

Jessica: Yes. Very exposed. I did also learn that I had a velamentous cord insertion which goes hand-in-hand I think. So yeah. Basically, the moral of the story was that it was a big deal on how I was going to birth this baby even more so because his life was at risk. I eventually saw three doctors at the same practice just for follow-ups. They eventually cleared me for vaginal birth. You think that you would be super excited about that, but everything that I was reading was saying that it has to move a big amount for it to be safe. The vessels could still rupture and all of that stuff. 

So then I got two second opinions at different practices. They also cleared me. I don’t know. Everything that I was reading, I was reading different stories on this Facebook group. I just felt in my gut that I needed to still have a C-section. That is not what I wanted. 

I still stayed with the specialist because I was still considered a high-risk pregnancy. She said that I could deliver vaginally, but I told her, “I feel like I would feel safer doing a C-section.” She said, “Okay, but we are going to wait until 39 weeks.” With vasa previa, you deliver much earlier than that just because they don’t want your body to go into labor at all. 

Basically, that whole pregnancy was full of anxiety and fear. I was worried every single time I went to the bathroom. I was worried there was going to be all of this blood. I felt invalidated and like I was silly for still wanting a C-section by this doctor. Yeah. It was really hard and then my husband couldn’t even be at the appointments to hear what was being said. So yeah, it was really hard. 

Meagan: Yeah. That is a really hard thing to hear. Especially when you are not even planning on giving birth in a hospital. It’s like, “So wait, wait, wait. I have to completely shift all gears.” But what I love was that your intuition was like, “I need a C-section. This is what I feel is best for me and my baby.” You followed that. That is so important. 

One of the messages here at The VBAC Link is that we strive to say that we don’t shame anyone for having a C-section. We know that they are happening a lot, but especially when your gut is saying, “This is what I should do,” we have to follow that. Women of Strength, we have to follow that. 

Jessica: Yep. Yep. So ultimately, yeah. I followed my gut and I’m really glad that I did. The nurse who was by my side in the C-section said that she had never seen a placenta like mine. The doctor, of course, said that it looked normal, but every person that I’ve shown, and some of them are birth workers, are just like, “Wow, yeah. I’ve never seen a placenta like that.” I had a ton of exposed, very fragile-looking vessels. I don’t know where they were in my belly, but still, they were very fragile-looking. I feel like I made the right decision. My doctor said that it was normal, but I don’t think that it was. 

Meagan: Was your baby IUGR at all with the velamentous cord on top of it? 

Jessica: No. 

Meagan: Okay, sounds good. Let me just– there are lots of abbreviations in this episode. IUGR is intrauterine growth restriction and that can be a baby that is being restricted of growth. Sometimes with a velamentous cord, a baby can be on the smaller side or have growth restrictions so it’s awesome that your baby didn’t. 

Jessica: Yeah, he was 7 pounds, 3 ounces at 39 weeks. Yeah. I mean, it was a fine C-section. Nothing eventful happened, but it was still traumatic being strapped. I wasn’t even strapped down. My arms weren’t, but still, the experience was. I didn’t get to hold my baby for an hour and when I did, I was super shaky. I was nervous to hold him.

I looked up at the monitors and I feel like my blood pressure was super low at one point. I thought I was dying. It did not feel great. It was traumatic for us. I know that trauma looks different for everybody, so for us, the whole experience was traumatic. 

My doctor did say, “You know, I’m giving you this incision so that if you do have another baby, you can have a VBAC.” It was always in my head that when we did have another baby, it would be a VBAC. 

Jessica: So yeah. Fast forward to April 2022, my husband and I were trying and I got pregnant. It was kind of a surprise but kind of not. I toyed with the idea of possibly giving birth in a hospital, but it was for a very short while like maybe five minutes, then I was like, “No. I think I need to do a home birth this time.” 

Just because of our experience at the hospital, I don’t know. I didn’t want to have to fight to have a vaginal birth. I didn’t want to be held to the hospital policies and whatnot. I follow a lot of birthworkers and see physiological birth and whatnot so we just decided to have a home birth. 

We found our midwife and she was a midwife. She’s been a midwife for 46 years so had lots of experience. She’s had lots of VBAC babies and it was just really exciting. It felt right to book her as our midwife. I had her, I think, from 9 weeks on and nothing exciting happened in my pregnancy. I was nervous about the anatomy scan, but they did a very thorough check and I could have cried hearing the news. I was just very confident knowing that the placenta was good, the umbilical cord looked good, and all of that. 

We went on to have an uneventful pregnancy. I would say from 37 weeks on, I would have cramping and whatnot. I always had Braxton Hicks from 15 weeks on, but around 37 weeks, it changed to that more period-like cramping. I tried not to read into it. I was just like, “This is my body preparing.” There were a couple of times where I was like, “Oh my gosh. Is this happening?” I was listening to lots of podcasts and birth stories and stuff to just kind of prepare myself for every scenario. 

I think I went to my midwife at an appointment the day before I turned 40 weeks. I was toying with the idea of getting checked or not because I didn’t want to be disappointed or get my hopes up. Ultimately, we– I keep saying we. My husband was a big part of this. I decided to get checked and I think I was a 2 and 70% effaced or something. I was in the right direction but I also knew, “Okay, that doesn’t really mean anything. It could be a week.” 

But they did want to schedule me for a membrane sweep the following week just in case because you can’t give birth at home past 42 weeks. I really did not want to do that, but I also really wanted to have the baby at home. I was just really anxious. Now I felt like I was on a timeline. My due date came and went. I was disappointed. I knew that it’s totally normal for your baby to not come at or before 40 weeks, but you have that hope that maybe they will. Your body is starting to have all of these symptoms so you’re hoping that this is it. 

My midwife had said, “Make plans because babies like to come when you have plans. They don’t like it when you’re waiting around for them.” 

Meagan: I love that. 

Jessica: Yeah. I tried to get out of the house and then one day, I was like, “Okay, do you know what? We have to go do something.” I planned for me and my toddler to go to the aquarium. We had to buy tickets. The day after my due date, I lost some of my mucus plug so I was very excited about that. Two days after my due date, I listened to Bridget Teyler. She has an induction meditation on YouTube. I just did it because when my husband was putting my toddler to bed, that was my time to get in the zone, drink my red raspberry tea, and prepare for birth. I just did it because it was something to do. I didn’t expect it to work. I thought, “You know, if nothing else, I’m bonding with my baby.” It was really great. 

The next day, I woke up and I was pregnant still. My mucus plug still kept coming out. It was pink and I was like, “Oh, is this my bloody show?” but my midwives were like, “No, that’s still your mucus plug.” I was kind of disappointed about that. I talked to my husband about all of the anxiety and how people were wondering where the baby was and all of that stuff. 

We had a steak dinner that night. That was the meal that I envisioned that I would have before I went into labor. That was 40 weeks and 3 days. The next day, at 40 weeks and 4 days, I woke up still pregnant with no signs. I was emotional about it but that was the day I was supposed to take my son to the aquarium. 

We get ready and we’re driving. On the way there, I’m starting to get cramps every four to every 30 minutes. They were 30 seconds long. I was like, “Oh my gosh. What the heck?” We get to the aquarium and my son wants me to hold him. Meanwhile, I’m having these contractions. I’m just like, “Oh my gosh. I wasn’t timing them because obviously, I had my hands full.” 

We ate at the aquarium and I remember feeling dizzy and nauseous at one point. But then we went home and my toddler fell asleep in the car which is pretty rare. That means it’s going to be a short nap, so I was like, “Oh if he takes a short nap, he’s going to go to bed earlier. Maybe this is meant to be. Maybe if I go into labor tonight, this is meant to be.” I had always envisioned that I would give birth at home while my toddler was sleeping just because he’s a very sensitive little guy. I figured that my being in labor would scare him. 

So I was just like, “Oh my gosh. He’s going to go to bed earlier than normal.” I got home and my husband got home from work. I was like, “I’m going to go rest and lay down to try and take a nap in case.” I couldn’t sleep, but I did lay in bed for an hour and a half. I went downstairs. I tried to make dinner and I kept having to stop and lean on the counter. My husband was like, “Do I need to turn the lights down? You’re going inward.” I’m like, “No, I’m not.” I was in total denial. 

He eventually took over because I was just like, “Yeah, I’m trying to cut raw chicken here and I’m not feeling too hot.” They still were pretty inconsistent. I still hadn’t really been timing them. They were probably every 4-20 minutes for 30 seconds. 

So then we ate. I think I ate on my birth ball and then I texted my doula who was also a student-midwife with my midwife. I saw her at every appointment which was pretty convenient. She was just like, “You know, don’t really worry about timing them. Just try and rest. Eat some snacks and let me know when they pick up in intensity.” It was 6:00 PM and I was just waiting for bedtime because I knew that once my toddler went to bed, I could really focus and not have to hide that I was in labor. 

But I still don’t think I realized how far along I was. So we did the bedtime routine. I do want to note that I was leaning over on a pillow and my toddler was rubbing my back and saying, “Baby brother, I help you.” It was the sweetest thing. 

Meagan: Aw, that’s adorable. 

Jessica: Yeah. So finally put him in bed and I told my husband, “Maybe you should just go to sleep with him just in case. Well, I don’t know. I’ll text you.” I didn’t know if he should go to bed or if he should come downstairs and act as my doula. So he was putting my toddler to sleep. I tried to get in the bath. I could not get comfortable. Our bathtub is so tiny and they were definitely picking up in intensity. I just could not get comfortable. That didn’t last long. I texted my doula and told her, “I feel like they’re on top of each other, my contractions, but they’re not quite a minute long.” I think I texted her, “I’ve had four in a matter of five minutes, but they’re short.” She was just like, “Try different positions. Maybe try a shower.” 

At that point, I had already gone downstairs to try something else. I could not find a comfortable position. So my husband texted me, “What’s the situation?” I don’t know. All I said was, “Come.” Yeah. I was just like, “Come,” because it was just so uncomfortable. I could not find a comfortable position. 

I could see him on the monitor because we already had the monitor set up but he was just lying in bed taking his time. I’m like, “What is this man doing?” He did not realize how intense things had gotten. He came downstairs and we tried different positions– laying down on my side and on all fours on the couch, on the ball, and I just couldn’t get comfortable. 

So after 15 or 20 minutes of him trying to help me, I had him text the doula. She got over there around 8:30 and she was helpful with having me take sips of water and giving us ideas for different positions. She tried doing the Spinning Babies side-lying release and that was unbearable, but we did it. Then she had me move to the ball. 

Actually, I think while we were on the couch and I was lying down doing the side-lying release, I felt something come out. I had a diaper on at this point because I just kept having bloody show. I was like, “Something just came out. What was that? What was that?” It kind of felt like I pooped but it was out of my vagina, so I was just like, “Was that the baby? What just happened?” She looked and it was my bag of water, but it was still intact. It looked like a boob implant to me. 

Meagan: Yeah, like it was bulging out of you. 

Jessica: Yeah, but it came out in a bulge, so that was wild. So that was cool. I knew that because she was the student midwife, she would be the one to tell the midwives to come. We weren’t even worried about that. She was timing contractions, but I had no idea how fast they were coming. I said at one point, “Why are they coming so frequently?” She was like, “Well, you’re in active labor.”

Then we moved to the ball and that was unbearable. I felt him move down which was so wild and then I had a birth pool. It was already blown up, but we hadn’t even added water or anything. I was like, “Should we start setting that up?” My husband went and got the pool and tried to start putting water in it and whatnot. I was like, “I feel like I need to move to the couch,” so I did. I got on all fours and I had pillows up by my face. It was just so intense. 

I just remember thinking, “I’m never doing this again.” I asked my husband, “Whose idea was this?” meaning to have another baby and to do it vaginally because I was like, “This is awful.” It was so painful. Then you know, I just stayed in that position. I knew that once I was in that position, there was no way that I was going to be able to move. My husband was setting the pool up for no reason because I was like, “I don’t know how I’m going to make it in that pool.”

I think one of the midwives showed up around 9:30ish. At that point, I was having the fetal ejection reflex. I was making these guttural noises. You hear about what that feels like and how you just can’t control it and it’s so true. I felt like when you feel like you have to puke and you puke uncontrollably. It felt like that in my vagina. The noise I was making was totally uncontrollable. There were some intense sounds. 

The midwife showed up and before I knew it, she was saying, “You’re going to feel the ring of fire.” My husband, in hindsight, was like, “I thought she was just saying that. Of course, she’s going to feel the ring of fire.” He didn’t realize she was saying it because the baby was crowning. He was up by my head holding my hand and stuff. 

Finally, he realized that the baby’s head was coming out. My baby’s head popped out and then you heard a tiny little cry, but then it went back in. She had me get in the runner’s lunge to try and help him out. I think I pushed maybe three times. She had to remind me to breathe because the fetal ejection reflex was taking over. I just couldn’t stop having that feeling to push, so she reminded me to breathe. 

He came out. He was born at 9:58 so I had, I guess, 12 hours of labor, but I think active labor probably started around 4:00 or 6:00. Again, I’m not really sure because we weren’t really timing contractions. He was 8 pounds, 7 ounces. Yeah. It was insane but in the best way. It was so empowering. I couldn’t believe that I had done that. One of my affirmation cards was like, “You’re a badass for having an HBAC.” My husband was just like, “Yeah. You’re a badass. I can’t believe you just did that.” Yeah. It was just wild. So amazing. 

Meagan: Absolutely. I’m sure it was very different for him, too just with the whole situation. “Okay, I’m going to set up the birth pool. She’s telling me to come but I’m going to take my time.” It’s just a very different experience. Then he’s like, “Okay, wow. We’re in labor. Let’s go.” Then it’s like, “Yeah, of course she’s going to feel that. Oh, you mean that now she’s going to feel that.” 

Jessica: Yeah, I think neither of us knew how far along I was and how quickly things were progressing. It just happened so fast. 

Meagan: Yeah. I want to talk about this too because sometimes we get diagnosed with failure to progress. We get to 3 or 4 centimeters and we’re told that we’ll likely never progress and whatever, then we go to have a C-section. Then we fear having a VBAC sometimes because we are like, “Well, maybe we won’t progress past what we’ve progressed.” But a cool factor about your story is that you never even went into labor, right? You had never even dilated or gone through that whole process. This whole birth, this whole HBAC was essentially like you’re a first-time mom. Your cervix was doing this the first time.

When we’ve already progressed in maybe previous labor, that’s an even greater chance of a VBAC. You went in and your body did exactly what it needed to do to get this baby out even though you hadn’t had any labor previously. 

Jessica: Yep. 

Meagan: Pretty cool. 

Jessica: Yeah. I was very excited to see how it was all going to unfold. 

Meagan: Mhmm. Well, it sounds like it unfolded beautifully. Now you’ve got two cute babes and a beautiful home birth under your belt. So now– you were explaining that you were like, “Wow. Why did we do this? Why did we choose to get pregnant? Why did we choose to give birth vaginally?” After it is all said and done, are you like, “Yeah. I would do it again. I’m super happy we did it”?

Jessica: Yeah. I actually want to do it again just because it was amazing. At the moment, yeah, it felt like the most painful thing of my life, but after that baby’s out and you do it, it’s like, “Wow. I did that. I am capable. My body isn’t broken. Just because this happened one time doesn’t mean it’s going to happen again.” It was very empowering. Yeah. It was just amazing. I would love to do it again. 

Meagan: I love that. Well, huge congrats. Huge, huge congrats. I want to talk a little bit more about vasa previa because I don’t think we’ve had anyone on the podcast who have actually had that before. Usually reasons for a Cesarean– we talked about this before we started recording– are “big baby”, small pelvis, failure to progress, or breech. We don’t see these because it is really, really rare. It actually only occurs in 1 in every 2500 deliveries. I don’t know if you said anything about IVF but it’s more common in IVF which is about 1 in 200 but even then, it’s a pretty rare chance. It can happen randomly or if IVF was going on, there is definitely a chance that it could increase your chances. Did you do any IVF at all or was it a spontaneous pregnancy? 

Jessica: It was spontaneous. I didn’t have any of the risk factors for vasa previa so it was totally random. 

Meagan: Totally random. You were just one of the really rare cases, but it worked out really well. 

Jessica: Mhmm, it did. 

Meagan: Well, thank you so much for sharing your stories with us today. 

Jessica: Thank you for having me. 

Closing

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

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

Meagan and Julie went Live in The VBAC Link Community Facebook Group answering your questions. They recorded the conversation to share with you on the podcast today. 

Topics include: 

• Risks of VBAC, Repeat Cesarean, and CBAC
• Cook versus Foley Catheters
• Cervical lips
• Membrane sweeps
• VBA2C and VBAMC
• CPD

Thank you for sending in your questions! An educated birth is an empowered one. You’ve got this, Women of Strength!

Additional Links

The VBAC Link Blog: VBAC vs Repeat Cesarean

Cook versus Foley Catheter Study

EBB 151: Updated Evidence on the Pros and Cons of Membrane Sweeping

ACOG Article: VBAC

The VBAC Link Blog: VBA2C

Needed Website

Full Transcript under Episode Details 

Meagan: Hey, hey everybody! Guess what? It’s November which is one of my favorite months because it is my birthday month. I have forever and ever loved birthday months so this is going to be a great month because it is my birthday month. 

Today we are kicking it off with questions and answers with myself and Julie. Hey, Julie. 

Julie: Hey, I’m so excited to be here. 

Meagan: Welcome back. We’re going to get right into this review and get some of these great questions answered. We know you guys have so many questions. This review is from bunnyfolife777. It says, “So much hope.” It says, “I’m 16 weeks pregnant and shooting for my VBAC. I’ve been in The VBAC Link group on Facebook for over a year, but I’ve only just started listening to the podcast. I don’t know why I waited. I’m bawling now just two episodes in. The statistics and advice you share are golden. I’m going to listen to it again and take notes this time. I’m scared about having to advocate for myself living abroad where most doctors push for C-sections so I’m thankful I can arm myself with the knowledge through The VBAC Link. Thank you.”

Oh, that makes me so happy. We’re going to be talking about statistics on this podcast episode today. 

Julie: You know I love a good statistic. 

Meagan: I know. You are the statistic junkie. 

Julie: I’m a nerd. 

Meagan: Okay, okay Julie. I love having you back on the show. It just feels so natural. 

Julie: It’s fun. 

Meagan: It is fun. It’s so fun so thank you for being willing to join me again on these random episodes. As we were saying, we are really just wanting to answer some of these questions. So yeah. What is one of the questions right here that you love that you are like, “Let’s start this off with”?

Julie: Okay, so gosh. I mean, there are so many good ones. I feel like we’ve talked about a lot of these things many, many times over the years, but I feel like every time we talk about them, we get a new perspective in. There is new information and new evidence. Not everyone goes and listens to every single one of the episodes although lots of people do, but I think it’s fun to revisit some of these things. I don’t know. There are so many that stuck out to me. 

VBAC vs Repeat Cesarean vs CBAC

One thing that we haven’t really talked about directly in this way is, is it really safer to give birth vaginally? I mean, yes. It is. We can go over that but I really like the second part of that question which is, “What if that labor doesn’t work and goes to a C-section? Is that more dangerous?” I want to talk about that because we talk about VBAC is safer than a repeat Cesarean statistically. We are talking about all of the numbers when we talk about all of the different things that could go wrong between vaginal birth and Cesarean birth then actually, for the second, whether you choose VBAC or repeat Cesarean, the statistics are actually not that much different as far as safety goes. VBAC is slightly safer overall, but there really isn’t a big enough difference to say, “You should absolutely do this.” Right? That’s where your intuition comes in. 

But if you want more than two kids, the more C-sections you have, the higher the chance you have of having severe complications. By the time you get to your fourth or fifth C-section, you have a 1 in 3 chance of having a major medical intervention during your Cesarean. I feel like so many times we as people educating about birth or talking about birth talk about just those two things. VBAC and repeat Cesarean, but there’s actually a third thing that’s worth talking about. That is a TOLAC– I know it’s kind of a trigger word for some, but it’s just a medical term we’re going to use here– that ends in a repeat Cesarean. 

Meagan: Yes, because we know that happens. 

Julie: We know it happens. It does happen. 

Meagan: It happened with me. 

Julie: Sometimes it’s medically necessary. Sometimes it’s not, and you just don’t know. We’ve got to put it in the order of three things. First, the safest is VBAC or a vaginal birth. Second is a scheduled C-section and the third is a VBAC attempt or a TOLAC that ends in a repeat Cesarean. We also call that a CBAC or a Cesarean birth after a Cesarean. Now, if you labor and then have to have a C-section for whatever reason, there are more risks with that including postpartum hemorrhage or bleeding, and needing a blood transfusion. Obviously, the risks to baby are pretty similar but it’s just harder to operate on a uterus that is contracting. You’re more likely to bleed because that uterus is contracting. 

Sometimes, if it’s an emergency situation, the providers have to do things like a special scar or a special type of incision or they have to put you under general anesthesia. That has more risks in and of itself. I feel like that’s a really valid question that she asked. What if? What if? There are always what if’s, but what is safer? 

Meagan: Right, right. For patients or parents that are going for a TOLAC, a trial of labor after a Cesarean, and then may require or end up going to have that Cesarean, there is also a slightly increased risk of postpartum infection. 

Julie: Yes. 

Meagan: And also some possible complications. You just touched on it a little bit, but when a uterus is already contracting– so I’m going to backpedal a little bit. When we go in for an elective Cesarean, typically we are not already in labor. We’re not already having contractions so performing a Cesarean on a contracting uterus can possibly cause some issues there as well. That is sometimes why a lot of providers don’t want an elective Cesarean to even go to 40 weeks or past. They want to have an elective earlier on. That may also help give you some understanding of why providers are saying that. 

But yeah, it just slightly increases in other ways. Yeah. Anyway, keep going. 

Julie: No, I love that. I just don’t think we’ve ever– I mean, we do in our course and things like that. We talk about it directly, but that’s something to consider. I think that’s also really important. I feel like it adds the extra layer of where you want to make sure you have a really good provider because if you have a provider who is not really supportive or who is giving you tons of red flags or who is saying that you have to induce because of a big baby– I’m surprised that big baby isn’t in some of these questions, to be honest. We can talk about that a little bit later, but it’s really important. 

That’s something to consider. It’s all about weighing the risks and what risks are you more comfortable with taking on? Are you more comfortable taking on the risk of going into a vaginal birth attempt– you want to try for a VBAC– and having the possibility of it ending in a repeat Cesarean? The possibility of it ending in a repeat Cesarean varies depending on where you are birthing. If it is a home birth, you have a 10% chance of it ending in a Cesarean. Statistically, nationwide, you have a 30-40% chance of it ending in a repeat Cesarean. But if you have a really good provider, there’s probably only a 10-20% chance of it ending in a repeat Cesarean. 

Sometimes, if you have a really bad provider, you might be looking at a 50 or 60 or 70% chance of having a repeat Cesarean. So what is an acceptable risk for one person is not for another. If that just sounds too scary for you or are risks that you are not willing to take, then maybe scheduling a repeat Cesarean is the right choice for you and that’s okay. 

But if you’re a diehard and want to fight the system to prove everybody wrong no matter what the costs are, then maybe you just want to have a VBAC and that’s okay. Not that that’s a bad thing, but it’s also probably not a very healthy way of thinking. I was like that. I’m like, “I’m getting my VBAC and I’m going to do everything I can to safely set up the best chances for me and my baby.” That’s why I ultimately chose an out-of-hospital birth with a really amazing provider who had tons of experience in all types of birth situations. But I don’t know. I think that’s super important and something to consider. 

We’re not trying to scare anyone here, but we are never going to lie to you. We’re never going to dance around the issues. We’re never going to sugarcoat things. 

Meagan: Yeah. Yeah. I think that was a good question. Okay, well if it really is safer to have a vaginal birth, what’s the safety here? Yeah. I really loved that question a lot. 

Julie: I wish I had some statistics off of the top of my head, to be honest. I’m pretty sure we wrote a blog about it. VBAC versus a repeat Cesarean. 

Meagan: Okay. I’m going to bounce to this next question– 

Julie: Wait, wait, wait, wait. Wait, wait, wait, wait. I have something. 

Meagan: Did you find a stat? 

Julie: No. Well, yes actually. I found the blog. If you guys want to know more about the blogs, I’m not going to get into it because we want to move on to all of these other questions. Our wonderful transcriber, Paige, is going to put a link to the blog in the show notes so make sure you check it out and it goes in super, really big detail about all of those statistics, and pros and cons for all of those things. I say our transcriber, but you know what I mean. I feel like it’s still us. It’s still we, right? I don’t know. I’m never going to not feel like that. Maybe one day. No, probably not. I miss it so much. 

Meagan: Probably not. No, probably not. 

Julie: Sorry, let’s go on. 

Cook vs Foley Catheter

Meagan: No, you’re fine. So I want to talk about catheters. Not catheters to drain urine, but the catheters to help with an induction. Someone asked, “What’s the difference?” We’ll even hear in Utah a Cook versus a Foley. A Foley catheter can also be the type that actually goes into your bladder through your urethra and drains urine but there’s also a Foley catheter that can help induce labor. 

There’s Cook and Foley. One of the questions was, “What is the difference between the two?” Really, the only difference is that a Cook has a double-balloon and the Foley is not a double. There’s just one. If you can– I don’t even know how to give this image. How would you give this image of what a Cook catheter is like? The catheter with two balloons on it? I don’t know, like ice cream? Oh, you’re muted. 

Julie: I’m sitting over here dancing. 

Meagan: She’s dancing in this image and I’m like, “She’s saying something.” I’m thinking of a double scoop of ice cream.

Julie: I’m thinking it’s kind of like a barbell. Yeah. Or like a barbell, right? If you think of a cartoon barbell with the balls on the end but much shorter. 

Meagan: Yeah. Both of them are inflated with saline. It’s inserted through the cervix, the balloons are inflated, and then they put pressure mechanically onto the cervix which causes pressure and dilation and effacement and things like that. 

Yeah. It’s been a really long time since these have been being used. We will see, once in a while, providers say that a catheter, Cook or a Foley, is a contraindication for someone who wants to have a VBAC. That is kind of hard. It’s really interesting. It’s just a balloon that goes in. There’s no medicine that is put in at all. It’s just saline and like I said, it’s a mechanical dilation. So if you are curious about methods of induction that your provider is comfortable with, I would encourage you before you get to the 37th, 38th, 39th, 40th, 41st, and 42nd week of pregnancy to discuss with your provider more about a Cook catheter and what they are comfortable with. 

It is really hard because sometimes, those catheters can be one of the best ways to help induce a cervix or a TOLAC for someone who is wanting to go for a VBAC because they can’t always just do other ripening aids and this can definitely help with the cervical ripening to help get to that further progress of having a baby. 

Julie: I love it. I think it’s silly sometimes how providers will not induce with a Foley for VBAC. I just don’t get it because there’s no solid evidence that supports not doing that. I just think– me and you, we’ve seen so many VBACs induced with that. It’s been fine and healthy. There is just not anything out there. I know every provider has their things that they will and won’t do. If you have a provider that won’t do that, then you might want to talk to another provider. 

Meagan: Now that we kind of know that there are two different types, let’s talk a little bit about the differences. There is a difference in what they do. Why would we even use them? Which one is better? I think that is a big question. Which one is better to use? I’m just going to tell you after some evidence that a Cook catheter for cervical ripening has greater results. What have you seen, Julie? What have you seen in the past?

Julie: Honestly, I’m trying to think if I’ve ever seen anybody use the Cook catheter. I think I’ve only seen Foleys to be honest. I’m trying to think back. Maybe there has been one but I just can’t think of any. 

Meagan: I’ve only seen one. Yep, I’ve only seen one and it was up at the University Hospital here in Utah. They used that. She was barely half of a centimeter dilated and 30% effaced, very little. They used that for softening really, but the Cook catheter, I think, through studies has shown that it is more effective or has greater cervical ripening compared to the Foley. However, in fact, I’m going to hurry and pull this up. I’m just going to read this. It shows, “The duration from the balloon insertion to it exiting and delivery was significantly shorter using a Foley catheter.” 

Julie: Interesting. 

Meagan: Yeah. So Cook catheter has a greater result of actually ripening the cervix, but the Foley has a greater success rate overall from start to finish. I mean, I have seen so many people with Foleys. It sounds weird because sometimes, everyone is like, “You’re suggesting Pitocin?” I’m not suggesting it. I’m just saying that I have seen a Foley placed with Pitocin at 4mL, just a little bit, and it is insane sometimes how great the result is. 

Sometimes when the Foley comes out– maybe you’ve seen this– it’s a mechanical dilation so it kind of relaxes just a little. It’s not like we go backward. It just kind of relaxes like it’s overstretched and it relaxes. Then we have to catch up, right? But I have seen where with there is a tiny, tiny lift of Pitocin being involved–

Julie: You don’t have that relaxing as much, yeah. 

Meagan: Yeah. I don’t see where it’s like, “Oh, you’re a 4,” and then they check and they’re like, “Well, you’re kind of a 3.” Listeners, I just want you to know that that’s a thing too. If a Foley comes out, remember that it’s a mechanical dilation in your cervix. It may be stretchy-stretchy, but you might not be a full 4 or whatever. 

So talking about top to bottom, Julie you just mentioned that a little bit ago. With me, do you want to talk about that?

Julie: Yeah. Well, I mean, the Cook catheter has two balloons essentially that they fill up with saline. The Cook has two balloons. The Foley has one. The idea with the Cook catheter is that it puts pressure on both ends of the cervix. My gosh, I don’t know if we even said how they put it in. You insert a catheter in through the cervix and then the Cook has two balloons on either end that they inflate so it pushes to soften and open the cervix. Then, the Foley only has one balloon that they put. They insert it into the top through the cervix inside of the uterus and inflate it there with the balloon. They tape it to your leg and it pulls. 

Meagan: They tug it. 

Julie: You’ve got to tug it and it pulls down. It provides a lot of pressure so that the cervix can soften and open. All of my clients have just been pretty uncomfortable with it in. They feel some relief when it comes out because then it just falls out. It pulls out at some point. Honestly, I don’t know. This is maybe making me sound like an idiot but do they tape the Cook catheter to the leg or not? I don’t know. 

Meagan: I did not see it taped to the leg. 

Julie: I’m wondering if maybe that’s why the Foley is more successful because you’re having just one downward motion instead of two pressures going toward each other. I don’t know. I don’t know. 

Meagan: Yeah, maybe. It’s kind of interesting because with the Foley, every 20-30 minutes, they’re wanting you to pull on it. 

Julie: I don’t know if they do that with the Cook. 

Meagan: I don’t either because we haven’t seen enough. 

Julie: Yeah. 

Meagan: So if you’re listening today, go comment in today’s episode. If you had a Cook catheter, let us know what happened. Tell us about it. Tell us what your experience was. I think they said in the study that really, there was no significant difference in the outcomes specifically between the two having more Pitocin or the mode of delivery or anything like that. It’s just that the Cook catheter had a greater result of cervical ripening and the Foley catheter maybe shortened the duration but there wasn’t any crazy, significant difference of mode of delivery or your for sure had to use Pitocin with a Cook or anything like that. So that’s interesting. 

Julie: Yeah, interesting. 

The point is that it is safe for VBAC. This is another thing. I’m going on a teeny little soapbox that I’m going to get off really fast, but why does it take the burn of proof to show that something is or is not evidence-based or is a reasonable patient? Rely on the patient. If your provider says, “No, it’s dangerous. We can’t do Foley for a VBAC,” make them show you why. Ask them where the source is coming from. I don’t understand why we have to bring the stuff to show that it is safe. Why? It’s stupid. 

Meagan: I don’t know. I don’t know. Why? 

Julie: Why? 

Meagan: I mean, even the American Journal of Obstetrics and Gynecology says– 

Julie: Yeah, and that’s ACOG’s journey. 

Meagan: They say, “Foley catheter did not increase the risk of uterine rupture in TOLAC.” It says that. “Similar, uterine scar dehiscence was not associated with a Foley catheter.” I don’t ever want to make it sound like we are bashing a provider or it’s a show bashing providers, but we’re having providers tell people that they have zero option to be induced especially if there’s a medical reason. Sometimes there’s a medical reason. We’ve got preeclampsia or something is going on, but this mom wants to have a trial of labor and a VBAC, but then her cervix isn’t super great for induction. We’re being robbed of these options. 

They even say, “The data shows the Foley catheter is a safe tool for mechanical dilation in women undergoing a trial of labor after a Cesarean.” If your provider is saying that you’re not a candidate or it’s a contraindication for VBAC, then maybe I invite you to have a discussion with them. Right? An open discussion of, “Okay, what I have learned is that it’s not necessarily a contraindication. Is there new evidence that we’re not aware of?” Maybe there is. Maybe there’s new evidence. 

Julie: There’s not. 

Meagan: I know, but right? Maybe they have secret evidence. 

Julie: Give them the benefit of the doubt, right? 

Meagan: Is there new evidence that we’re not aware of and is there any way that we can have a conversation about it? Can we talk about this because if it is, then okay? But if not–

Julie: Well, and honestly, gosh. I just think that it’s just something that they’ve heard or something that their practice does or something that the hospital says. You know, I mean, we all do it in our lives. Our mom says, “Oh, this and this. Oh, you should never cook with refined sugar. You should always use granulated sugar.” I don’t know. I’m not a baker so it’s probably not a good example. 

But you know, and then you go throughout your life like, “Oh, my mom says you should never cook with this type of sugar,” but that type of sugar is totally fine. Someone you trust had told you that so it’s just ingrained in your belief. I have those things. 

Meagan: It’s like the trans-fat argument. 

Julie: Yes. It’s like, my gosh. How many beliefs do we hold that maybe we know they’re just silly, but it’s just something we’ve known for so long that doing it otherwise would feel so foreign to us. There are so many things in the system like that where the providers aren’t meaning to do harm, it’s just the way that they’ve been taught. It doesn’t give them an excuse. Oh my gosh, there was a quote the other day that popped up in my feed. I was arguing online with some photographer about birth photography and I got a little heated because I was super tired because I’d been to three births in four days and I was awake for 16 hours through the night. 

Anyway, but a little while later, some unrelated person posted this quote in their stories and I like it because it goes along with what I was just talking about. It says, “Don’t assume malice. Assume ignorance. Life is easier. The world is kinder and you can educate. Actual malice is pretty rare, I find.” Then somebody else commented and said, “I always remember Hanlon’s Razor. Never assume malice when incompetence will suffice as an explanation. With that said, never forget Fred Clark’s lot either. Sufficiently advanced incompetence is indistinguishable from malice. There is a certain point at which ignorance becomes malice at which there is simply no way to become that ignorant except deliberately and maliciously.” I’m going to forward this to you. 

Meagan: I was just going to say will you forward that because that is amazing. Never just assume malice. 

Julie: Assume ignorance. They just don’t know. It’s okay because there are lots of things we don’t know too but when it gets to the point where you’re just completely refusing to see that there’s any other way, then that’s where it gets to be malice and aggressive. But I love a provider or a nurse when I’m in the delivery room doing peanut ball or Spinning Babies and the nurse is like, “Oh, tell me more about that.” That is a position of maybe ignorance and they want to learn and do better. They just don’t know those things. 

But when you have a nurse come in who says, “Oh, we don’t use the peanut ball before 7 centimeters because it doesn’t do anything,” that is a malicious form of ignorance. 

Meagan: Yeah. Yeah. Okay, I love that so, so much. Thank you for sharing that. 

Julie: You’re welcome. I’m glad I screenshotted it. 

Cervical Lips

Meagan: Me too. Okay, one of the questions is about cervical lips. 

Julie: Mmm. 

Meagan: I know, it’s a good question. It’s hard because it happens and it’s frustrating if it doesn’t go away. Right? It’s like, if I make it to 9.5 centimeters and I have this lip that will not go away, one– why doesn’t it go away? Why does it happen? Two– how can I get it away? What are some ways? It sucks if that is the only reason why a Cesarean happens. 

Julie: Well, first do you want to say what a cervical lip is just in case people don’t know? 

Meagan: Yep, yep. 

Julie: Oh, me? Well, a cervical lip is just where your cervix is almost fully dilated, but there is just a little sliver of it, or part of it– so if you imagine a crescent moon shape, where part of your cervix is all the way gone behind baby’s head and there is just a little sliver of it on some part of the baby’s head coming over. Just a teeny bit. Just like a lip. Just like a little lip. 

Meagan: Yes. So when we have cervical lips, sometimes pressure on that part of the cervix helps it melt away and thin. We work through positions like what Julie was saying by using a peanut ball or we make you more central through a squat or sitting on the toilet. Sometimes it’s an anterior lip. Sometimes it’s way on the side. Sometimes it’s a little puffier in the back. Sometimes we will use positions to help get rid of that lip.

But it’s really hard because sometimes even through positions, that lip sometimes doesn’t go away. Sometimes it can be massaged or it can be advanced. I’m happy to continue but I want to give you an opportunity to talk too. 

Julie: No, you’re good. 

Meagan: But advancing, right? 

Julie: The provider will hold it during a contraction and push it back. That’s really painful if you don’t have an epidural. If you have an epidural, that’s a good way to do it. The medical system is going to hate me for saying this, but I’ve also seen people push through a contraction when they have a cervical lip and it slips right over baby’s head. 

You don’t want to push too much with a cervical lip also because it can cause the cervix to swell if it’s a positional issue. There are a whole bunch of things you can do, but Meagan, I think you were right on track when you were talking about movement, positions, squatting, and all of those things to help put that pressure on and help straighten baby’s head out. I mean, it’s not always because of the baby’s head, but it could be. Squatting and putting that pressure down is just going to really help. 

Meagan: Yeah, so when a provider is holding it and helping it, I call it an advance. Advancing it over the baby’s head. Sometimes it just needs to slip over the baby’s head. It’s so stretchy. 

Julie: It will stay there. 

Meagan: Sometimes, it’s so stretchy that it will just go away. I’m always giving sound effects on this podcast. Sometimes it’s like we’re trying, trying, and trying, but then we have possible issues because then we’re swelling. We’re aggravating it. It’s tissue. It’s the cervix so it can get bogged and it can swell. So if that is happening and your provider is like, “Yes. I think through this push, I can push it. I can help advance it over this baby’s head and it’s going to go away and we’re going to have a baby,” great. It’s worth trying. 

But if it’s over and over and over again and we’re advancing it and it’s just not going, we are risking it to swell. So yeah. Movement. This sounds weird too. Here I am suggesting Pitocin again. Sometimes a little stronger of a contraction, just a little bit stronger of a contraction and a little bit of a lift can just put the amount of pressure on the cervix or cause the cervix to continue dilating. Then the cervix is done and you can turn the Pitocin off. That’s always an option to say, “Okay. We’ve done this, this, and this. Let’s move on.” 

Some providers, usually out-of-hospital providers– Julie, I don’t know if you’ve seen this– will place Arnica. 

Julie: Yeah. I have seen that. 

Meagan: If it’s starting to feel puffy or maybe have done advancing a couple of times. 

Julie: I love Arnica, man. It is my favorite. Arnica gel. 

Meagan: I love it too. 

Julie: Love it. 

Meagan: Yes. I love it. Sometimes providers will do some Arnica up there to help reduce inflammation and swelling and things like that. Cervical lips can happen for no reason really other than just it’s happening. People say, “Oh, sometimes it’s baby’s position.” Again, maybe we want more pressure. Sometimes it’s the lack of intensity. If I remember right, if you’ve ever had a LEEP procedure–

Julie: Yeah, like some scarring on the cervix can cause that. 

Meagan: Yes. Yeah. So a LEEP procedure or maybe really bad cervical tearing or trauma to the cervix can create less elasticity. I don’t know if that’s the right word. But it can cause a cervical lip. I’ve also seen– this is more for the edema again on the Arnica– Benadryl. Providers give someone Benadryl because it’s an antihistamine for swelling. Yeah. There are so many things that you can talk to your provider about. If you have a cervical lip, oh. Go ahead. 

Julie: I was going to say that sometimes, just doing nothing. 

Meagan: Just waiting, yes. 

Julie: Sometimes in labor, even us as doulas, we see, “Oh, well it looks like contractions are coupling. Let’s do some abdominal lifts.” But sometimes, that’s an intervention. It just is. Spinning Babies® is an intervention. It’s a more natural intervention, but sometimes, maybe a lot of the time, you just need to leave it alone. I don’t know. I saw this post on social media the other day that was talking about, “I hate Spinning Babies® because it’s an intervention and all of these doulas and midwives are like, ‘Oh, let’s do Spinning Babies®. Let’s do Spinning Babies®.’ It’s an intervention just like Pitocin or whatever.”

I don’t think it’s just like Pitocin, but it kind of takes away from the trust of the natural labor process when you’re like, “Oh, you’ve got to fix this.” It’s kind of, in a way, saying that we don’t trust the natural labor process as much. But there are some times when it is good and beneficial to do those things. There are some times when you can’t just trust the natural labor process alone, but a lot of times, you can. A lot of times, we just need to let these things be and they will resolve themselves. 

This is a big thing where knowing all of your options then trusting your intuition and having someone to guide you like a doula will help you know which is the right thing for you whether you want to try squatting, try different positions, try Arnica gel, or just leave it be for a little while. There’s no right answer. 

Meagan: There is no right answer and there are these things that we can do. Sometimes they work and sometimes they don’t, but we want you to know that there are things you can do. Sometimes those things just do nothing. Absolutely. 

Membrane Sweeps

So let’s talk about sweeping membranes. Talking about interventions, sweeping the membranes. I’ve heard it called a sweep and a scrape. 

Julie: Ew. 

Meagan: Yeah. People say “scraping the membrane”. If you don’t know what sweeping the membranes is, it’s when a provider will insert typically their fingers inside the cervix and separate the membrane of the amniotic sac from the cervix and do a little sweep around. That releases hormones like prostaglandins and things like that. Sometimes, it’s used to induce. It’s a more gentle– I don’t know if that’s how you say it– way of inducing. 

One of the questions, Julie, was, “Does it work? What are the pros and cons? Should I do this?” We do have a lot of providers that will say, “Oh, we can just strip your membranes.” What do you think? What do you say? 

Julie: Evidence Based Birth® used to have a great article on this. The one thing that I– okay, I love Evidence Based Birth®. 

Meagan: I think she still does. 

Julie: This is the thing though, they took away all of their articles and replaced them with just their podcast transcripts. I wish that they would have their regular blog articles still instead of just having the podcast and the transcripts which makes me a little bit sad because then you have to read through the whole thing in order to find what you are looking for. But I do love me some Evidence Based Birth®.

Listen, Evidence Based Birth® does say that there is research that shows that starting regular membrane sweeps at 37 weeks of pregnancy and doing them, I think it’s twice a week until delivery can shorten your pregnancy by one to two days. Personally, for me, that’s not enough evidence to want to do them because you are getting 10+ cervical membrane sweeps. That is a lot for just a one or two-day shorter pregnancy. 

But for some people, that might be worth it to them. It’s just one of those things where there is that evidence that shows, but this is the thing. Doing one membrane sweep at 40 weeks is not going to shorten your pregnancy by one or two days. It’s not going to shorten your pregnancy at all. This is what the studies show. There might be some anecdotal things or your water might break prematurely and that might kickstart labor, but the one-off or the one or two membrane sweeps here and there is not statistically proven to shorten that. You have to start super early. Another thing I want to say–

Meagan: Two days to have to avoid going in or having it massaged or swept twice a week? 

Julie: Yeah, one to two days. It would cause you so much pain and cramping and it would make you miserable. 

Meagan: That’s the thing I wanted to say. Sometimes cervical sweeps or membrane sweeps can actually promote prodromal labor. 

Julie: Yeah. 

Meagan: Right? We’re up there and we’re disrupting the cervix and making it think that we need to start contracting, but our body is not really ready to labor so we’re contracting, contracting, contracting, and getting exhausted, but labor is not happening. Then the next day, we’re sweeping again or we’re contracting again, but then really, we don’t have a baby for 2-3 weeks. Right? We’re exhausted when labor starts. 

Julie: Yeah. 

Meagan: Like you said, they can hurt. If our cervix is posterior, especially at 37 weeks, it’s a lot more likely for our cervix to be posterior than it is anterior, they have to go in, back, and around to get to the cervix and sweep. It’s not just in and out. That can cause a lot of discomfort that’s really unnecessary. 

One of the questions is, “Does it possibly increase infection?” We are inserting something into the cervix and sweeping around, maybe yeah. 

Julie: Well, here’s the thing though. I’m just skimming through this podcast article on Evidence Based Birth®’s website. If you want to find it, it’s super easy. Just Google “Evidence Based Birth® Membrane Sweeping” and it will pop up right there for you. 

Meagan: They give you updated evidence on it. Don’t they have it updated? It was in 2020. 

Julie: Yeah. It’s in 2020 for sure. They break it down. There are 44 studies that they look at. Some of them show no difference. Some of them show 9% increase in artificial rupture of membranes. Premature and accidental. 

There are a whole bunch of varying interpretations here, but none of them are too conclusive as far as it causing that significant of a difference in when labor will start. Yes. Go and read it if you’re curious. It’s really good. Or you can listen to it, I guess as well. There is great stuff there. 

Meagan: Yeah. It’s Episode 151 on Evidence Based Birth®. Yeah. 

Julie: Yeah.

Meagan: Yeah. So I think just closing out this question as a whole, it’s a personal preference. If you want to try something to encourage labor to begin on more of a natural basis, then it could be worth it. But for my personal suggestion to my doula clients and what I would do– again, I’m me. I’m not you. If I was being faced with a medical reason to induce or a concern, but I was going to be induced anyway, I would maybe try it. Does that make sense? If I was already going to be induced for a medical reason, then I would probably try it. 

Julie: One or two days might be beneficial for you at that point. 

Meagan: One or two days might be beneficial. If I can avoid going in and being hooked up to a Pit drip, then that might be better for me. That’s one of my things. If I was facing an actual induction, I maybe would try it. For my actual birth, my midwife wanted to. She said, “Hey, why don’t you come in and we’ll strip your membranes?” I said, “Nope.” I didn’t feel like I needed it. I don’t know if it would weaken my membranes or accidentally rupture my membranes because that is a possible consequence. We can induce infection. We can accidentally break our water. We can weaken it as we separate it. So those types of things, for me, were not worth it. I was good to just keep going as I was. 

Julie: Yeah. 

VBA2C

Meagan: Okay. What are some other questions? I know we have a couple more before we end. 

Julie: There’s one about VBAC after two C-sections I know. 

Meagan: Oh yeah. Yes. 

Julie: Let’s talk about that one. “Why do so many providers not support VBAC after two C-sections? What does the evidence say?” 

Meagan: Mhmm. Well, the evidence says that it is reasonable. 

Julie: Yeah. It is. Even ACOG says that it’s reasonable. 

Meagan: Yep. Yep. Yep. 

Julie: I feel like this goes back to what we were talking to about before with that quote. I feel like most providers have just been told that it is not safe, so they say that it’s not safe, so they don’t do it and they don’t support it. They throw around terms like, “Oh, it doubles your chance of uterine rupture. 50% chance of uterine rupture,” and things like that, right? We have the system that is just content on not wanting to have or support any evidence that will go contrary to the things that they’ve been taught. 

You see with the ARRIVE trial. We have been throwing evidence at providers that so many things reduce your chances of C-section for years. Right? Like waiting for labor to start on its own, laboring at home as long as possible, avoiding Pitocin, avoiding elective inductions, and all of those things. 

We’ve been throwing these things at providers for years about nice, safe, non-medical ways to avoid Cesareans and providers weren’t interested in it all. Then all of a sudden, the ARRIVE trial comes out and they’re like, “Oh, inducing at 39 weeks decreases Cesarean rates,” which, it doesn’t by the way. As soon as providers are shown something that reinforces things they already know and do, they’re like, “Oh, yeah. That’s something I can get behind. I can do this because I already do this all of the time anyways. I already schedule inductions. I already do Pitocin. I already do these surgeries.”

So when they’re shown something that will reinforce their beliefs and things that they already know how to do, they’re on board with it. But my gosh, you try and show them these nonmedical ways of improving birth outcomes and nobody wants to buy it because they’re like, “Oh well, that’s just–”. It’s not how they’ve been trained. 

Meagan: It’s not how they’ve been trained and sometimes they’ve seen a scary outcome. 

Julie: Yeah, of course. 

Meagan: Studies do say that women requesting for a trial of labor, a VBAC and having a VBAC, should absolutely be counseled and absolutely be offered an opportunity because we know that the success rate is as high of 71%, if not higher. 71% or higher, right? The uterine rupture rate is not much higher and if you compare VBAC after two Cesareans, maternal morbidity is really comparable to a repeat Cesarean. It’s low. It’s overall safe and reasonable to have a vaginal birth after two Cesareans. 

Julie: The risks to baby are similar. The risks to mom are actually higher in a repeat Cesarean like increased blood loss, pulmonary embolism, and maternal death is still incredibly low. Maternal death is incredibly low. We’re talking about .000-something-percent, but when you’re looking at it against VBAC, it’s 10 times more likely for a mother to die during a Cesarean birth during a vaginal birth. I don’t want to scare you because 10 times more likely sounds like a super scary number like, “Oh, you’re twice as likely to have a stillbirth after you’re 41 weeks,” but it’s an incredibly small increase and incredibly small risk already. It’s the same thing with this. It’s an incredibly small risk but we don’t talk about those things. 

Meagan: It’s even harder to find evidence for vaginal birth after three or more Cesareans. That’s where we don’t have a lot of information. Most providers out there, to be honest, if you’ve had three Cesareans, it’s going to be harder to find someone that will allow you to give birth vaginally. It’s so hard. But it still doesn’t mean that you’re absolutely not a candidate or that it is a ginormous risk that completely risks everybody out. People do it and again, we were talking about it earlier. If it’s a risk that you are willing to take and it’s a comfortable risk for you, then that says something. 

Yeah. VBAC after two Cesareans is totally reasonable and totally possible. We’ve got lots of stories on the podcast. I’m living and walking proof. 

Julie: And lots of stories of VBAC after three or four Cesareans too. 

Meagan: Three or four, yeah. Yeah. It’s totally possible. If a provider is trying to tell you that your risk of rupture really is 50-60%, then that is one– not a provider that you should probably be going to for a VBAC, but two– something that probably needs to be changed because maybe they just are really uneducated on the evidence. We’re looking at just barely over 1%. It’s really low. 

Julie: And not even that, there are several different studies. ACOG sites two studies in their practice bulletin and one of the studies shows no difference in rupture rates between VBAC and VBAC after two C-sections. The other one shows a slightly higher increase. I don’t remember what the numbers are off of the top of my  head, but VBAC Link does have a blog on VBAC after two C-sections. You can probably just Google “VBA2C” and it will pull up in the first or second search results, but I’m sure that Paige will probably also link it in the show notes for us. 

So take a look at those statistics because even ACOG says that and if ACOG says something, why are we not behind that evidence that ACOG published? 

Meagan: I know. It’s so funny because ACOG goes through a lot to publish these things, these articles and journals, but then we’re not having providers– I’m going to say midwives too. We have midwives that don’t follow these practices. We have providers that don’t follow it. The evidence is there. They’re showing that it’s there. Why aren’t we doing it? 

CPD

I know we’re almost out of time, but I just really want to talk about CPD a little bit because lately in our inbox, we have been seeing a lot of people being told that they hear the stories. They see the stories and they wish they could, but they were diagnosed with CPD and they can’t. They can’t get a baby out of their pelvis. For those who don’t know what CPD is, it’s cephalopelvic disproportion. It’s just pretty much saying that your pelvis is too small. 

Yeah. Julie and I personally have both been diagnosed. 

Julie: Told that, yeah, in our op reports. Here’s the thing about CPD. It’s incredibly rare. It’s incredibly rare and most of the time comes from growing up incredibly malnourished like in third-world countries so your bones grow in a deformed way or after a traumatic pelvic injury. It’s very rare for a true CPD diagnosis to come from a normal, healthy person. You can’t even diagnose it without pelvic imagery exam, like an actual scan. It’s not even an x-ray. If you go, “My doctor gave me an x-ray and told me my pelvis is too small.” 

First of all, that’s not the right way to diagnose it. Second of all, pelvises– your body is so pumped full of hormones that our pelvises expand. They literally move around as baby is coming down. Babies’ heads overlap, the skulls and these bones in their heads overlap and squish together and smoosh together to come out of that pelvis. Your pelvis is opening in ways that it doesn’t normally and babies’ heads are smooshing together in ways that they never will again, so how are you even supposed to tell how much a pelvis is going to open and expand and how much a baby’s head is going to smoosh together? 

I will die on that hill. Man, I will die on that hill. No. You were diagnosed with CPD and that’s bull crap. That diagnosis was bull crap and unless you grew up in Africa or in these poor countries. All of these African women are still having babies. Sorry, that probably sounded a little bit bad. I didn’t mean to say it like that. These women are still having babies even though they were malnourished. You have to have a severe, severe deformity from malnourishment. Rickets is the disease that comes along usually wth CPD or a traumatic pelvic injury like maybe you got in a car accident. 

Meagan: Thrown off a horse. 

Julie: Or got kicked hard in there somewhere sometime by something. I don’t know. But it’s just not as common as people are saying. It’s not. 

Meagan: Right. Yeah. It’s just overused. So if you have been told that, I hope that through the evidence– we’re going to have links here in the show notes to all of these studies and things. I hope you know that your pelvis is perfect. 

Julie: Your pelvis is perfect. Let’s make a shirt. “My pelvis is perfect.” Make it a shirt. Do it. “My pelvis is perfect. Hashtag why we VBAC.” 

Meagan: Right. Okay, well thank you for being here. Thanks everybody for submitting your questions. We’re going to keep doing these. We’re going to bring the questions and answers. We’re going to talk about them. We’re going to talk about some of the statistics and the evidence behind some of this. So yeah. Make sure to watch out on our Instagram if you haven’t followed us on Instagram, and I’ll make sure to let you know when the next Q&A with Julie and I will be. 

Julie: If you’re in Utah looking for a birth photographer, come and find me. My Instagram is @juliefrancombirth or you can find me at www.juliefrancom.com. I would love to support you and I would love it even more if Meagan and I could support you. So reach out, we’ll give you a deal. We’ll hook you up because we love being in the birth space together. 

Meagan: Yes, we do. We just got our first one the other day and it was awesome. 

Julie: It was 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.

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Meagan is joined today by our friend, Hannah, who has been through so much during her motherhood journey. Hannah’s experiences include a blissful first birth at a birth center, multiple twin pregnancies, miscarriages, a difficult C-section, infant loss, and a redemptive VBAC. 

Hannah shares her unexpectedly traumatic experiences with pregnancy, birth, and grief while living in Argentina. Yet even with all that she’s been through, you can feel Hannah’s strength, positivity, and light. 

Hannah wasn’t sure if she wanted another baby, but learning about the possibility of a VBAC restored hope in her heart. Hannah spent years researching providers and birthing locations in preparation for her move back to the US. When she became pregnant, Hannah was able to feel safe in the providers she chose. Her VBAC birth was everything she hoped it would be and Hannah was able to find so much joy and healing through her experience. 

Additional Links

The Lactation Network

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hey, hey you guys! We have another episode for you today and we are sharing stories from our friend, Hannah. Welcome, Hannah. 

Hannah: Hi. Thanks for having me. 

Meagan: Thanks for being here. We are always excited to be sharing new stories. Just a little bit about cute Hannah here– we were just chatting right before we pushed record and she’s had three babies. She has had three babies in three different states which is kind of cool. You kind of know how the birth world looks in a few different areas. Would you say they are very similar? Would you say they are vastly different? How would you rate having babies in three different places? 

Hannah: Right. Well, I would say from my experience that they were very different but more so having a baby out of the country. I’ve had one in South Carolina and then I’ve had one in Argentina, and then one in Texas. They are very different places and have different levels of care. 

Meagan: Yes. I think if I were to choose to do anything with my free time– I mean there are a lot of things– but one of the things in the birth world that I’d like to do is teleport to all of the different areas, just be a fly on the wall, and witness birth all around the world, truly. I would love to see the differences between them. As a doula, I’ve only seen birth live here in Utah. I think that would be really interesting. 

Well, like I said, her last baby was born in Texas so if you guys are listening from Texas, listen up because she did have her VBAC in Texas. But yes, she is a wife. They’ve been married for nine years, right? You and David have been married for nine years and they have three beautiful girls. We’re going to talk about their births and then we’re going to talk a little bit about miscarriage too, right? 

Hannah: Yes. 

Meagan: Yes. She’s got some angel babies as well. I’m excited to have you share these stories with us today. I would just love to turn the time over to you. 

Hannah’s Stories

Hannah: All right. Well, thank you. I have had, I guess, a different birth story in the sense that I’ve given birth in different places. I’ll start with our first. 

I’m from a large family. I’m one of eight kids. My mom had four of us at home, so I was very familiar with midwifery and all of those things. I knew that if we had a baby when my husband and I got married, that’s kind of what I wanted to pursue. My husband, of course, was not familiar with that. 

Meagan: A little more foreign. 

Hannah: Right. I think he thought it was a little weird, but he was very, very supportive. About two years into our marriage, we found out we were expecting our first. We were living in South Carolina at the time. I started researching midwives. I found one there, Labors of Love, in Spartanburg, South Carolina. She was just a great midwife. My husband went to all of the appointments. We had an initial meeting with her. I remember he had some questions, but I think what really helped us as a couple and my husband to really get on board and just to be that support that I needed is we took a pretty intensive birth class together. 

It was about an eight-week course. It was about two hours each night. It was with a group of other couples. We learned about labor techniques and the whole pregnancy process, and then she also covered postpartum. That just really helped, of course, me because I’ve never had a baby before, but also my husband to understand more and then to really be supportive because he really was there for me during my birth. In the beginning, he was like, “I don’t know.” It was a little weird to him. 

My first birth, I’ll just go over pretty quickly. It was a pretty smooth pregnancy. I wasn’t sick. I was very active. Of course, I was a little bit younger. It was just very smooth. I didn’t hardly gain any weight and it just went by very well. But at about 37 weeks, we went in and she was breech. My midwife suggested I try a chiropractor. I had never been to a chiropractor. I remember I went and was so nervous. 

We had a couple of sessions with her and thank the Lord, the baby flipped. She got in position. 

Meagan: Yay!

Hannah: I was so excited. We were able to have that natural birth with my first daughter. I really wanted a water birth and at the birthing center, they had a tub. I was laboring for quite a while in the water, but then I had a lip. 

Meagan: A cervical lip?

Hannah: A cervical lip, yes. She had checked me and everything seemed like it was going really well. I had been in labor for about six hours and she was like, “You’re a 10. Do you feel pushy or this?” I’m like, “No. I don’t feel anything.” She’s like, “Let’s get you out of the water and see what’s going on.” 

It was a lip, so we tried different things to try to get that moved. We ended up going outside on the porch and walking. 

Meagan: Oh yeah. 

Hannah: My husband still reminds me of this because he’s like, “Whose idea was it to go walk on the porch?” because it was my husband’s idea. I didn’t want to go. I was in the tub. I’m like, “I don’t want to move. I don’t want to walk.” He’s like, “Come on.” He was putting a robe on me and he was like, “Let’s go outside and walk.” Within 10 minutes of walking outside, my water broke and she was crowning. 

Meagan: Wow. 

Hannah: She was there. I remember I reached down and I’m like, “I think that’s her head.” My husband called the midwife and she’s like, “Let’s try to get her inside,” because we were still outside at this point. They got me inside to the bed and in the next contraction, I didn’t really feel like I pushed that much. It was like my body just pushed. 

Meagan: Involuntary. 

Hannah: Yes. Her head came out, and then in the next push, her body came out. It was very smooth and very quick. She was 6 pounds, 11 ounces, and was perfect. We were so excited. 

Then the next year, we found out we were expecting again. We were very excited. They were going to be pretty close together, but we were happy. We went and did an early ultrasound because, between these two pregnancies, I had not gotten my period back. I was breastfeeding. So I was kind of like, “I have no idea how far along I am.” I was nervous about that because at the time, we were planning to move to South America, to Argentina. We were packing up and getting ready to move. I’m like, “I don’t know. Should we stay stateside and have the baby at home?”

Meagan: That’s stressful. 

Hannah: Right. So we went in for an ultrasound, but that ended up ending in a miscarriage at around eight weeks. One of the things that we didn’t know– we were working with the same midwife at the time but didn’t do ultrasounds in her office because she was just a midwife– it was a pretty small birthing center so you would go to another office and do ultrasounds. 

We had done one and they didn’t tell us anything, but when I miscarried, I called my midwife to tell her that I miscarried and she informed me that I was actually pregnant with twins. 

Meagan: Whoa. 

Hannah: She said, “I was going to tell you in your appointment, but that’s what the ultrasound tech saw.” So I was like, “Oh my goodness.” She said, “The reason they didn’t tell you is because in one of the babies, they saw a little bit of an irregular heart so maybe you just miscarried the one and you’re going to keep the other baby.” 

Meagan: Which does happen. It actually does happen where one twin unfortunately will pass, but then the other, if they are not identical and stuff, will continue. 

Hannah: I had not heard of that, but that’s what my midwife had told me so I was like, “Okay.” We were actually out of state, so we were driving back home. I miscarried out of state. We were driving back home and then I miscarried a few days later the second baby. It was a rollercoaster of loss then thinking maybe– 

Meagan: Hope. Oh, I’m so sorry. 

Hannah: Yeah. That was really tough. We hadn’t really told anybody we were expecting. I had told my parents but we really hadn’t told anybody else. Then when we lost the baby, we just didn’t really feel like telling anybody because we had lost a baby. But then as a little bit of time went on, we did end up telling people and I think for me personally, everyone’s different, but for me personally, it helped a little bit in the loss because I felt like my babies were acknowledged. I know some people would maybe rather just keep it private, but for me, it actually helped me a little bit in the grieving process because I felt like they were acknowledged even though I was only eight weeks along. It was a miscarriage. We did end up telling people that we lost the babies. 

We lost the babies. We said, “All right. Let’s go ahead and move because I’m no longer expecting.” We bought the tickets. We started packing up and then we found out we were expecting again. Yeah. So I miscarried in April and I found out I was expecting in July. We said, “Well, let’s go ahead and go.” I was a little ignorant on my end. I hadn’t done research, but I’m just thinking, “We’re moving to South America. Argentina is a pretty modern country.” We were going to a big city, Córdoba. We were like, “There had to be people there. There have to be midwives or doulas.” I knew they obviously had big hospitals, but I wanted the same experiences so I was like, “I’m sure they have people there.”

I just went with the idea that I would find care there very optimistically which is my personality. I’m just like, “We’ll go and figure it out. We’ll get there and we’ll find people there.” 

We got to Argentina and I’m trying to find a house, trying to buy furniture. We started from zero. We didn’t know anybody in the state that we were moving to. We’re trying to meet new people and all of this stuff. I started asking people that I would meet, “Do you know midwives?” They’re like, “No. We’ve never heard of that before.” I’m like, “What?” 

Meagan: Whoa, really? 

Hannah: Yes. They all start telling me no. So then I asked doctors because then we went in– well, let me go back a little bit. We went in and got an ultrasound because I hadn’t had an ultrasound yet in my pregnancy. We found out it was twins again. 

Meagan: Really? 

Hannah: Yes. I had two twin pregnancies back to back. 

Meagan: Back to back. 

Hannah: Back to back. They told me it was twins and we were shocked because I had miscarried the twins. I just never thought I was going to be pregnant with twins again. We were very, very surprised. We did an ultrasound. I started interviewing doctors. I couldn’t find any midwives so then the doctors told me, “No. Midwifery is illegal.” Some doctors would tell me that midwifery was illegal in Argentina. Other people would say, “Well, we don’t have any.” It was very confusing. I was pretty bummed because I really wanted that experience that I had with my first. I felt like it was just such a great experience and such a great birth. 

Through different people and different connections, we started to find health food stores. I really like to eat healthy and things like that. We found more of the hippies I guess you could say. They didn’t live in the city. They lived further out and they would come in and sell stuff. They told me, “We know midwives,” because they had their babies with midwives. I was like, “Oh, this is great.” 

We actually traveled about an hour out of the city. We would meet with these midwives. I was really happy again. I started feeling optimistic. I was very excited, but it was just very different than midwifery care stateside. 

For example, they were very nice, but they didn’t do any medical things. Really, they would just be like, “How do you feel?” 

Meagan: Like more of a monitrice? Well, because midwife and doula– hmm. 

Hannah: Yeah. They never measured me. They never listened to the heartbeat. They never weighed me. Blood pressure, nothing. 

Meagan: Did you know what their credentials were? I’m so curious. 

Hannah: That was kind of a thing too that we were worried about in the sense that some of the people that birthed with them didn’t have birth certificates for their babies. 

Meagan: Oh. 

Hannah: We’re like, “Well, obviously we need their birth certificates. We need to get their papers. We need to travel to the embassy.” 

Meagan: Right. 

Hannah: Then we started learning that it was more like people who almost wanted to be off-grid. I’m like, “I’m not that natural. I don’t want that.” 

Meagan: Like underground midwives. Okay, okay. 

Hannah: Exactly. I was wanting a little bit more care than that because obviously I have twins and I wanted to check on the babies and everything. So they were like, “Well, go to this doctor.” They suggested I go to a doctor so we went to this doctor. In the beginning, he seemed very supportive. That’s where I did all of my bloodwork and my blood pressure. He would check on the babies and all of that. The plan was that I was going to deliver with the midwives as long as everything was looking good. He said that he would sign off on it because he was a doctor and I was under his care. 

So that was the plan. I was very happy. I was like, “Okay. I’m going to get it.” We were going to do a home birth this time. I had my birthing kit and everything. My parents came in from Texas for the birth so we were super excited about that. 

Then I went in for my 37-week appointment and everything had been good. The babies were in a good position. Nobody was in distress. My blood pressure was good. Everything was good. I was very healthy in my pregnancy. I go in and he’s like, “All right. Are you going to do your C-section today or tomorrow?”

Meagan: You’re like, “What?” 

Hannah: He completely flipped. It was just like he became very disassociated almost like he hadn’t talked to us about other things whereas before he had told me all of these things that he was going to let me do even if I delivered in a hospital. He said, “Oh yeah. I’ll let you deliver and this and that,” but there was another head doctor that was in that appointment so I don’t know if it was something. 

Meagan: Maybe. 

Hannah: Maybe he wasn’t supposed to let me have the baby vaginally. I’m not sure, but it just became a very weird situation. My husband and I just left that appointment like, “What just happened?” 

Meagan: I bet you were very confused. 

Hannah: Very confused. We were just like, “We’ll call you,” and just left. So then after that, he started pressuring us a lot to come in and do the C-section. We had to come in and do the C-section. I talked to our midwives about it and they said, “Oh, he called us too and we’re not going to deliver your baby anymore.” I was like, “Why?” They didn’t want to be involved politically because they were underground. It just became– I just felt completely abandoned really by both of my providers because I thought I had a supportive OB and then I thought I had supportive midwives and then within a week they both just abandoned me. 

Meagan: Switched on you, yeah. I’m so sorry. 

Hannah: It was very like, “Oh my goodness.” I didn’t know what to do. It was just one of those things. I kept asking the doctor, “Will you just let me try to labor and try to have a delivery if I go into the hospital?” “No.” They wouldn’t. The policy was that they didn’t let the husbands go in. In Argentina, they don’t let the hospital go in. 

Meagan: Really? 

Hannah: Yes. 

Meagan: These are the things I wish I could find out. I wish I could know birth all around the world. That’s interesting. 

Hannah: Yeah, so there they don’t let the husband go in with you. I think typically, the women are also knocked out under general anesthesia. 

Meagan: Really? Still today? 

Hannah: Yes. I think that’s one of the reasons why the husband is not in there. It’s more of really like a surgery surgery in that sense. Our doctor knew that me and my husband wanted to be together so he told us, “If you come in on Sunday, I’ll do the C-section and I’ll let your husband in there because we don’t have any other C-sections scheduled for that morning.” 

So me and my husband talked about it. We cried. We didn’t know what to do. I just felt like, “Well, at least he’s letting my husband in.” It was just one of those things.

Meagan: Yeah. You take the wins where you can. That’s hard. 

Hannah: Yeah. It’s like, “We’re not going to free birth. What are we going to do?” And my parents were there. That was another thing. I knew especially if I had the C-section, my mom only had a week left to stay. Especially if I have a C-section, I had a one-year-old. She was about to be two but she wasn’t two yet. We were going to have two babies. I’m going to have a C-section. We might as well go ahead and do it. That way I would have my mom here to help us for the first week. 

We decided to go in. Like I said, I was completely ignorant. I had grown up in this circle, I guess in the sense that my mom had home births. A lot of my friends were also doing home births or birth centers. I didn’t really know anybody who had a C-section. I should have researched it, especially with twins but I really just didn’t. I really did not know what to expect at all. I just went in not really knowing anything. 

That’s one thing– I wish I had done more research and looked into what it really entails and with recovery just to prepare myself because I really went in with no idea. 

I went in for the C-section. I felt very forced because we pretty much were forced. It wasn’t like we wanted it. They hooked me up to the monitors and then they told me they were going to monitor me for two hours. They hooked me up and watched me before they did a C-section. They hooked me up and then about ten minutes into being hooked up, they were like, “You’re in labor.” I was like, “What?” They checked me and I was 5 centimeters dilated. 

Meagan: What? You weren’t even feeling anything? Contractions? 

Hannah: I was feeling uncomfortable, but I was expecting twins. I was 39 weeks at this point. I’m just uncomfortable all of the time. 

Meagan: Right, yeah. 

Hannah: I mean, I felt uncomfortable. My back hurt but I didn’t think it was labor. I just felt like, “I’m uncomfortable. I’m tired. I’m not sleeping well.” I didn’t recognize that I was in labor. I think it probably started that morning, but that day I was so stressed just getting ready for the C-section. I had it in the back of my mind, but then when they told me that, I was like, “Oh stink. I wouldn’t have come in if I knew I was in labor.” 

Meagan: Yes. Yeah. 

Hannah: Anyways. Then it just became this cascade of everybody rushing in the room. Rush, rush, rush. They were trying to get the IV in me. They couldn’t get the IV in me. Of course, I was freezing. They wouldn’t let me drink all day. My C-section was planned for 7:00 that night. 

Meagan: Whoa. 

Hannah: They didn’t want me eating or drinking since that morning. I hadn’t had anything. Then they were trying to stick all of these IVs in me and it was just not working. I had tons of bruises all over my arms so they brought in a peds to do the IV. 

Meagan: The light? Yeah. 

Hannah: That worked and then they rushed me to the OR. Of course, it was freezing. They do the spinal tap and as soon as they put in the spinal tap, I got the shakes really bad. It was just uncontrollable. I almost felt like I was going to fall off the table. My husband wasn’t in there yet or my doctor so there was nobody that I knew in the room. I wasn’t covered and I just remember I felt so exposed. 

They tied my arms down and it was just very traumatic. I know some people have C-sections and they go really well and really smoothly. I’m like, “That’s great,” but that was not my experience.” My experience was very traumatic. But then my husband came in. He calmed me down. My doctor came in. He was like, “Get her drapes on,” and all of that stuff. He brought a little more order. The thing that surprised me was how fast it was. I guess from having a labor before a C-section, I just felt like they started and he was like, “Here’s your baby!” I felt like I wasn’t ready. My brain wasn’t connecting. 

Meagan: Yeah. It’s quick. 

Hannah: It’s so fast. But then again, no skin-to-skin. Nothing. They just showed me the baby over the curtain and rushed it off. They showed me the next baby over the curtain and rushed it off. I told my husband, “Go with the babies.” I wanted him to be with the babies. I stayed there and they stitched me up and everything. 

We got back to the room and it was just a rough recovery from the beginning. I won’t go into everything for time, but one of the things was that my pain medicine was not administered so they thought they had an IV in me for the pain medicine. When the nurses would come in, they kept on checking on me and I kept telling them that I was in a lot of pain. They told me, “Oh, it’s because you’re breastfeeding. We can keep the babies. Let us take them to the nursery and we’ll give them a bottle.” I’m like, “No. I’ve breastfed before. No. I’m in a lot of pain.” 

The other thing was they had me up walking pretty quickly. Within about an hour and a half, I was up because I didn’t have a catheter in. They didn’t put one in during the surgery. They came in after the surgery and wanted to place one. I’m like, “No.” So I’m like, “I’ll get up and go to the bathroom,” but I was in a lot of pain. I tried to get up and go to the bathroom. I didn’t know what was going on. That was all night. 

Then the next morning, a new shift of nurses came on. I told the nurses the same thing when they came in. “I’m in a lot of discomfort and a lot of pain.” They went and they checked my IV. They were like, “Oh, it was never hooked up to the bag.” I had my IV in my arm but it wasn’t connected to the bag. I was taking no pain medication. 

Meagan: Oh dear. 

Hannah: Then they just reconnected it but by that time, my pain is–

Meagan: Past the point. 

Hannah: I needed something stronger. That was tough. Just trying to nurse and change your babies’ diapers and trying to swaddle the baby. 

Meagan: Yeah. Oh my gosh. 

Hannah: So that was really hard. But we got over that and then I also had an allergic reaction to something that they cleaned me with for the C-section. I had these red, itchy bumps. 

Meagan: Like the betadine or something? 

Hannah: I think that’s what it was. It was just these red, itchy bumps all over my torso. That was uncomfortable as well. We ended up being able to go home finally. We were so happy to go home. There is nothing like home. 

Then about a week into being home, my C-section scar reopened. 

Meagan: Oh no. 

Hannah: It was again, something I had no idea that could happen. I had never– of course, I hadn’t researched C-sections, but I was like, “How can this happen? I didn’t know this could happen.” We battled with that for a while. Eventually, it did reclose. We didn’t have to go in and do another surgery. It was just a small part that had opened. That was good. But it was one of those other hurdles I didn’t think would come from a C-section. 

Then about a month postpartum, the babies were doing well. They were nursing. I was able to breastfeed both of them which I really wanted to do but I didn’t know if I was going to be able to. 

Meagan: Yeah, because that’s hard. That’s really hard. 

Hannah: Yes. I did just feel like I was breastfeeding all of the time, but I loved it because it gave me a chance to bond more with the babies. 

Meagan: Yeah. Yeah. 

Hannah: So that was really good. But then our son passed away unexpectedly. He was a month and a day old. He passed away in his sleep. That was really, really hard of course. 

Meagan: I’m so sorry. I just got the chills watching you. I’m so sorry. 

Hannah: Yeah. That was really, really tough. In any circumstance, it would be, but we didn’t have any family or really any friends. We had met people and we were getting to know people, but we had only been in the country for about six months so it’s different. We didn’t know the procedures of funerals and just all of that stuff you don’t think you’re ever going to navigate. 

Meagan: No, no. 

Hannah: With a funeral and things like that, you never think you’re going to plan that for your child. So it was just very unexpected and very hard. It was just something that we didn’t expect obviously and something that when it happened, I was kind of like, “I never want to have a baby again.” 

Meagan: Yeah. Yeah. 

Hannah: The C-section being really hard, having a really rough recovery, and then finally feeling like I’m kind of recovering. At this point, my C-section still had not closed so I still had this open wound and I was still dealing with a lot of stuff postpartum, and then to have our son pass away, I was just like, “We’re never going to do this again.” It was very, very traumatic and very hard. 

Me and my husband are very religious and I think that really, really helped us just clinging to the Lord and reading the songs and all of those things. Of course, we had a lot of people praying for us around the country, and in the States, a lot of people who knew us were supporting us. I think that really helped us to get through that time. 

Meagan: Yeah. Yeah. 

Hannah: About a year after losing our son and after having my C-section, I still wasn’t thinking about having another baby. I didn’t know anything about a VBAC or the chances of having a vaginal birth after a Cesarean. I was scrolling my Facebook and I was in a home birth group on my Facebook page. I thought I had put it on mute because it was one of those things where I didn’t want to see people having these beautiful home births. I thought I had put them on mute. 

One day, it just showed up on my feed. It was a lady and I wish I could remember who it was, but I couldn’t go back and find it. She had actually had a VBAC home birth. She was on The VBAC Link Facebook page but she had posted on the home birth page as well. She was talking about this and then I was so sucked in like, “What? This is possible?” I started researching and I found the Facebook group. Then I found the podcast and I binged every episode. 

I still didn’t feel ready to have a baby, but just the sense of that possibility gave me so much hope. I was so excited. I remember telling my husband about it. I would listen to it during lunch because, at the time, our babies were still really little so that was my time. I would eat my lunch and I would listen to The VBAC Link. It was so encouraging and so inspiring to hear all of these stories of these ladies. They had different circumstances and different backgrounds and were able to achieve that. 

I was so happy. I started researching and reading anything I could about VBAC and its options. So about a year after that, me and my husband were talking. We said, “Maybe we would like to try to have a baby next year.” We weren’t ready still at that time, but we were talking about, “Maybe. Maybe we could do this and that.” But I was like, “If we’re going to have another baby, I really, really need to have a supportive provider.” That was my biggest thing that I just really felt like they failed me. I felt like I had support and then I really didn’t have any support from either side. I felt very abandoned. 

I was like, “I just don’t want that to happen again.” I started researching providers. We were still in Argentina and we had this app where you can call the states so I just started calling doctors, OBs, midwives, and all in different states because we were scheduled the next year to go back stateside. We had been in Argentina for a few years and then we were going to be about nine months stateside. 

So I was like, “I can pretty much– I’m open. I can go to North Carolina, South Carolina, Georgia, Florida.” I was just calling everywhere. Of course, originally I called my provider who I had my first with. She told me for the state that they could not do VBACs. She couldn’t do VBACs anymore. I was disappointed about that. She referred me to some people who might. So I was calling that area. 

My parents had recently moved to South Texas. That’s where I am now. We are in South Texas. It’s the valley area so it’s all the way down in Texas. I had not heard great stuff about providers here. I had never really lived here. I started calling around here as well. I was like, “You know what?” I was just calling everywhere. It was so funny. I was like, “I know I’m not expecting but I’m just wondering.” 

Meagan: Do you know what though? That is one thing I actually think is really good to do before you’re expecting because we’re in a different timeframe. It’s actually really healthy to start before because we’re vulnerable but we’re not expecting. I don’t know. We’re in a different place. Right? 

Hannah: Yes, for sure. We don’t feel like we’re on a time clock. 

Meagan: Exactly. “I have to find a provider. I have to make a decision now.” It’s like, “No. I’m preparing and I’m going through these motions to find a supportive provider so when I get there, it’s there. I’m supported from the beginning.” 

Hannah: Yeah. So that’s what I felt like. I wanted to find somebody before. Of course, I knew maybe once I got pregnant and once I met them in person, it might not work. 

Meagan: It could change, yeah. 

Hannah: But I at least wanted a base and something to go off to feel like I had found somebody and at least had someone to talk to if we did get pregnant. Thankfully and fortunately, I did find somebody here in the valley. I talked to her on the phone about two times. We had two phone conversations. She was so nice and really just took the time to talk with me. We went through my history and looking back, I wasn’t even expecting. She just really took time with me and really talked through it. She was so sweet but also very informative letting me know, “These are things that could happen with a VBAC,” and just giving me all the facts. I really appreciated that with her. She wasn’t trying to sugarcoat anything, but also not fear-mongering me at the same time. I don’t know if that makes sense. 

Meagan: Yeah, totally. 

Hannah: I really liked her. Anyway, time happened. I’m trying to remember. That was the second year. So the third year, we headed back stateside and we were not pregnant. This had never happened to us before. We had always gotten pregnant pretty quickly with all of our babies. With this baby, it took us about a year to get pregnant with her. 

You know, six months into it, it’s like, “That can happen.” But then 8-9 months you start thinking, “Something’s wrong with me.” I really didn’t know and to this day, I don’t know because I never went in. I didn’t get any testing. I just thought, “Maybe it’s taking longer.” I really wasn’t sure. I just started trying to focus more on my health, taking some supplements, and making sure I was eating good food and all that stuff. 

About around the year mark, we found out that we were expecting. We were super excited. We were living in Indiana at the time so I went to an OB in Indiana and actually, we went just because we weren’t going to move here to the valley until I was 27 weeks and my midwife wanted me to have some form of care before. 

Meagan: Right. 

Hannah: Obviously, and she wanted to make sure it was not twins again with my track record. 

Meagan: With your history, yeah. 

Hannah: She said, “I do not feel comfortable doing a VBAC twin birth.” That’s what she had told me which is fine. So she said, “I do want you to go in. Do an ultrasound. Have a couple of checkups. See what’s going on.” We found an OB, not necessarily looking for a VBAC-supportive OB, but just going in for an OB. But he ended up being great. I really recommend him. He was Dr. Labban in Bloomington, Indiana. 

They were so great. I was actually kind of sad when we left them because I felt like I could have maybe had a VBAC there as well. They were very supportive of me doing a VBAC and just really, really nice. But of course, he was a doctor and an OB. They weren’t at a birth center or something like that but it was a great experience. 

We found out it was one baby. She was a baby girl and everything looked perfect. We were so excited. We moved to the valley and I was able to reconnect with that same midwife I had called almost two years ago now when we were still in Argentina. We had done a couple of Zoom calls while we were in Indiana. It was really great just feeling like we could get to know each other. 

Meagan: More connection, mhmm. 

Hannah: Right. We could build a connection. We started care with her and really, the pregnancy was wonderful. It was really great. I was really sick in the beginning. I wasn’t with my other wones but that’s okay. I was sick for about four months throwing up every day which I hadn’t had with my other pregnancies. 

Everything was well. I did start seeing chiropractic care from the beginning this time. I really wanted to stay on top of everything. I was walking. I was doing my squats. I was just trying to do everything to get this VBAC. 

Around 34 weeks, we decided to hire a doula which I had never had. My husband and I were talking. I was like, “I just feel like maybe I could have a little more support just coming from the traumatic experience we had with our last birth.” I really felt like I wanted that support. So I talked to my midwife and she had some recommendations. She recommended a few doulas in the area. 

I met with them. We hired a doula and it was really great because she really helped me in the sense of calming me down, in the sense of – I didn’t want to think about if my VBAC didn’t work or if I ended up in another Cesarean. I just was like, “I don’t want to think about that. I just want to focus on my VBAC,” which is great, but at the same time, I think we have to be realistic. She really helped me come up with a birth plan of what if’s. I really felt more prepared in the end because we had a birth plan if I transferred and if it ended up being a C-section with things that I wanted because we talked through it. 

She was like, “You can request skin-to-skin,” and things I didn’t know about. I’m like, “I didn’t know you could do that.” Something I learned just by listening to The VBAC Link, you can have skin-to-skin with a C-section. You can do the clear drape and things I didn’t know about so that even if it was a repeat Cesarean, I would be able to have a better experience. I think that it is possible to have a beautiful Cesarean as well. 

She really helped me write everything up and that way, I think I felt a lot more prepared like, “Even if this doesn’t go the way I want it to go, I can still have a really beautiful birth.” That really gave me confidence either way. 

Time progressed. I got to 40 weeks. I kept on telling my family, “I feel huge. I think I’m to go before. I think I’m going to have this baby early.” It was wishful thinking. I got to 40 weeks and it was a Sunday and I was having labor. I started having some contractions, nothing crazy, but I started having some contractions. We went to church that morning anyway. Sitting through church, I was very uncomfortable I guess because you’re just sitting too. I was like, “I’m really uncomfortable. I don’t like this.”

I started losing a little bit of my mucus plug so I started getting really excited because with my first, I didn’t really have any of that until I was in labor. It was like I was going to have her in a few hours when I lost my mucus plug. Oh, this was happening today. I got so pumped. After church, I told my husband, “Let’s go walk,” because I just wanted to get things going. But it was a rainy, really windy, nasty day. We went to this mall and we were just doing rounds walking, walking, walking, and walking. 

We walked for hours and we came home. I took a bath and my contractions pretty much stopped. I was so bummed. I was like, “It’s okay. It’s all right.” I went to bed. I woke up at 4:00 in the morning with contractions but they were just very sporadic. So I was like, “Oh, here we go again.” I got in the water and of course, as soon as I got in the water, they stopped. They fizzled out. 

I had a chiropractic appointment though that morning. I was like, “Maybe you’ll get adjusted and it will start things up.” So now I’m 40 and 1 day. I go in. I’m adjusted. Nothing happens. Then I was talking to my mom. She was like, “Maybe I’ll come and get the girls,” because I had the two girls at the house still. “I’ll go ahead and pick them up,” and that way me and my husband could just have time by ourselves and see if we could get something started. 

So she came. She took the girls and really, nothing happened that day. I mean, I was on the ball. I was walking. I was doing squats. I was just so ready to have the baby. Looking back, I don’t know why I was in such a hurry, but I was so ready. 

Meagan: Just ready, yeah. 

Hannah: I was ready. We started timing contractions at 10:00 that night because they did start getting more regular. They were about 5-7 minutes apart lasting about 45 seconds. I was like, “Well, I don’t know.” They were regular for about an hour. My doula is about an hour from us, so I really wanted to labor at home with our doula and then go to the birthing center. My midwife is about 30 minutes from us so I’m kind of trying to calculate all of this. 

My husband was like, “I think we should call the doula. Let’s go ahead and call her.” So we did. We called her and she was so sweet. She came and of course, as soon as she came, she took my phone away. She was like, “You don’t need to be timing your contractions.” She was like, “I’ll time your contractions.” She turned off the lights. She just really brought everything down. I actually ended up going to sleep. She put me in this exaggerated side–

Meagan: Side-lying, yes. 

Hannah: She’s like, “I think you need to rest,” which was true. I hadn’t rested Sunday night. I hadn’t rested Monday night and this was now Tuesday. So I did. I fell asleep and I slept for about probably 30 minutes and then I woke up and I was contracting again. They were pretty regular and we were here about an hour or so. Then we said, “Okay, let’s go in. Now they were about 5 minutes apart. 

We went in and we got checked in. My midwife checked me and listened to the baby. Everything looked good. I got in the water because I really wanted my water birth and then within about an hour or two, it was like my contractions just stopped. I was just having prodromal labor now looking back. 

Meagan: Oh, yeah. 

Hannah: I didn’t register it during the days that it was going on. I actually ended up going to sleep. I remember I got out of the water and she had these stairs. I wanted to do the curb walking. I wanted to get them started again, but they could tell that I was very tired. They said, “Why don’t you just lay for a few minutes, and then you can start walking again?” I lay down and I went to sleep. I woke up and it was about 6:00 in the morning. I was so mad. Like, “What?” 

I had no contractions, nothing. We ended up going home. I cried the whole way home because there was no baby and all of this stuff. We went back home and slept. The next day, I was like, “I’m not timing my contractions. Whatever.” Around 1:00, I was having some contractions and my midwife sent me home with a TENS unit. I had never used it before so my husband was like, “Well, maybe just put it on and try it. We’ve never used it before.” 

So I put it on and within 15 minutes, my water broke. I was like, “Oh my goodness.” I called my husband in the bedroom. I was actually in the bedroom. He came running in. I was like, “My water just broke.” There was some meconium in the water, just a little bit. I called my midwife and she was like– we were about to eat lunch. It was about 1:00. 

She was like, “Well, how do you feel? How are contractions?” While I was on the phone with her, I had two big contractions that just felt very different than what I was having before. We were going to have lunch at the house and then go. I’m like, “No. Let’s go. Let’s go.”

I labored in the car. It was very uncomfortable laboring in the car. By the time we got in the car, I was like, “Okay, this is the real thing.” It felt different. 

Meagan: This is labor. 

Hannah: I was like, “I’m in labor.” I just remember my husband doing the countdown like, “20 minutes. 15 minutes.” 

Meagan: Until you got to the birth center? 

Hannah: Until we got to the birth center. We made it and then again, of course, she had filled up the tub. I was a little nervous to get in the tub because I was like, “What if it stops?” 

Meagan: Sure. 

Hannah: But she really encouraged me. She was like, “If you want to get in the water, get in. Go ahead and get in. Relax.” So I was like, “Okay.” I got in the tub and I’m sitting there. They did slow down a little bit, but then I’m sitting there. My husband had actually stepped out to let people know, let my mom know, and my parents that we were back at the birth center. I remember hearing my midwife tell my doula, “You probably want to bring her husband back in.” I kind of thought, “Why? Why? I don’t know what’s going on.” 

Then within about 10 minutes, I hit transition. It hit so hard. I was just like, “Oh my goodness. I do not remember transition being like this.” My husband came in. He actually got in the birth pool with me. 

Meagan: Oh cool. 

Hannah: I really loved that. He was helping me through the contractions. My doula was giving me counterpressure and another thing at the birth center that I hadn’t had with my first birth was that she had the nitrous oxide. 

Meagan: Uh-huh, yeah. 

Hannah: I didn’t know if I wanted to use it, but I remember being in transition and I had in the back of my mind that I wanted to use it but I didn’t verbalize it. I looked up and my midwife was like, “Do you want to put this on?” “Yes, I do.” She noticed that I wanted it, so I did use that during transition and if anything, I think it just really helped to steady my breath because you have to hold it up and breathe that in, then breathe that out. I think it just helped to calm me and ground me if nothing else. 

Meagan: Yeah. 

Hannah: But that was super helpful and again, two things that I didn’t have with my first birth center birth. So I went through transition and then I just started feeling that pushy feel. I reached down and I could feel her head. I could just feel this head full of hair. I was like, “She’s going to have a lot of hair.” I was so excited. I had envisioned leaning back onto my husband in the birth pool and catching my own baby. That was what I really wanted to do. That was my vision for this VBAC. That’s really what I wanted. 

So I tried leaning back on my husband and it was just horrible. I couldn’t do it. I was like, “I need to be on all fours.” It was a huge birthtub, obviously, because we were both in there. I was like, “I just need to be on all fours.” My husband had already told me previously that he did not want to catch the baby which is fine. He was there to support me but that’s why I really wanted to catch the baby. 

But then I remember, I’m in this zone on the baby’s traveling down. I’m pushing the baby. I have my hand on her head. I remember hearing my husband ask my midwife, “Can I catch the baby?” I was like, “Yes.” 

Meagan: I love that. That’s awesome.

Hannah: So he actually caught her. She came out. It seemed like I was pushing forever with her just because with my first, it was two pushes and she was out and with this one, I would feel her head come out and then with the end of the contractions, it would go back in, retract, and then come back in, then retract. It took forever. Once she was out, it was only about 20 minutes that I was pushing, but it felt really long. 

Meagan: I’m sure, yes. 

Hannah: But my labor was really short. It was about three hours from start to finish. Yeah. So prodromal labor did do something. It was working. 

Meagan: Yes, so for those listening, if you have a history of prodromal labor or are having prodromal labor, it’s not always this so I don’t want to tell you for sure that it’s always this, but there’s a very possible chance that you will have a precipitous birth once labor does begin. So anytime we have clients that are having prodromal labor, we are on extra alert because we do see those 3-5 hour births and a precipitous labor with prodromal labor happening especially if it’s been happening for days and days and days like in your case. 

Hannah: Yes. I was happy about that because it is a very defeating feeling to have prodromal labor and to feel like nothing is going on. Just to back up, that morning when she ended up sending us home, she did ask me before sending us home, “Do you want me to check you?” I never had a cervical check. I didn’t have any cervical checks during that labor so she did ask me, “Do you want me to check you?” I went back and forth, but I ended up deciding no because if I am not dilated, I am going to feel very defeated in the sense that I feel like I’ve been laboring on and off for two days and I just feel like it’s going to make things worse. 

Meagan: Yeah. Yeah. 

Hannah: I’m going to feel like it’s not doing anything. I’m sure it was, but at the same time, if I am dilated far along enough, I’m going to know so it’s kind of one of those things that we wait out and we just decided that I wasn’t going to be checked. So through my whole labor, I never had a cervical check which was great. I was just in the zone doing my thing and we just decided we weren’t going to do any. It worked out really great with this labor. I know some people want to know and everyone’s different but with me, what if she checks me and I’m a 4 and I feel like I’ve been laboring for two days and get really discouraged? What if I’m a 2? I didn’t know what I was going to be. That worked out really well. 

But going back to her birth when she was born, her head came out. My husband was back there. He caught her and then her body came out later. She opened her eyes and she actually looked at my husband. It was so sweet. He was like, “I can see her!” Of course, I couldn’t see her. I’m like, “What does she look like?” It was really neat. She came out and he passed her to me. We were just in the water with her and it was so magical. It was everything I wanted even from my first. Even though my first birth went so well, it felt rushed being outside and then having to be rushed to bed. This was very much more on my terms in the sense that nobody was down there with me when I was pushing. I didn’t have any cervical checks. I was just very hands-on the whole time with my baby and I just really, really loved that. 

She was born. We were in the water. We stayed in the water for about 15 minutes just having that time with her. Then we got out of the water because I had decided that I would prefer to deliver the placenta out of the water. I know with water births it goes either way depending on your provider. We get out of the water and we just have this golden hour. I didn’t really realize anything was going on. It goes by quickly when you give birth. You don’t have a concept of time. My midwife came up and she was like, “You know what? It’s getting close to two hours and the placenta is not–”

Meagan: Detached? 

Hannah: Yes. The placenta was not detached and the thing that was worrying her was that I wasn’t bleeding. She said, “I don’t see any bleeding.” Of course, in my mind, I’m thinking worst case scenario, placenta accreta. Is that what it’s called when it’s attaches? 

Meagan: Attaches to the scar, yeah. 

Hannah: So I was like, “Oh no.” Again, she was just very realistic and so they gave the baby to my husband. They got off the bed and went over there. She told me, “I have this water saline that I can inject into the umbilical cord.” She said, “We’ll wait ten minutes but if nothing happens, I’m going to call an ambulance and we’re going to have to transfer you to get the placenta out.” 

Oh, my. I had this beautiful birth. It was such a great experience. That was the last thing I wanted to do was to have to be transported. My midwife took out this shot and it’s huge. It was about this big, this really, really thick thing, and at first, I thought, “Where is she going to do that?” “Don’t worry, it’s going to go into the cord.” I remember I got the shakes. I don’t know if it was the postbirth shakes. I did feel very nervous. My doula started praying. She was a believer and my husband was praying that I wouldn’t have to transfer. 

So she injected it into the cord and then in about 10 minutes, I started bleeding and contracting. It was just the best feeling to feel like I was going to get this out. 

Meagan: Wow. 

Hannah: They stood me up and my midwife was on one side– no, her assistant was on one side, my doula was on the other just standing to give me some gravity and I was able to deliver the placenta with no transferring. 

Meagan: That’s awesome. Really awesome. 

Hannah: Yes, so it was one of those really scary moments. It didn’t last that long, but at the time, it felt like this could be really scary because we didn’t know what was going on. My midwife later, she didn’t tell me at the time of course, but later when she came and did visits, she was like, “I’ve never done that before, the injection.” She said, “I had just taken a class a couple of months ago about it and learned that you can do that with placentas if they’re not detaching.” She said, “I’ve never used it before.” I was like, “Oh my goodness.”

Meagan: That’s really cool though. I want to research it. I’ve never heard of it. 

Hannah: I’d never heard of it either. She was kind of explaining it to me but not if it’s a placenta accreta and not if it’s ingrown obviously, but if it’s just kind of stuck, when you inject that water in it, it almost blows it up a little bit and it helps to move it. It gets it a little heavier where it comes down almost. What my midwife explained to me afterward is my placenta did have a big blood clot that had formed on it. She said it was almost like it had formed a suction. I don’t know if that makes sense. My blood clot was in the middle almost like it had a sucky. You know like those bath toys that have you stick on the bath is kind of how she explained it. She said that it wasn’t really stuck-stuck like ingrown, it was just suctioned because of that blood clot. I don’t really know why. 

Meagan: Very interesting. 

Hannah: Yeah, so that was something very interesting that happened after the whole beautiful birth was the whole placenta which was a whole other thing. I had never heard of that before and of course, my midwife had never used that technique, but we were very happy with the outcome. 

Meagan: I just Googled it really quick and it says, “Umbilical vein injection for management of retained placenta.” 

Hannah: Yes. Yes. 

Meagan: Cool! I am totally going to geek out on this. This is very, very cool and I’m so glad that you didn’t have to transfer because that would be a bummer. Right? That would be a bummer but oh my gosh. Your picture– if you guys are listening, go check out their picture on Instagram or Facebook. You and your husband are in the tub holding your baby. Oh, it gives you all of the feels. 

Hannah: I love it. I love it. That’s another thing. My doula actually just snapped that picture on my phone. She had asked me previously of course. She was like, “Do you want me to snap some pictures? Really, once you start pushing, my job is done.” Of course, unless there were other issues, but she was like, “I can just use your phone. I’ll snap some pictures and videos. If you don’t like them, you can delete them. They’re yours.” I was like, “Sure,” because when you’re in labor you just kind of feel disconnected and I love them. Even though they are just snapshots from her, and we have a video of the baby being born. I love it. I’m so glad that she did. Yes and that I have that as a memory.” 

So yes, we had our VBAC baby. She was my biggest baby by far. We were very surprised. I’m pretty petite and pretty small. My babies were 6 pounds, 11 ounces, 6 pounds, and 5 pounds, 13 ounces. So I’ve had pretty smaller babies. That’s normal for my family. All my sisters have had babies like that and my mom. I did feel like she was big when I was birthing but then I thought that maybe I just forgot what that feels like. When they weighed her, she was 8 pounds, 11 ounces. 

Meagan: Wow!

Hannah: Yes. Compared to my other babies, she was a pretty hefty baby. I had no tearing and I think that letting my body work even though it was a little frustrating to feel her crown, then to feel like she was going back up. I think that allowing your body to stretch and work with your body, our bodies are made to do that and I just feel that if we give it time, I almost wanted in some instances to grit down and push, but I kept trying to slow myself down and have my hand there. Yeah. It was really happy. I’m so thankful. I had a great VBAC. It was a little scary with the placenta, but everything was really, really great. 

Meagan: Well, huge congratulations. Huge, huge congratulations and we learned something new about a way to help get out a retained placenta. So if you are having that and if you are having an out-of-hospital or even an in-hospital birth, maybe that’s something to ask your provider about and see. It looks like this Cochran data-based review was published in 2021 so definitely check that out especially if you have a history of that. That is such a great educational piece so thank you so much for that. Thank you for being here and sharing your beautiful stories. 

Hannah: Yeah. Thank you for having me and just thank you for everything you do. Like I said, that really encouraged me to have another baby but also to know that I could attempt this VBAC. I didn’t know it was possible and then just finding a community of other people who have gone through this. Thank you so much for everything you do and all of the research. I know that it takes a lot of time and effort, but thank you so much. 

Meagan: Absolutely, 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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“There was no fear. There was nothing traumatic about it. It was just healing and it was so empowering to know that my body could do that. It was an out-of-this-world experience.”

Windsar has had three pregnancies and four wildly different deliveries. Her first birth was a medicated, vaginal delivery in a hospital. About 18 months later, Windsar became pregnant with identical twins. Shortly after twin A was born vaginally at 32 weeks, Windsar experienced a cord prolapse, and twin B was then born via emergency Cesarean. 

Windsar knew her next birth needed to be healing and redemptive. She did all she could to achieve an unmedicated VBAC and finally get the golden hour she never had with her three other babies. Her VBAC birth story is intense, empowering, and absolutely beautiful.

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Full Transcript under Episode Details 

Meagan: Welcome, welcome to The VBAC Link. I am excited to be talking to you today with our friend, Windsar. Hello, Windsar. Welcome to the show. 

Windsar: Hello. Thanks for having me. 

Meagan: Absolutely. She has a story that is not something that we hear very often. We do have one person on the show that has had a similar scenario but actually, it was just her first two babies. Of course, it’s a VBAC, but it’s a twin birth where twin A is vaginal and twin B is Cesarean, then she went on to have a VBAC. 

So yeah, it’s not something that we hear about a ton or talk about but Windsar was just telling me something that I had heard but didn’t know if it was true, so I’m going to take it because she was told and had a twin birth. When they are identical, there is a higher chance, correct? 

Windsar: A higher chance of what specifically happened to me which was cord prolapse. 

Meagan: Right. Yep. I was going to say a higher chance of having this happen which would lead to a Cesarean and that’s cord prolapse. So when baby A came out, there was a whole bunch of room that was created. Baby B came, but the cord came first. 

Windsar: Mhmm. 

Review of the Week

Meagan: That is a very valid reason to have a Cesarean and get baby out. So we’re going to share your stories and your VBAC but of course, we have a Review of the Week. 

This review is from Janellemb142018. It says, “Perfect combination of data and stories.” It says, “I’m getting ready to attempt my VBAC after three C-sections this month.” Yay! It says, “I always wanted a VBAC, but my providers were what I know now to be more tolerant than supportive which resulted in me never getting the chance to attempt a VBAC. I stumbled across The VBAC Link and have now become a fierce advocate for myself.” 

Oh, I love that. “A fierce advocate”. That is what we want you guys to feel is that you can be a fierce advocate for yourself through learning from this podcast. It says, “This podcast arms you with the perfect balance of data and stories. The data has helped me make a better-informed decision and push back when providers and even loved ones at times try to fill me with fear. The stories are inspiring and make the data seem real. I know my VBAC is not guaranteed, but I feel like I’m in the driver’s seat which in itself is a better experience already. I am where I am today thanks to the resource like this amazing podcast.” 

Oh, thank you so much. You know, just like what she said. I know a VBAC isn’t guaranteed and sometimes it doesn’t end in a VBAC. That’s okay, right? Sometimes it doesn’t even end up with that and someone maybe might choose to switch their mind and say, “I want to have an elective Cesarean.” But what’s most important is that you find the information and feel that you have the data to make the best decision for you and your family. That is what this podcast is for. It’s to bring you guys empowerment through these stories, the data, and the knowledge so you can go out and make the best choice for you. 

Just a reminder, if you haven’t left a review, we love reviews. In fact, these reviews, you guys, make it possible for other people in the community to find this podcast. These reviews are so important. We are so grateful so if you haven’t had a chance yet, please leave a review. You can do it on Apple Podcasts, Google, or wherever. We would love your reviews. 

Windsar’s Stories

Meagan: Okay, cute Windsar. I heard that little baby in the background. 

Windsar: He’s noisy. 

Meagan: Oh, I love it. I love him being noisy. Those little coos and noises make me so happy. Welcome to the show. 

Windsar: Thank you. I’m so excited to share. 

Meagan: I’m so excited for you to share. Well, I’m going to turn the time over to you and let you start sharing your cute babies’ stories. 

Windsar: Okay, well my name is Windsar. I live in Austin, Texas. I’m married to my high school sweetheart and we have four kids. Our first is eight then we have twins that are identical twins that are six and then this new baby that is making all of the noise in the background will be four weeks in just a couple of days so he’s brand new. We’re still figuring things out. 

Meagan: Brand spanking new. 

Windsar: I’ve been pregnant three times and had four different deliveries. With my first child, a little girl, I had a medicated vaginal birth in the hospital. With my twins, I was medicated in the hospital and twin A came vaginally as you mentioned earlier. Twin B was an emergency C-section for a prolapse. Then this fourth baby, I had unmedicated in a birth center. 

So I’ll start with my oldest birth. I had the picture-perfect pregnancy. Actually, my OB was the son of the OB who delivered both me and my husband which was really special. 

Meagan: Really? That is really cool. 

Windsar: Mhmm, so his dad delivered both me and my husband. We had a great relationship with that OB. He was wonderful. If our daughter had been a boy, we were planning to name him after the doctor. That’s how close we were. We just had a wonderful relationship. 

Meagan: It just goes to show the impact he had on you guys. 

Windsar: Yes, but as I’ll say, it kind of clouded my judgment a little bit the day that we had her in regards to informed consent. I’ll get into that a little bit because it did shape my story for this baby’s birth eight years down the road. 

With her, I went into labor at 40 weeks and 1 day. It was very, very slow as it can be for first-time moms. When I got to the hospital, I was convinced that she was going to come out at any minute just based on the amount of pain I was in and I was 2 centimeters. It was a long night. They wound up putting me on Pit and I was able to sleep. 

At about 24 hours from the time I had my first contraction to the time that I had her was how long I was in labor. It was about 24 hours so not terrible, but a couple of things happened that changed this last delivery that I had revolving around informed consent. 

They broke my water without asking me. They just said, “Oh, we went ahead and broke your water,” which I didn’t know was something they could do without asking. They gave me an episiotomy and told me after the fact. 

Meagan: What?!

Windsar: After she was out, he said, “I did just go ahead and give you a little cut there and I’m going to stitch you.” Those two things, I felt a little bit violated after the fact that they didn’t ask me or tell me the risks regarding each thing. 

Meagan: When they broke your water, was it during a cervical check? 

Windsar: Yep. 

Meagan: It was like, “Oh, oops. We broke your water.” 

Windsar: He literally said, “I went ahead and broke your water when I was in there.” 

Meagan: “I went ahead.” He actually did make that choice. 

Windsar: Yes. Again, I trusted this man implicitly so I was just like, “Okay.” Well, it wound up possibly causing a problem because my little girl had a lot of meconium when she was born. She was covered in it, like slick. They suspected meconium aspiration and I had about three minutes with her before they took her to the NICU so I missed that golden hour with her. That was really unfortunate. 

We didn’t have too many breastfeeding struggles, but as a first-time mom and missing that first hour with her, breastfeeding was more of a challenge than I had anticipated. But overall, when she was born, everybody in the delivery room laughed because I said, “That was easy!” My perception of it was that it was a positive birth experience. I don’t look back on that, besides the lack of informed consent, in any way that I needed to heal from. 

Meagan: Right. 

Windsar: About 16-18 months later– so she was born in Dallas then we moved to Northern Colorado so my next birth was with a different doctor in a different hospital. We got pregnant and at about six weeks, I started thinking that something was weird. I was teaching 3rd grade at the time and was having these insane heart palpitations that would stop me in my tracks and make me put my hands on my knees. I thought, “Something is weird here. Something is different.” 

I started to suspect it was twins. When I went in for my first appointment with this new OB at eight weeks, I said, “I think it’s twins. Can you give me a transvaginal ultrasound to see?” He said, “No. I only hear one heartbeat and your belly is looking normal to me so I think we’re good. It’s just one.” I said, “Okay, well if I come back and there’s two, I’m going to say, ‘I told you so.’” He said, “That’s fine. You can tell me ‘I told you so’.” 

So I went back at 13 weeks and what do you know? There are two babies in there. Identical. 

For the rest of my pregnancy, I was pretty heavily monitored for twin-to-twin transfusion, going in every two weeks and then once the school year thankfully ended, I started doing the non-stress tests. The day that I went into labor, I was 32 weeks and 3 days. I had a non-stress test and they said, “Everything looks okay, but baby A is acting a little strange so we want you to come back in two days instead of a week.” I said, “Okay,” but I wasn’t feeling any contractions. Nothing seemed terribly off. 

I went home. I had dinner. I went to bed and something woke me up in the middle of the night. I sat up and it was like a tidal wave with my water breaking. 

Meagan: Wow. 

Windsar: Like in the movies, just whoosh. Very calmly, my husband wasn’t in our room. I think he was out on the couch watching TV. I said, “My water broke. Get the baby ready. We’ve got to go to the hospital.” We didn’t have family there to help us yet. It was 11:30 at night. 

So we went to the hospital and they did everything that they could to stop the labor. They put me on magnesium which was terrible because it makes you so hot. This train was coming no matter what we did. There was no stopping it. 

Meagan: How many weeks again?

Windsar: I delivered them at 32 and 4. When I got to the hospital, they were 32 and 3. 

Meagan: So preterm. 

Windsar: They were planning to induce me because they were identical at 37 weeks. They came 5 weeks before they were supposed to be induced. 

After several hours, I got an epidural because I knew that there was no chance for me to even try to go unmedicated in case there was an emergency. I got the epidural. We managed to get one of my former co-teachers to come and get our daughter. Literally, about 10 minutes before I told the nurse, “I feel like I have to go to the bathroom,” she looked down and baby A was coming out. She could see his head. 

Meagan: Oh my! 

Windsar: It was so quick. We handed our daughter off and they wheeled us so fast. Now, one thing I wanted to mention is that I had been begging for food since probably 1:00 AM. I was starving. So as they were wheeling me to the OR, tears were just streaming down my face and I was saying, “I’m so scared and I’m so hungry that I don’t feel like I have the strength to do this.” I was just bawling because my stomach was growling so much and I was starving. 

We got down there and they had me quickly sign some release that said I would consent to a C-section if necessary. I signed it and we started getting the rest of this baby A out. His head was basically already out when we got there. 

Meagan: Already out, crowning. 

Windsar: They turned my epidural down really, really low so I could feel. I had not prepared at all for any sensation down there and I could feel everything. I was screaming my head off and cussing. He was born. He was tiny. I’ve never seen such a tiny baby. He was 3 pounds, 9 ounces. 

Meagan: Oh, yeah. Itty bitty. 

Windsar: They gave him to me in a little warmer bag. It was like a little plastic bag. They put him on my chest. I was looking down at this tiny, tiny baby and they said, “Windsar, baby B’s cord has slipped down and we’re going to have to do an emergency C-section.” I don’t think I could even process that because I’m looking at this tiny baby and hearing those words. I think I just completely disassociated. 

Because of how vocal I was while I was having A, they said, “We’re going to turn your epidural up.” They turned it up so much that I had to hand off the baby because it felt like I was floating. They started doing the C-section and I was again, screaming throughout all that because I had never experienced a C-section. I could feel the pressure and I was just panicking. 

Baby A was born. In between when A was born and B was born, it was 26 minutes. I guess that time was them turning up the epidural trying to get me to calm down. 

Meagan: Were they holding cord inside? What were they doing with the cord?

Windsar: They had a hand up holding the cord in. During that time, I started telling them that I was having trouble breathing. Looking back, I don’t know if I was having a flat-out anxiety attack or if the epidural had gotten too high– 

Meagan: Traveled up, yeah. Which is possible if they turned it up really high. 

Windsar: But I was panicking and screaming. What they kept saying to me was, “If you’re able to scream like that, you are breathing,” because I was yelling and cussing. 

So baby was born. They took both of them immediately to the NICU. Baby B was 5 pounds, 4 ounces so that’s why they think that they were preterm because there was growth restriction there that they hadn’t anticipated to be that great. 

Meagan: For Baby A. 

Windsar: So they whisked both those babies off. Husband went with them and I had to sit in this little room, I guess while they were weaning the epidural down and I was still complaining that I was having trouble breathing and still complaining that– sorry if you can hear him. He’s eating really loudly. 

Meagan: That is okay. We welcome the baby coos. 

Windsar: I was still complaining that I was having trouble breathing and swallowing specifically and then being like, “I’m so hungry. Can I have crackers? Can I have anything?” and they wouldn’t feed me. 

So that was their birth. They were in the NICU for 26 days which is not terrible for them being eight weeks early. Then they came home and were on oxygen for four weeks. I was able to pump exclusively for them but we were never able to have that breastfeeding relationship on my breast. I pumped exclusively for them for 13 months.

Meagan: Wow. Good job! 

Windsar: I had pretty bad postpartum anxiety with my recovery with them both because of the trauma of the birth, the NICU stay, and then being attached to a pump plugged into a wall 20 hours a day with a toddler. It was just a lot. 

Fast forward, we wound up moving to Austin and we had a very big gap in between which has turned out to be wonderful. I started getting that feeling in my heart that I wanted another baby, so before I even got pregnant, I started planning what I wanted if I were to be blessed with another baby. I knew that I wanted a VBAC first and foremost. I knew that I wanted to go unmedicated. 

So before I even got pregnant, I started the mental prep by watching a million birth videos. That was my prep before I got pregnant just so that I could see what natural childbirth looked like. I found out I was pregnant in August and I had been seeing an OB here since we moved here about six years ago that is not VBAC friendly. 

I went in to him for my urine test to confirm the pregnancy and they said, “Okay, well we’ll see you again in however many weeks.” I said, “Actually, you won’t.” That was kind of my goodbye. 

Meagan: You’re like, “I’m leaving.” 

Windsar: Yep. I was like, “Thanks for confirming what I already knew, and see ya later.” So I immediately set up some interviews with doulas and asked them to share VBAC-friendly providers in the area. They both recommended the same practice. I wound up hiring an amazing doula. She has six children that she has all had unmedicated and she was just such a wonderful resource for me. 

When I was about eight weeks, I went and saw this VBAC-friendly provider for the first time. I do have to say from the get-go that I started seeing red flags that maybe she wasn’t going to be as supportive as I wanted. Tolerant, yes. Supportive, maybe not. 

Meagan: Just like the review today. 

Windsar: Yep, exactly like the review. One of the things I was up against was that I was going to turn 35 during this pregnancy so automatically now I was a VBAC candidate– 

Meagan: You old dinosaur you. 

Windsar: Yes and I was old. I even asked her, “How is my care going to change when that magical number comes?” She was like, “Well, we’re going to want to monitor you more.” Her office was 45 minutes away from our house and every time I would drive there, I was mentally preparing for a fight. That’s literally what I felt. I felt like I was gearing up for a fight with her about whatever it was– declining to use the glucose drink. I did the more natural version of that. That was a fight that I had to have with her to convince her that it would be okay. It was just every little thing that was a fight. She would only be with me for five minutes. I’d drive 45 minutes, sit in the waiting room for 15 or 20 or 30 and then see her for five. 

I just wasn’t feeling like I was going to get the birth I had been envisioning. 

Meagan: Right. 

Windsar: Around 26 weeks, I sent my doula my birth plan. It was basically a list that said, “No” stamped in red across it, all of the things I had planned to decline in the hospital. Then there was a list of things that I wanted too. She wrote me back and she said, “Windsar, I know that you have planned for a hospital birth, but looking at this birth plan, I just don’t think it’s going to go the way that you’re envisioning and have you thought about going to a birth center?”

It was like that was all I needed to hear. It was like I needed her permission or something to look into that option. That day, I booked a tour with the birth center. That was on a Thursday. I was touring it on a Monday and I had fired my second OB in the pregnancy by the following Wednesday. It was very, very fast. 

I did wind up going back to the OB once and told her, “You know, I’m switching to a birth center. I just feel like I’m pushing up against a wall with you and that things are not going to go my way.” What she said to me was, “I’m a trained surgeon and I can only do what I’ve been taught.” 

Meagan: Oh, whoa. Then that’s my answer because you’re even talking about surgery when I’m wanting to VBAC. 

Windsar: I was like, “Okay.” Yep. Mhmm yep. 

Rewind, I forgot to mention this big thing. At 20 weeks, I had the anatomy scan and growth scan. Baby was in the 96th percentile. We got this fun diagnosis of large for gestational age. Both the maternal fetal medicine doctor and my OB started saying, “You know, if you’re going to have an 11-pound baby, I think that you should consider a C-section.” 

That was pretty much the biggest fight at that point that I was having. Like, “No. I believe our bodies are divinely divined and I will be able to birth this baby no matter how big he is.” She just kept pushing, “We’ll see how it goes. We’ll see how it goes.” So when she finally made the comment that she was a trained surgeon as I was saying goodbye to her, it was just like this weight lifted off of me like I wasn’t supposed to be here in the first place. 

I switched to the birth center and immediately felt at ease with the midwives there. I brought up large for gestational age and they were like, “Do not worry about it. You will be fine. You can birth the baby that you grow.” That was so comforting to me. 

Yeah, so now I guess I can get into talking about his birth. 

I was 38 weeks and 2 days when I went into labor. My husband and I actually had a really good friend in town from New York. He was staying at his parents’ house about an hour and half away from where we lived and wanted us to come and spend the day there. I was like, “Yeah. This baby’s not coming. Let’s do it.” My husband said, “Stop. I don’t think that’s a good idea for us to travel an hour and a half to go see this friend when you’re this far along in your pregnancy.” 

I was like, “It’s not going to happen tonight. It’s not going to happen tonight.” He was like, “Just in case, let’s have him come to us. We have three other kids. He has no kids.” So we wound up having him and his girlfriend and his parents come. We went out to dinner with them and had a great time. We came home. It was on a Sunday night. We put the kids to bed. 

For some reason, I was like, “I want ice cream with a Butterfinger,” which was a very weird craving for me. My husband even was like, “You want a candy bar? What?” I don’t know. The body wants what it wants. That’s what I needed at that time. So we get in bed and turn on a show. I’m laying there eating my ice cream and at one point, I get up and I’m like, “That’s weird. My pants feel wet.” Not like a mom that’s had three other kids wet, but pretty wet. 

So I was like, “Hmm. That’s odd.” I just changed my clothes and got back in bed. I kept feeling dampness on the mattress so I’m like, “What? Am I just laying here peeing?” Because when my water broke with the twins, it was a tidal wave. I just thought I was peeing myself. At one point, I went to the bathroom and I had read somewhere that amniotic fluid had a different smell. 

Meagan: Mhmm. A sweet smell. 

Windsar: So I pulled my pants down. I sniffed my undies and I was like, “That’s not pee.” I told my husband, “I think my water is dribbling, but I’m not sure.” He was like, “Well, okay. What do you want to do?” I said, “I don’t know. I want you to go to sleep. I think that is what I want you to do.” At this point, it was almost midnight or a little past. It was like, “You go to sleep and I’m going to figure out what is going on here if it’s my fluid or not.” 

I left our room and not much longer after that, I was standing in our kitchen and I involuntary felt a ton of fluid come out so I was like, “Okay.”

Meagan: Water breaking. 

Windsar: This is definitely my water for sure. I went and put on a diaper and was like, “Here we go.” I had been so nervous the whole pregnancy that I would feel scared in labor just because of what had happened with the twins. Also, we’re 45 minutes away from the birth center and I had a lot of fear in my head about getting there on time, but I was just so calm. I was like, “This is happening. This is the day that I’ve been waiting for. Let’s do this.” 

Between midnight and 1:00, my water was continuing to flow and at about 1:00, I had a very small bloody show so I called my midwife and told her. She said, “Okay.” I wasn’t having any contractions. She said, “I want you to go to bed and go to sleep.” I wanted to say, “Lady, that’s not going to happen. I’m excited.” 

Meagan: It’s so hard. 

Windsar: Yeah. There’s no way I’m going to be able to sleep. But I did try to lay down and probably by 2:00, my contractions started up. At that point, it was over. There was no way I was going to be able to sleep. I was bustling around. I unloaded the dishwasher. I packed my kids’ lunches. I took three showers and every time I was in the shower, I was just visualizing what was going to happen once we got to the birth center. I was picturing the whole thing. I felt calm and such peace. 

At one point, I went out on our street and was curb walking. I did the Miles Circuit all by myself. I didn’t want my husband. I didn’t want to call my doula. I was like, “I’m just going to let the both of them sleep because I don’t need their support right now. I can do this.” 

Finally, around 5:45 AM, things were picking up really quickly and I called the doula and I said, “It’s happening. Don’t come over. We will meet you at the birth center. We will call you when we’re leaving.” She was like, “Okay. Go shower.” I was like, “I’ve already showered three times. No more showering for me.” 

In between 5:45 and 7:00, we got our big kids down, packed for school, and got them down to our neighbor’s house. I was doing all kinds of things, bouncing on my ball, on all fours just trying to stay comfortable. Around 7:00, my husband said, “Listen, I think we need to go because we’re going to hit traffic.” 

I don’t think I was completely ready to leave at that time, but I was like, “Good point. We don’t want to be stalled out in the car and go through transition or something.” We got in the car at 7:00. I was so concerned about him. I was like, “You need to eat breakfast,” so I made him stop for breakfast tacos on the way to the birth center. I was standing outside of the car holding onto the side of the car moaning and swaying. People were probably wondering what was going on. 

He got his breakfast tacos and we were off. We hit terrible traffic just as he had anticipated. I had my labor playlist going. I was singing and holding onto that handrail in the car and just breathing through my contractions. We got to the birth center at about 7:50. From door to door, it was just about 45 minutes despite the traffic. 

They checked me when I got there and I said, “Do not tell me if I’m anything below a 4 because it will discourage me and I’ll get inside my head. I don’t want to know.” They checked me. I was 5 centimeters and 100% effaced. They were like, “We can feel the baby. It’s go time. Go sit on the toilet.” 

My doula and I went into the bathroom and I sat backward on the toilet. That is where I went through transition and oh my goodness, that was interesting to feel that for the first time. I was sweaty and I was not getting any relief. I kept saying to Peggy, my doula, “They’re not stopping. They’re not stopping.” It was just contraction, contraction, contraction. 

Finally, I had moved to the birthing tub. I had really envisioned a water birth the entire pregnancy. I wanted to birth in the water. I was just– at that point, I had entered a different realm of consciousness. I had studied Hypnobirthing so I was doing all of the Hypnobirthing stuff. I got into the tub and I was in there for probably about 15 minutes when I said, “I need to push.” My doula was not sure that I was really there. She said, “Are you sure?” I was like, “Girl, go get the midwives right now. I am ready.”

They came and I pushed in there for probably about eight minutes. I birthed his head in the tub and then the position that felt comfortable to me was one of my legs flat and then the other leg up. So on my bottom with one leg crossed in front of me and the other hiked up. I birthed his head like that, but was not really progressing from there so they wanted me to get out of the tub which was fun with a head sticking out. 

Meagan: Yes, I was going to say that’s gonna be interesting. 

Windsar: Yeah. I got out of the tub and waddled over onto the bed and got on all fours. I had two contractions on the bed and he was born. It was crazy and the first thing that I said when they handed him to me was, “You’re not big at all,” because he just felt so small to me. I had been so scared after that seed had been planted that he was going to be a monster, big baby. I think I was just shocked that he was so little. 

The second thing I said was, I looked up at my husband and said, “Oh my god, I did it.” I was just completely in awe of my body that I had done that. 

Meagan: Elated. 

Windsar: Yeah. He had a double nuchal cord and there was never any panic about it at all. The midwife said he had the longest cord she had ever seen so I’m just like that nuchal was a blessing. It’s protective against prolapse. Yeah. He was just perfect. He was 8 pounds, .5 ounce so a completely normal size, not big. It was just the most beautiful experience. We left four hours after he was born. We were like, “We’re ready to go home,” and we were back in time to pick up our older kids from school with a new baby in the car. 

Meagan: Wow. Isn’t that wild? That’s something that I loved about being in an out-of-hospital birth. It was like, “Okay, go home now.” I was like, “I get to go to my bed? That sounds delightful.” 

Windsar: Yes and there are not people coming in and out all night bothering you. It was just me and my baby. The big kids were coming in and out every once in a while, but it was just so wonderful. It truly was such a healing experience. There was no fear. There was nothing traumatic about it. It was just healing and it was so empowering to know that my body could do that. 

It was an out-of-this-world experience. All of my births were beautiful but it was just so impactful and I’m so grateful that I got to experience it like that. 

Meagan: I’m so grateful that you were as well and I’m so happy. It’s hard because I don’t ever want to say, “Change providers. Change providers,” as a bad thing. We love our providers. They’re all great but it’s not a one-size-fits-all and they don’t all meet our standards or our wishes or our desires. It’s really hard when you recognize that and then some people feel stuck. It’s hard to change. It’s hard to make that change. 

You went back and were like, “See ya. Peace out,” but you don’t even have to do that if you don’t want to. You can just go to a new provider and request your records. But it’s really hard to do so I’m so glad that you were able to follow your heart, trust your gut, and do what was best for you in this birth because yeah. It sounded like there were some red flags there. 

If you’re listening and you’re hearing red flags or you’re feeling red flags, know that it’s okay to switch. You don’t have to switch to out-of-hospital. You can still stay in the hospital or go to another provider, but it’s okay to switch. Like you, you switched. I switched at 24 weeks with my VBAC-after-two-Cesarean babe. I think back and I know I wouldn’t have had the same experience but I don’t know if I would have had as healing, as redemptive, and as peaceful of an experience or even a vaginal birth for that matter if I didn’t follow my gut at that time. Right? 

Windsar: Yeah. I thought about that a lot. Even if I had the exact same labor experience and had stayed in the hospital, from the time I got there to the time he was born was two hours but if I had been in the hospital, so much of the time would have been them forcing me to get an IV, them taking my temperature and just doing all of that triage stuff whereas at the birth center, for me, I was just able to labor in peace alone with my husband and doula. There was nothing that raised my adrenaline to cause me to slow down whereas if they were putting in the IV on me, putting the belly monitors, I know that would have stalled me out in the hospital. I was just grateful that I didn’t have to go that route this time. 

Meagan: Yes. Absolutely. Well, huge congratulations. 

Windsar: Thank you. 

Meagan: Thank you so much for sharing your story. Yeah. It’s just so important to walk away from a birth and feel confident and comfortable and at peace with the outcome. We know it doesn’t always happen, but if we can do things to advocate for ourselves and help that happen, let’s do it. 

Windsar: Yeah. 

Meagan: You matter enough. You matter enough to take care of you and do what’s best for you and your baby. 

Windsar: Yeah. It’s like, everybody always says, “Healthy mom and healthy baby is all that matters.” Of course, that’s true. You want healthy outcomes for both mom and baby, but also, I want to feel positive about my birth experience after the fact. I want to feel empowered and I really, truly wanted a redemptive experience this time as you said. Those things were important too.  

Meagan: Yes, exactly. The whole “healthy mom, healthy baby” thing– I literally can’t stand it. Duh. Of course. No brainer there. But “healthy mom, healthy baby, good experience, positive outcome” is really still important. We can’t forget about those because we do hold onto these experiences whether we remember every detail or not, they are happening to our body. It’s happening to us, right? If we have someone come in and– talking about your first birth– just do things without your consent, it doesn’t feel good. It’s not going to leave us with a positive experience. 

Windsar: Right. I mean, this time is the first time out of three deliveries that I got that golden hour with my baby and our breastfeeding relationship has been so easy. I mean, he latched 15 minutes after he was born. That hour where we just laid there and I just stared at him and was like, “That’s who was in there this whole time.” I hadn’t had that before and it was magical. It was truly magical and I’m so grateful that I was able to finally experience that. 

Meagan: Absolutely. Well, huge congratulations. I’m so happy for you. Your baby is absolutely adorable. I know they can’t see your baby but I can see your baby and I love babies so much. Huge congrats again. Thank you so much for sharing and inspiring others. These stories– I really so wish that I had these stories and I’m so glad that we have these opportunities to share these stories with the listeners out there. 

Windsar: Yes. It makes all the difference to be able to hear the positive stories. It really, really does. 

Meagan: Absolutely. 

Windsar: So thank you so much for having me. 

Meagan: 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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Anneke is a Pelvic Floor Physical Therapist from Oregon who is a long-time VBAC Link Podcast listener. During her first pregnancy, she would listen to 5+ hours of episodes commuting back and forth from work! Anneke was more than committed to having a vaginal birth with each of her pregnancies, but what she has learned from her births about advocacy, trust, and defining success are beautiful lessons that have changed her forever.

At The VBAC Link, we are here to help you achieve your goals of a vaginal birth. But even more importantly, we are here to advocate for empowered decision-making in the birth space. Anneke is an inspiring example of being educated, strong, and finding healing within circumstances that were out of her control.

“Since my first birth, I’ve asked, ‘Why? Why not me? Why does this keep happening and why can’t I just be like so many others on the podcast and so many others across the country? Why can’t I just will it into being?’ 

From these questions, I’m starting to believe that my story actually might begin at the end. I’ve realized that maybe my story isn’t about the mechanism of birth at all, but what it birthed in me which was the ability to see my own strength.”

Additional Links

The Lactation Network Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello. Wherever you are listening from, welcome to The VBAC Link. We have three beautiful stories for you today. They are all unique. They all have certain things along the way that add some unique factors. 

We have our friend Anneke. I keep questioning that, but it’s Anneke and she has had three Cesareans. Her Cesareans really all have been a little bit different and for different reasons. We’ve got IVF. We’ve got low fluid and we have breech presentation. I’m excited to share your stories or have you share your stories today, but as always, we love starting our podcast out with a review. 

Review of the Week

Today’s reviewer is from a girl named Megan. It says, “Great resource.” It says, “Such a great resource for VBAC mamas to come and listen to women’s stories and get great evidence-based practice information. I do wish these ladies would do a little less interrupting of the storytellers.” Well, I’m so sorry, Megan. We definitely do jump in so hopefully, Anneke, you don’t feel too interrupted. But we do like to be a part of your story as well because we want you to share your story, but we are listening and we are listening for the first time. We are reacting as if someone else would react the first time they are listening, right? 

So yeah. Thank you, Megan, for your review. We do love your reviews as always. Seriously, anywhere you listen– Apple Podcasts or Google. You can email us. Write us on Instagram. Let us know what your review is because we would love to read it on the next podcast. 

Anneke’s Stories

Meagan: Okay, Ms. Anneke. Welcome to the show. 

Anneke: Thank you. 

Meagan: Thank you for being here and sharing these stories. I just want to turn the time over to you and have you share away and educate these listeners. 

Anneke: Awesome, well I am a long-time listener of your podcast actually. I think I found your podcast before I gave birth to my first child. 

Meagan: Oh really? 

Anneke: Yeah. I was doing 5-hour drives. I am a pelvic floor physical therapist. 

Meagan: Oh yes. I wanted to talk about that too by the way at the end. Don’t let me forget. 

Anneke: Well, I was contracted to work where I am actually working now. It was a 5.5-hour drive. I would go down once a month and treat patients so I would listen to 5.5 hours of your podcast. 

Meagan: You would get through quite a few episodes. 

Anneke: Yeah. Lots of episodes. I always had this dream that I would be able to come on The VBAC Link with this triumphant VBAC– well, with this triumphant story. I never expected to have a Cesarean. I don’t think anybody ever does. But after I had my first, I was like, “Okay. My goal is to someday be on The VBAC Link with this triumphant story.” 

I’m not here today with the triumphant vaginal birth that I was hoping for, but I really think that my births tell three stories. The first one is about advocacy and then the second one is about trust and then the third one is about defining success. 

Meagan: Oh, that just gave me the chills. That really did. So let’s talk about this. 

Anneke: So my first pregnancy started after about three and a half years of infertility. We went all the way through to IVF. I’d been having some mental health struggles getting through all of the infertility pieces so I’d been doing counseling and that was amazingly helpful. We get into the pregnancy. Everything is going beautifully and at about 18 weeks, I had some really bad swelling. 

I told my provider and he was like, “Well, sorry. Sometimes people just get swelling.” I just went with that. A friend of mine who is a pelvic floor PT– I was seeing her because I was doing all of the things. I had prenatal yoga and I was seeing a pelvic floor therapist because I had some pelvic pain and pelvic tension in the past. She took my blood pressure one day and it had always been normal in the OB’s office. She was like, “Wow, you’re a little elevated.” 

That was in August at about 20 weeks probably. Baby looked fine and he was growing just fine. I’m just continuing to get more and more swelling. They were like, “Well, shucks.” I probably went into OB triage three times because I had systolic pressures above 150. 

Meagan: Oh!

Anneke: Yeah. The third time I went in, they said, “Stop taking your blood pressure. Stop coming in. You’re fine.” 

Meagan: Did you have protein at all? 

Anneke: No, so everything was always really clear. I was peeing in a cup every time I went into the OB’s office. They would take my blood pressure and they’d say, “You’re fine.” I went in sometime in October to get my flu shot and they said, “Oh, your diastolic (bottom number), is a little high.” I had an OB visit two days later and they said, “Just let him know.” 

He put me on metoprolol, a beta-blocker blood pressure medication, and had me start tracking my blood pressure which was kind of validating because I had been trying to tell them for weeks that my blood pressure was high. So I’m tracking it and the metoprolo was working okay. My blood pressure was elevated, but it wasn’t scary. 

I went to my 32-week visit and I actually did have a little bit of protein in my urine at that visit. So we were living in Salem which is the capital of Oregon so it’s a big city. The big research hospital is only an hour away. It’s really close. They went and sent me for bloodwork after I had some protein in my urine. They called me later that day and said, “Hey, your numbers are borderline so we want you to come in and get these injections.”

Nobody had talked to me about preeclampsia. Nobody had talked to me about, “Hey, we’re concerned about this.” They were just like, “Hey, you’re probably looking at an induction at 37 weeks.” They said, “You’re borderline. We need you to come in for these shots.” I was heading down to Lakeview where I live now to do some contract work. 

I said, “Well, I’m going out of town this weekend. Can it wait until next week?” I could come tomorrow. The shots are supposed to be 24 hours apart. They said, “Oh yeah, yeah. It’s fine.” Now, looking back, in a movie, that’s where they would say, “Dun, dun, dun.” They sent me 5.5 hours away to rural Oregon where the only hospital there is a critical access hospital that does not have a NICU. It does not have on-call anesthesia. It has nothing. Although now, having been here, it has a lot more than what we think. 

So anyway, I go down. I work that day. I woke up the next morning and had all of the preeclampsia symptoms. I bet I had gained 20 pounds overnight. 

Meagan: Oh man. 

Anneke: My blood pressure was 180/25. I came down and my mom and my husband were staring at me because I was so swollen. 

Meagan: You didn’t look good. 

Anneke: Yeah, and because of the attitude I got from triage– my husband had me call triage up in Salem and they said, “You need to go in right away.” But they had sent me home so many times before, so I was like, “Well, I have a hair appointment so I’m going to go to my hair appointment.” My hair looked awesome and I walked into the local ER here. This is where I grew up, so I knew everybody working and they didn’t recognize me because I was so swollen. 

I had gone from borderline preeclamptic on Wednesday to by Saturday morning, severely preeclamptic. I ended up being life-flighted out to Salem. 

Meagan: Oh my gosh. 

Anneke: The ER doc that was here said, “If you were one week farther along, I would deliver you.” I was only 33 weeks at that point. 

They got me up to Salem and they were able to stabilize me. They said, “Okay. We’re just going to go week by week. We’re going to try to hold you off until 34 and 35 and get you as close as we can.” So Saturday went by. Everything was looking better. Sunday, our game plan was to wait, and then by Sunday evening, I had stopped peeing. I was drinking tons of fluid. That was actually the first time– I mean, I’m a medical provider and that was the first time that I was like, “Okay. Something is wrong.”

Meagan: Yeah. My body is not happy right now. 

Anneke: Yeah. The nurse was like, “Okay, come on. Let’s just go pee.” I was like, “Dude. There’s nothing in there.” Lo and behold, I had kicked over to near eclampsia. They worked for a couple of hours to try to get my blood pressure down and stabilize me. It wouldn’t stabilize. The OB who was at the hospital in Salem came in and said, “I think we are going to induce you tonight and you’re going to have 36 hours to deliver or we’re going to take you to C-section.” 

That was really scary for me. I had a doula. I had a doula team that I loved, but my whole birth plan was movement. I really wanted to go medication-free, but they said, “Look, no. We’re going to induce you. Cytotec, Pitocin, and you’re going to be in bed.” I got really scared and talked to my doula and my husband, and then the OB came back in probably an hour later and said, “Nope. Actually, we’re just going to take you to C-section,” then basically turned around and walked off. 

The poor nurse. I remember just bursting into tears because even though I was scared of not moving, I really didn’t want a C-section. That actually– my son was born the next morning at 3:00 AM and they whisked him straight to the NICU then because of all of the magnesium they had me on, I didn’t hold him. That was Monday morning. I probably didn’t hold him until Tuesday afternoon. I got to see him briefly, but one of the things that stands out to me the most is being in the PACU, the recovery from surgery, and the doc staying with me for about 2.5 hours. 

Looking back, docs don’t stay with you. 

Meagan: No. 

Anneke: They are very worried about you if they are by your bedside for 2.5 hours. We were really lucky. We had a very short NICU stay. We had a wonderful NICU team. My recovery was rough, but as soon as I gave birth, the preeclampsia started to fade. I lost all of that water and I felt a lot better. 

But I walked out of the hospital 10 days later with my baby, looked at my husband and said, “Next time, I am doing a vaginal birth.” He was like, “Pump the brakes for a minute.” 

Meagan: He’s like, “Maybe let’s just not even talk about that.” 

Anneke: Yeah. But I was so committed. I had really severe postpartum anxiety that I probably should have been treated for because if anyone comes out of the NICU, you come out of this gruesome schedule of waking your baby up and pumping and feeding. So for about 6 weeks, I just didn’t sleep and had really severe postpartum anxiety. I should have been treated probably, but you’re not really in a headspace to think about that. 

But I remember, thank God for my mom and my husband, screaming at my mom about washing the bottles incorrectly. Thank goodness my mom loves me because she was like, “Okay,” and just supported me. 

Meagan: Yeah, but those are actually signs of postpartum anxiety where you need things to have to be just so or you’re really nervous about a binky falling on the ground. Yeah. It seems super irrational to other people, but it is so real to the person going through it. 

Anneke: Right. Right. I think it just speaks to the lack of postpartum care that we have. They discharged me. I mean, I found out about 5 years later that I almost died that night. The Cesarean was life-saving. That was absolutely what I needed. They discharged me 5 days later with just, “All right. We’ll see you in 6 weeks,” and then at 6 weeks, they’re like, “Well, back in the saddle, Sally.” There’s no coverage there. No coverage of care for me. 

Meagan: I know. It’s where we’re going wrong. 

Anneke: Right. 

Meagan: They’re going wrong in the postpartum area in a lot of ways. 

Anneke: Yeah. I had trauma and nervousness. It was probably 6 or 7 months before I finally came out of that postpartum anxiety, probably a year before I felt like myself. After about a year, I mean, I think just like everybody, you’re like, “Okay. I could do this again.” You know? I started to get in shape. I started to exercise again, and then I had this weird episode of bleeding. I thought, “Oh, it’s just my period coming back and being stupid. 

It actually ended up being a miscarriage. I had never gotten pregnant before. I had never gotten pregnant on my own before so it was kind of this weird happy/sad experience. Fortunately, we were able to naturally conceive my second child, my first daughter, about two months later. 

Meagan: That’s awesome. 

Anneke: Yeah, it was amazing. I was so grateful. I found immediately that I had this focus on wanting this vaginal birth. I felt very fortunate because the other podcast I listened to all throughout my pregnancy was one by Parijat Deshpande. She had a podcast– I guess she doesn’t record for it anymore– called Delivering Miracles. It was all about high-risk pregnancy and doing all you can to reduce your risks of having a high-risk pregnancy and also recovering. 

I think I emailed her office person every week for a year because I really wanted to work with her. I finally was able to get in with her right around the time we found out we were pregnant. She does a lot of trauma relief work. It’s a lot less of talking out your issues and more using movements and visualizations to help bring down your sympathetic fight and flight nervous system. 

I worked with her throughout my entire pregnancy. I felt like a rockstar. There was no swelling. I guess in the meantime, the other part of the story is that we had moved down to Lakeview– the really rural, critical-access hospital place. We moved down here in between my first and second child. There are no VBACs here so the closest place is about 3.5 hours away for a supportive VBAC provider. 

Meagan: That’s a long drive. 

Anneke: It’s a long drive. We actually made the decision that we were going to go back to Salem to do a VBAC. I love my provider down here. I actually went with the guy who admitted me to the ER the day I had preeclampsia. He was a totally different personality than I thought was going to be a good fit for me. When he admitted me that day in the ER, he explained exactly what was happening to me. He explained why he wanted me to do the things he wanted me to do. I thought being flown– and he explained, “Look. You could have a seizure. You could have a stroke. This is my very strong recommendation. This is not a prison, but this is a strong recommendation.” 

I just really liked that approach. I felt like I had a lot of trust there. He had saved my life. I mean, it sounds dramatic, but he had saved my life once. I went with him again and he was very supportive of figuring out how to make the VBAC work and when to go and how to transition, but he also had a backup plan for a Cesarean just in case. 

At about 28 weeks, they always do a little ultrasound at the visits, and she was breech but everything else looked fine. He was like, “Oh, you have plenty of time.” The weeks go on and she continues to be breech. He’s in the back of his head thinking, “Okay, we need to probably start looking at the calendar and thinking about dates.” I’m just in denial at this point. I’m like, “It’s going to happen.” Like all of the stories on The VBAC Link, you will it. You positively think. You do the stretches and the walking and the whatever and they’re going to turn. Baby is going to turn. 

We get to 34 weeks and he said, “You know, let’s just check you on ultrasound. I just want to make sure,” because my placenta had been anterior. He was like, “I just want to make sure that your placenta is off your scar in case we have to do a Cesarean.” We were excited because of course, it’s a really small town. Lakeview is where I live and it is a town of about 2,000 people and a county of about 7,000. You literally know everybody. We’re about 100 miles from the closest next hospital. We’re very rural. 

We know the ultrasound tech of course and she was like, “Oh, we’re going to do 3D,” so we walked in being very excited. She did the biophysical profile and I had a fluid level that day of– my AFI was a 4.1. 

Meagan: Oh. What week is this? 

Anneke: 34. 

Meagan: 34. That’s low. 

Anneke: That’s low. She was like, “You’re not leaving today.” I was like, “What?” So thank God, I was working with Parjat Deshpande. We immediately kick into all of the things to help keep my anxiety low and help keep it all out of my body. We were tracking so now I was doing biophysical profiles. I think they started every other day and my fluid numbers started to come back up. 

Our docs here consult with maternal-fetal medicine out of a town about 3.5 hours away. They said, “Okay, as long as you are trending upward, you are fine.” But at that point, we kind of knew that a VBAC was off the table because with that low of fluid, baby is really unlikely to turn. At that point, I was like, “Okay. Let’s just keep her healthy. Whatever we need, whatever we’ve got to do.” 

So we are chugging along and at about 35 weeks and a couple of days, my fluid level got all the way down to 2.1. It had come up and then it started to come way back down. The earliest that our hospital can deliver babies is 36 weeks. 

Meagan: You were a week out. 

Anneke: I’m a week out, yep. Oh my gosh. There’s all of this lore about low amniotic fluid, so I was probably drinking close to 2 gallons of water a day. There is no direct correlation. There is a correlation with hydration and low fluid, but not pathologically low fluid. But there is all of this lore, so I was drinking close to 2 gallons of water a day and also drinking these buttermilk and blueberry smoothies. It was an Indian culture thing to have buttermilk to help with fluids. They are actually weirdly good but I was drinking one of those every day. 

Meagan: Interesting. I’ve never even heard of that. 

Anneke: Yeah. I mean, all of the Google things. We were just doing all of the Google things. We made it to– when I was 36 weeks, both my OB and I breathed a sigh of relief. We’re like, “Okay, we made it. Okay, so here we go now. We’re going to keep tracking her to 37 and get her to early term or late preterm.” The MFM was like, “Nope, just go for it.” 

We ended up delivering her at 36+1 via Cesarean. What was so wonderful about that birth is because of my work with Parijat and really trusting in a medical team that was around me, I felt like that birth was not traumatic. It was scary and we were worried, but she came out of me and just started screaming right away. I was able to breastfeed. She came right to me in the OR and we breastfed in the OR. 

I mean, the one nice thing about having a Cesarean is that the spinal takes a long time to wear off and you have a catheter. I think I did skin-to-skin for 6 hours. My husband did not hold her for 6 hours. That was one of the things that really left me with some trauma from my son. So I just remembered these goldeny, autumn afternoons and she was just on my chest and I just could not have been happier. Even though it wasn’t the VBAC and it was preterm, it was still like I just had this incredible team around me that ultimately gave me the experience I wanted even though it wasn’t the method. 

Meagan: Right. That is something that I feel is so important to touch on because sometimes we hear Cesarean stories and we hear trauma. Scary, traumatic. 

Anneke: Right. 

Meagan: I don’t want to say that Cesareans can’t be scary or traumatic or that they’re not, but they don’t always have to be. They actually can be very healing. 

Anneke: Right. 

Meagan: And redemptive. You might think, “Oh, you didn’t get a redemption birth because you didn’t have a VBAC,” but there are a lot of really amazing beautiful wins that were very redemptive in her birth, right? 

Anneke: Right. 

Meagan: That skin-to-skin and being involved and having that team be supportive of the whole team and motivating you, “Okay, we’re going to get to 36 weeks.” All of these things are really awesome stuff. 

Anneke: Yeah. It was incredible. You know, we’ve had two births now that were– the first one was very scary. The second one was very scary and we almost stopped having kids. I had this dream of having four children. My husband is like, “Well, I wanted two. You wanted four so we compromised on four kids.” That’s what he says now, but at the time, he was like, “No. I can’t go through this again.” 

I was actually kind of along, especially for the first year, on the same path. I felt so grateful to have a positive experience. Everybody was healthy. Our family was wonderful. About a year out from her birth, maybe 7 or 8 months out from her birth, I really started feeling like I wanted to pursue our dream of having four kids. My husband really struggled with that so he and I both went to counseling. We went separately to counseling because we both had a lot of trauma actually left over from the first birth, my son’s birth. 

Both of us– he did some EMDR work which was really powerful and I just did some talk therapy which was really good. Ultimately, we decided that we wanted to have a third baby and then eventually go on for a fourth. It took us a little bit longer to get pregnant. At that time, I found out that in my first birth, they were tracking my labs and one of the things they track is sodium. That fluid imbalance, sodium is a very important lab value that we need. I was digging through pages and pages and pages of notes trying to figure out, “Why did they never even give me a chance?” 

Because even though my daughter’s birth was very redemptive, I still had this fire in me for wanting to know what a contraction felt like. In the meantime, I’ve developed this pelvic floor and OB program at our little local hospital here and I’m a childbirth educator and I’m just touting the virtues of vaginal birth and feeling like we have totally overmedicalized birth. So I’m digging through all of my notes and I find that my sodium had been trending over the 12 hours before even I realized that I wasn’t peeding. My sodium had been trending down. 

By the time they made the call to go to C-section, I was three data points away from being a 50/50 survivor. My sodium had gotten so low. I didn’t have 36 hours to try to labor. 

Meagan: Well, and when sodium gets really, really, really low, can’t you actually have a stroke? 

Anneke: Yeah. Yeah. 

Meagan: And a major stroke. 

Anneke: Yeah. Like 50/50 coin flip on survival. It actually gave me a lot of closure to see that. I wish they had explained it to me like that at the moment, but it was like, “Okay, that was the right call.” 

Meagan: Validation.

Anneke: Right. I hate it when you’re given platitudes about, “Well, healthy mom and healthy baby.” It’s like, “Well, obviously.” I wouldn’t wish for something different, but there’s also an experience that I’m looking for. 

So rolling into our third pregnancy, shoot. Being pregnant with two kids is no joke. I kind of had a harder pregnancy. We were able to conceive naturally again. 

Meagan: Yay!

Anneke: Yeah. This time, we started with maternal-fetal medicine. They were tracking us from 16 weeks on. I had monthly visits with them all the way up to 36 weeks. Again, everything is going swimmingly. She looked lovely. My fluid is great. My blood pressure is low. We get to 28 weeks and she’s breech. 

Along with being a pelvic floor PT and a mom of two at the time, I am a varsity volleyball coach and my husband is a wildman firefighter. If you haven’t been out west for the last couple of years, it’s been insane or I guess living under a rock because it’s made national news. So this is during the summer rolling into volleyball season. I’ve got a breech baby. I’ve got this whole plan for a VBAC. I’m going to go into labor. We’re going to drive 3.5 hours. I’m going to labor in the car with my husband driving like a grandma. We’re going to do this. 

I was back to every day listening to a VBAC Link podcast and just willing it into being. I hit about 33 weeks and I’m doing uterine ligament mobilizations on myself. I bought a Spinning Babies class and was doing close to 2 hours of exercises a day to do inversions and side-lying and all of the rebozo sifting. 

At about 33 weeks, a friend of mine told me about this postural restoration physical therapist over in Grants Pass which is about 4 hours away from here and I went. I got an appointment with her and drove 4 hours one way to go see her. I got in with an acupuncturist. We did all of the things. 

Meagan: Literally, yeah. 

Anneke: Literally all of the things. A little after Labor Day, my husband was home. So firefighters work for 2-3 weeks on and then they get 2-3 days off. Usually, in busy fire burn season, they will turn and burn and go back out. He came home after Labor Day and I was a wreck because I was so stressed out with trying to get her turned. It was the middle of volleyball season. It was a busy fire season. They were supposed to leave the next day to go on another 2-week assignment and I just burst into tears. He was like, “Do you need me to stay?” I’m not very good at asking for help, but I knew that if I didn’t leave everything out on the table, I would always wonder if she didn’t turn, I would always wonder, “What if?” 

We made the decision that he was going to stay back from what would have probably been his last fire assignment before she was born anyway and we did, like I said, 2-2.5 hours of exercises daily to try to get her to turn. I drove back and forth to Grants Pass several more times and then finally, I was really nervous about doing a version, but that was something that my OB in Medford had suggested as a possible thought and my OB here was like, “Look, we can’t offer you a VBAC here. I don’t feel comfortable doing a version here because we just don’t have the resources.” 

So at my 36-week appointment, I said, “Look. I don’t know how comfortable I feel with a version. Is that going to be too much?” This is what I love about my OB. He leaned forward and said, “I have never known anyone as committed to wanting a VBAC as you. I think you need to do everything.” 

We drove over to Medford. We took all of our bags just in case it threw me into labor or something. 

Meagan: Right, or you had to stay. 

Anneke: Right. We went over and saw my OB there. He was like, “Okay. You’re going to go to the hospital.” He explains the whole procedure. They couldn’t give me the uterine relaxing medication because I had a little cardiac event in the pregnancy earlier that was just a one-off but he didn’t feel comfortable giving that to me. For anyone who has been through a version, those are really uncomfortable. I mean, it wasn’t the worst pain I’ve ever felt, but it’s like being squished, very heavily squished by a full-grown man. 

You could see it in his face. He gets a hold of my daughter and he turns her 90 degrees and then she slips back. You can see that he’s like, “Oh yeah. We’ve totally got this.” He hooks his hands on again and turns her 90 degrees and she slips back. So he’s like, “Okay. Third time’s the charm. Third time’s the last time. We’re not going to do it anymore, but we’re going to get her.” 

He gets a good grip on her and he gets her to 90 degrees and gets her a little bit farther. I felt her jerk and her heart rate dropped to 60. We all just held up our hands and we’re like, “Nope. Nope.” I didn’t know this guy very well. He came very highly recommended. He was very friendly, but I’d only seen him a couple of times. He was just like, “Okay, well you can drive back to Lakeview and go schedule a C-section. We’ll see you later. I have more patients to see.” I really liked him, but I’m starting to get a little sniffly and teary. He was just like, “I’m really sorry,” and left. I think I cried the entire way home and then I cried the whole next day. I told my husband, “I’m not calling my local OB. I’m not calling him.” He was like, “Yeah, but the baby’s got to come out at some point.” 

I did finally see my OB the next week which would have been close to 38 weeks. I mean, the poor guy. I know he felt so bad, so he was like, “Okay, what can we do?” I really wanted to go into labor. I mean, this OB puts up with a lot of my shenanigans, but that was a hard no. He was like, “Absolutely not. You’re not going into labor. We’re not going to introduce bacteria when we don’t need to.”

I’d read a lot about a gentle Cesarean where mom gets to pick baby up or baby gets to go straight to her chest. 

Meagan: Mother-assisted Cesarean. We’re seeing it happen. 

Anneke: I know. I’m very committed to the next one to maybe making this happen. I’ve got to work on this guy for a little bit, but that was a hard no on this one. One week was not enough time to prepare him, but what we were able to do is I had good friends who were OB nurses. We were able to schedule it on a day that they could be there. Our normal procedure for Cesareans here is that baby is born and then they do the cord clamping and then baby goes to the warmer, but my OB for delayed cord clamping instead of just laying her on my legs, held her out with full arms extended, probably burning to let me see her. She was a big kid. She was almost 9 pounds. 

That’s actually the picture that I sent to go along with it. Then he took her over to the warmer and my friend, the nurse, was right behind him and swooped her up and brought her right to me. It was as close to that immediate skin-to-skin as we could have gotten. My struggle in the week between the version and her birth was that I just felt so broken. I really felt like my body had failed me and that for whatever reason, I wasn’t destined to ever feel a contraction or to even try to give birth vaginally. 

I worked with my therapist over that week and actually did some EMDR myself because I just really felt like what I had done was valuable. I did everything I could to give her a vaginal birth and I under no circumstances wanted that feeling of brokenness to be passed to her even via osmosis. I worked really, really hard to have that open, brave feeling the day of her birth. 

When she got put on my chest, I didn’t want any of my insecurities to get passed on to her. It was difficult after her birth too. I really struggled with feeling like I was worthy and like I had done enough. The other thing too is that I felt like I was going to have difficulty teaching childbirth education. Who am I to teach in this space? 

Meagan: I get that. When I became a doula, people would say, “Oh, so how was your vaginal birth? Did you go unmedicated?” I’m like, “I had two C-sections.” They’re like, “Well, how do you feel qualified to support me through a vaginal birth then?” It’s like, “I totally do.” Yeah. It was really something hard to overcome not having ever had a vaginal birth. 

Anneke: Right. Right. I had one patient. She sticks out to me. She said, “Well, okay. What do contractions feel like?” I had to be like, “Well, people describe them as–”. I wasn’t able to tell her and that tore me apart. Since she was born, I’ve taught two series of childbirth education. I’ve had a bunch of pregnant patients and I’ve helped patients labor and helped teach them positioning and counterpressure. I realize looking back, I’m a pelvic floor PT and I threw my entire base of knowledge into my drive and journey to achieving a vaginal birth three times. 

When that failed, I literally went with blind faith. Anything that the internet or anyone suggested to me, I tried. I prayed and I meditated and I positive-affirmed myself every day and it still didn’t happen. So in the end, I’ve never had that chance to be able to actively tell her or from experience tell my patients what a contraction felt like. 

Since my first birth, I’ve really asked, “Why? Why not me? Why does this keep happening and why can’t I just be like so many others on the podcast and so many others across the country? Why can’t I just will it into being?” So from these questions, I’m starting to believe that my story actually might begin at the end. 

After my belly has been cut into for the final time after the scar tissue knits back down and I can cough without pain, I’ve realized that maybe my story isn’t about the mechanism of birth at all but what it birthed in me which was the ability to see my own strength and give that to my people who are in a world where victimhood and fragility eat away at our resilience and our grit. 

I thought that not being able to labor to not meet my children has broken me but I can’t be broken. I can’t be a broken mother to them. I want my kids to be strong, confident, and powerful. I can’t teach them that if I can’t model that. 

So I didn’t get a vaginal delivery. I didn’t get to experience labor pain and comfort measures and to have my partner doing counterpressure and using a comb and work together to bring my babies through my pelvis. I didn’t get to look adoringly at my husband as I pulled my baby onto my chest myself, but what I did was I made the choice to put my child’s needs before my own desires and I sacrificed my body in order to protect theirs. 

My labor was really giving my control and placing trust in my medical team and God to bring my babies into the world. I’m not broken by my births. I really feel like I’d been remade into what a mother is supposed to be. 

Meagan: Absolutely. I’m just crying over here. That was beautiful. That was absolutely beautiful. You know, I’ve talked about this before, but the way we give birth doesn’t define us. It doesn’t say that we are a successful mom for giving birth vaginally or by a Cesarean. It doesn’t mean that our children are going to be weak or struggle because they didn’t come out vaginally. 

Anneke: Right. 

Meagan: Wow. I just love everything. I’m seriously crying here. That was just beautiful. You are beautiful. 

Anneke: Thank you. 

Meagan: Every single one of these births is beautiful. You don’t have to give birth vaginally to have a beautiful experience and to be a powerful mom. Like you said, “I’m not coming here today to share the vaginal birth that I wanted so badly and that I longed for,” but look at what you have done. Look at how you’ve grown. Look at how strong you are. I believe that our children– right now, they are little. They probably don’t really understand the magnitude of what a Cesarean birth or a vaginal birth even looks like and what that means, but I promise you that no matter what, these babies are going to be grateful for you. 

Women of Strength, as you are listening, know that the way you give birth does not define you. You are incredible. 

Anneke: It actually hit me during the last childbirth education series that we taught. We go around and we talk about all of the interventions for birth– epidural, IV meds, Cesarean, or vaginal. So often, we have people who say, “Well, whatever baby needs.” It actually struck me during this last class. I said, “Look, of course, it’s whatever baby needs. What you need is to cope. You need to know your strength and what will keep you strong because that is what takes you through this without trauma and takes you through feeling stronger and successful no matter the mechanism, no matter the medications, or the delivery method. It’s about how you approach your birth and how you are going to continue to be strong whether you are pushing them or whether you are being brave and being cut open. No matter what it is.” 

Meagan: No matter what, yeah. Well, thanks for that. That was amazing. 

Anneke: You’re so welcome. 

Meagan: Sorry for the sniffles, guys. That was beautiful. Congratulations. 

Anneke: Thank you. 

Meagan: Huge congratulations to all of your growth. Even through your journey with pelvic floor, you are going to help so many people. And with pelvic floor, tell us a little bit more about what you’ve learned even both ways with vaginal and Cesarean and how the pelvic floor actually is connected to both, and how even Cesarean mamas need guidance through pelvic floor. 

Anneke: Yeah, absolutely. I actually see a lot of the same issues post-vaginal and post-Cesarean birth. With vaginal birth, usually what happens is you’re pushing a watermelon through a quarter-sized hole so those muscles and your joints are designed to stretch. There are lots of movements and things that can help. It would be like overstretching your hamstring. It just reactively spasms and tightens back down. That’s even in the absence of tearing and things like that. 

Pelvic floor tension is really, really common after a vaginal birth but also after a Cesarean birth. Now you’ve lost stability from your abdomen. You can’t even sneeze for 8 weeks without feeling like you’re going to burst open. My nose actually wasn’t better for a year after my first son because it was just so fast. 

Oftentimes, I actually see a reactive spasm of the pelvic floor in women with Cesarean deliveries as well because your pelvic floor is overcompensating through your lack of abdomen support. I actually treat those women a lot of the same and then of course, we do a lot more of scar tissue work with Cesarean. It’s a lot more like abdominal training early on in women with vaginal delivery, but yeah. I mean, it’s almost identical. The initial recommendations are a little bit different, but by 6 weeks, I’m treating women the same. 

What I actually love, I wanted to mention this about rural hospitals. People get scared to deliver in rural hospitals, but what’s beautiful about our situation is that your OB will also likely be the one to come deliver and will also see you for the 3-day weight and color check, the 2-week visit, the 4-week visit, and the 8-week visit. They’ll see you at the 6-week visit for you too. We have so much better follow-up for mom and baby here than I got in a big, fancy hospital in the city. 

I think I see people way sooner than I would see them in the city. I’m seeing people easily 4 and 6 weeks out where in the city, it might be 6 or 8 months. 

Meagan: Right. There are so many of us that it’s 6 weeks out. That’s when we are going in for our first visit and they’re like, “Oh, what birth control do you want?” That’s what we’re asking. We’ve gone weeks and weeks and weeks with the pelvic pressure and that bulge or the leaking or that disconnect when we could have been doing something. Maybe 2 weeks out, we’re not doing the exact same things, but there are things that we can do even through breath with our scar or mobilization for a Cesarean and all of these things that we can do. 

If you are like the many of us who don’t get seen as you have which is the way it should be in my opinion, I think that we should be seeing people 3 days out or 2 weeks out and all of these things because that’s when so many things are not caught. Know that it’s okay. You can still turn to a pelvic floor specialist and therapist even while you’re waiting. 

Anneke: Yeah. I’ve started a program at our hospital where I actually try to catch C-section moms in-house. I’ll give them laying on your stomach and early abdominal work and how to get out of bed. Nobody teaches you how to get out of bed after a Cesarean. You can really screw up your scar tissue by straining on it too much or just be in a lot of pain for a really long time. 

The other really great thing about PT and insurance companies now is that you actually don’t often have to wait for your doctor to refer you. If you are 2 weeks out and you are still leaking or you have a lot of peeing, you don’t have to wait to see your doc. You can actually just call a pelvic floor PT and a lot of insurances will let you self-refer. It’s pretty awesome. 

Meagan: Right. It is awesome. I just think, like you were saying, we just don’t talk about pelvic floor after a Cesarean very much because we just don’t think about it. We haven’t pushed a baby out of our vagina so probably are okay, but the disconnect with our abs– Cesarean birth really is quite intense internally. So yeah. Don’t hesitate. Go out. Can you tell everyone where to follow you?

Anneke: Yeah, so where I talk most about pelvic floor and PT stuff is actually called @teamgriffith2011 on Instagram. If you are interested in finding a pelvic floor PT near you, if you go to the section on Pelvic Health, just Google that on the internet and there is actually a PT locator. That is how you will be able to find someone close to you. 

Meagan: Fantastic. Do you suggest people do it even before birth? I know you did with yours, but as a pelvic floor PT, do you suggest people go before?

Anneke: Especially if you don’t have a program in your hospital where PT tries to snag you before you leave, I would think it would be helpful. I do what I call a labor and delivery biomechanics visit. I’ll have people come in. We’ll talk about positioning and counterpressure and then I almost always give them vaginal delivery and Cesarean early-stage exercises. That would be something that a PT would be able to tell you what are the very first things you should start doing, when to start doing kegels, or how to get back. A lot of times, it’s just teaching you how to diaphragmatically breathe because that will teach you how to coordinate your pelvic floor to the yoga breath. 

Meagan: Awesome. Well, thank you so much for giving me a good cry today. 

Anneke: You’re so welcome. 

Meagan: And educating us on pelvic floor. Seriously, it was beautiful, and congratulations to all three of your babies. 

Anneke: Thank you so much. 

Meagan: Yep.

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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Anneke is a Pelvic Floor Physical Therapist from Oregon who is a long-time VBAC Link Podcast listener. During her first pregnancy, she would listen to 5+ hours of episodes commuting back and forth from work! Anneke was more than committed to having a vaginal birth with each of her pregnancies, but what she has learned from her births about advocacy, trust, and defining success are beautiful lessons that have changed her forever.

At The VBAC Link, we are here to help you achieve your goals of a vaginal birth. But even more importantly, we are here to advocate for empowered decision-making in the birth space. Anneke is an inspiring example of being educated, strong, and finding healing within circumstances that were out of her control.

“Since my first birth, I’ve asked, ‘Why? Why not me? Why does this keep happening and why can’t I just be like so many others on the podcast and so many others across the country? Why can’t I just will it into being?’ 

From these questions, I’m starting to believe that my story actually might begin at the end. I’ve realized that maybe my story isn’t about the mechanism of birth at all, but what it birthed in me which was the ability to see my own strength.”

Additional Links

The Lactation Network Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello. Wherever you are listening from, welcome to The VBAC Link. We have three beautiful stories for you today. They are all unique. They all have certain things along the way that add some unique factors. 

We have our friend Anneke. I keep questioning that, but it’s Anneke and she has had three Cesareans. Her Cesareans really all have been a little bit different and for different reasons. We’ve got IVF. We’ve got low fluid and we have breech presentation. I’m excited to share your stories or have you share your stories today, but as always, we love starting our podcast out with a review. 

Review of the Week

Today’s reviewer is from a girl named Megan. It says, “Great resource.” It says, “Such a great resource for VBAC mamas to come and listen to women’s stories and get great evidence-based practice information. I do wish these ladies would do a little less interrupting of the storytellers.” Well, I’m so sorry, Megan. We definitely do jump in so hopefully, Anneke, you don’t feel too interrupted. But we do like to be a part of your story as well because we want you to share your story, but we are listening and we are listening for the first time. We are reacting as if someone else would react the first time they are listening, right? 

So yeah. Thank you, Megan, for your review. We do love your reviews as always. Seriously, anywhere you listen– Apple Podcasts or Google. You can email us. Write us on Instagram. Let us know what your review is because we would love to read it on the next podcast. 

Anneke’s Stories

Meagan: Okay, Ms. Anneke. Welcome to the show. 

Anneke: Thank you. 

Meagan: Thank you for being here and sharing these stories. I just want to turn the time over to you and have you share away and educate these listeners. 

Anneke: Awesome, well I am a long-time listener of your podcast actually. I think I found your podcast before I gave birth to my first child. 

Meagan: Oh really? 

Anneke: Yeah. I was doing 5-hour drives. I am a pelvic floor physical therapist. 

Meagan: Oh yes. I wanted to talk about that too by the way at the end. Don’t let me forget. 

Anneke: Well, I was contracted to work where I am actually working now. It was a 5.5-hour drive. I would go down once a month and treat patients so I would listen to 5.5 hours of your podcast. 

Meagan: You would get through quite a few episodes. 

Anneke: Yeah. Lots of episodes. I always had this dream that I would be able to come on The VBAC Link with this triumphant VBAC– well, with this triumphant story. I never expected to have a Cesarean. I don’t think anybody ever does. But after I had my first, I was like, “Okay. My goal is to someday be on The VBAC Link with this triumphant story.” 

I’m not here today with the triumphant vaginal birth that I was hoping for, but I really think that my births tell three stories. The first one is about advocacy and then the second one is about trust and then the third one is about defining success. 

Meagan: Oh, that just gave me the chills. That really did. So let’s talk about this. 

Anneke: So my first pregnancy started after about three and a half years of infertility. We went all the way through to IVF. I’d been having some mental health struggles getting through all of the infertility pieces so I’d been doing counseling and that was amazingly helpful. We get into the pregnancy. Everything is going beautifully and at about 18 weeks, I had some really bad swelling. 

I told my provider and he was like, “Well, sorry. Sometimes people just get swelling.” I just went with that. A friend of mine who is a pelvic floor PT– I was seeing her because I was doing all of the things. I had prenatal yoga and I was seeing a pelvic floor therapist because I had some pelvic pain and pelvic tension in the past. She took my blood pressure one day and it had always been normal in the OB’s office. She was like, “Wow, you’re a little elevated.” 

That was in August at about 20 weeks probably. Baby looked fine and he was growing just fine. I’m just continuing to get more and more swelling. They were like, “Well, shucks.” I probably went into OB triage three times because I had systolic pressures above 150. 

Meagan: Oh!

Anneke: Yeah. The third time I went in, they said, “Stop taking your blood pressure. Stop coming in. You’re fine.” 

Meagan: Did you have protein at all? 

Anneke: No, so everything was always really clear. I was peeing in a cup every time I went into the OB’s office. They would take my blood pressure and they’d say, “You’re fine.” I went in sometime in October to get my flu shot and they said, “Oh, your diastolic (bottom number), is a little high.” I had an OB visit two days later and they said, “Just let him know.” 

He put me on metoprolol, a beta-blocker blood pressure medication, and had me start tracking my blood pressure which was kind of validating because I had been trying to tell them for weeks that my blood pressure was high. So I’m tracking it and the metoprolo was working okay. My blood pressure was elevated, but it wasn’t scary. 

I went to my 32-week visit and I actually did have a little bit of protein in my urine at that visit. So we were living in Salem which is the capital of Oregon so it’s a big city. The big research hospital is only an hour away. It’s really close. They went and sent me for bloodwork after I had some protein in my urine. They called me later that day and said, “Hey, your numbers are borderline so we want you to come in and get these injections.”

Nobody had talked to me about preeclampsia. Nobody had talked to me about, “Hey, we’re concerned about this.” They were just like, “Hey, you’re probably looking at an induction at 37 weeks.” They said, “You’re borderline. We need you to come in for these shots.” I was heading down to Lakeview where I live now to do some contract work. 

I said, “Well, I’m going out of town this weekend. Can it wait until next week?” I could come tomorrow. The shots are supposed to be 24 hours apart. They said, “Oh yeah, yeah. It’s fine.” Now, looking back, in a movie, that’s where they would say, “Dun, dun, dun.” They sent me 5.5 hours away to rural Oregon where the only hospital there is a critical access hospital that does not have a NICU. It does not have on-call anesthesia. It has nothing. Although now, having been here, it has a lot more than what we think. 

So anyway, I go down. I work that day. I woke up the next morning and had all of the preeclampsia symptoms. I bet I had gained 20 pounds overnight. 

Meagan: Oh man. 

Anneke: My blood pressure was 180/25. I came down and my mom and my husband were staring at me because I was so swollen. 

Meagan: You didn’t look good. 

Anneke: Yeah, and because of the attitude I got from triage– my husband had me call triage up in Salem and they said, “You need to go in right away.” But they had sent me home so many times before, so I was like, “Well, I have a hair appointment so I’m going to go to my hair appointment.” My hair looked awesome and I walked into the local ER here. This is where I grew up, so I knew everybody working and they didn’t recognize me because I was so swollen. 

I had gone from borderline preeclamptic on Wednesday to by Saturday morning, severely preeclamptic. I ended up being life-flighted out to Salem. 

Meagan: Oh my gosh. 

Anneke: The ER doc that was here said, “If you were one week farther along, I would deliver you.” I was only 33 weeks at that point. 

They got me up to Salem and they were able to stabilize me. They said, “Okay. We’re just going to go week by week. We’re going to try to hold you off until 34 and 35 and get you as close as we can.” So Saturday went by. Everything was looking better. Sunday, our game plan was to wait, and then by Sunday evening, I had stopped peeing. I was drinking tons of fluid. That was actually the first time– I mean, I’m a medical provider and that was the first time that I was like, “Okay. Something is wrong.”

Meagan: Yeah. My body is not happy right now. 

Anneke: Yeah. The nurse was like, “Okay, come on. Let’s just go pee.” I was like, “Dude. There’s nothing in there.” Lo and behold, I had kicked over to near eclampsia. They worked for a couple of hours to try to get my blood pressure down and stabilize me. It wouldn’t stabilize. The OB who was at the hospital in Salem came in and said, “I think we are going to induce you tonight and you’re going to have 36 hours to deliver or we’re going to take you to C-section.” 

That was really scary for me. I had a doula. I had a doula team that I loved, but my whole birth plan was movement. I really wanted to go medication-free, but they said, “Look, no. We’re going to induce you. Cytotec, Pitocin, and you’re going to be in bed.” I got really scared and talked to my doula and my husband, and then the OB came back in probably an hour later and said, “Nope. Actually, we’re just going to take you to C-section,” then basically turned around and walked off. 

The poor nurse. I remember just bursting into tears because even though I was scared of not moving, I really didn’t want a C-section. That actually– my son was born the next morning at 3:00 AM and they whisked him straight to the NICU then because of all of the magnesium they had me on, I didn’t hold him. That was Monday morning. I probably didn’t hold him until Tuesday afternoon. I got to see him briefly, but one of the things that stands out to me the most is being in the PACU, the recovery from surgery, and the doc staying with me for about 2.5 hours. 

Looking back, docs don’t stay with you. 

Meagan: No. 

Anneke: They are very worried about you if they are by your bedside for 2.5 hours. We were really lucky. We had a very short NICU stay. We had a wonderful NICU team. My recovery was rough, but as soon as I gave birth, the preeclampsia started to fade. I lost all of that water and I felt a lot better. 

But I walked out of the hospital 10 days later with my baby, looked at my husband and said, “Next time, I am doing a vaginal birth.” He was like, “Pump the brakes for a minute.” 

Meagan: He’s like, “Maybe let’s just not even talk about that.” 

Anneke: Yeah. But I was so committed. I had really severe postpartum anxiety that I probably should have been treated for because if anyone comes out of the NICU, you come out of this gruesome schedule of waking your baby up and pumping and feeding. So for about 6 weeks, I just didn’t sleep and had really severe postpartum anxiety. I should have been treated probably, but you’re not really in a headspace to think about that. 

But I remember, thank God for my mom and my husband, screaming at my mom about washing the bottles incorrectly. Thank goodness my mom loves me because she was like, “Okay,” and just supported me. 

Meagan: Yeah, but those are actually signs of postpartum anxiety where you need things to have to be just so or you’re really nervous about a binky falling on the ground. Yeah. It seems super irrational to other people, but it is so real to the person going through it. 

Anneke: Right. Right. I think it just speaks to the lack of postpartum care that we have. They discharged me. I mean, I found out about 5 years later that I almost died that night. The Cesarean was life-saving. That was absolutely what I needed. They discharged me 5 days later with just, “All right. We’ll see you in 6 weeks,” and then at 6 weeks, they’re like, “Well, back in the saddle, Sally.” There’s no coverage there. No coverage of care for me. 

Meagan: I know. It’s where we’re going wrong. 

Anneke: Right. 

Meagan: They’re going wrong in the postpartum area in a lot of ways. 

Anneke: Yeah. I had trauma and nervousness. It was probably 6 or 7 months before I finally came out of that postpartum anxiety, probably a year before I felt like myself. After about a year, I mean, I think just like everybody, you’re like, “Okay. I could do this again.” You know? I started to get in shape. I started to exercise again, and then I had this weird episode of bleeding. I thought, “Oh, it’s just my period coming back and being stupid. 

It actually ended up being a miscarriage. I had never gotten pregnant before. I had never gotten pregnant on my own before so it was kind of this weird happy/sad experience. Fortunately, we were able to naturally conceive my second child, my first daughter, about two months later. 

Meagan: That’s awesome. 

Anneke: Yeah, it was amazing. I was so grateful. I found immediately that I had this focus on wanting this vaginal birth. I felt very fortunate because the other podcast I listened to all throughout my pregnancy was one by Parijat Deshpande. She had a podcast– I guess she doesn’t record for it anymore– called Delivering Miracles. It was all about high-risk pregnancy and doing all you can to reduce your risks of having a high-risk pregnancy and also recovering. 

I think I emailed her office person every week for a year because I really wanted to work with her. I finally was able to get in with her right around the time we found out we were pregnant. She does a lot of trauma relief work. It’s a lot less of talking out your issues and more using movements and visualizations to help bring down your sympathetic fight and flight nervous system. 

I worked with her throughout my entire pregnancy. I felt like a rockstar. There was no swelling. I guess in the meantime, the other part of the story is that we had moved down to Lakeview– the really rural, critical-access hospital place. We moved down here in between my first and second child. There are no VBACs here so the closest place is about 3.5 hours away for a supportive VBAC provider. 

Meagan: That’s a long drive. 

Anneke: It’s a long drive. We actually made the decision that we were going to go back to Salem to do a VBAC. I love my provider down here. I actually went with the guy who admitted me to the ER the day I had preeclampsia. He was a totally different personality than I thought was going to be a good fit for me. When he admitted me that day in the ER, he explained exactly what was happening to me. He explained why he wanted me to do the things he wanted me to do. I thought being flown– and he explained, “Look. You could have a seizure. You could have a stroke. This is my very strong recommendation. This is not a prison, but this is a strong recommendation.” 

I just really liked that approach. I felt like I had a lot of trust there. He had saved my life. I mean, it sounds dramatic, but he had saved my life once. I went with him again and he was very supportive of figuring out how to make the VBAC work and when to go and how to transition, but he also had a backup plan for a Cesarean just in case. 

At about 28 weeks, they always do a little ultrasound at the visits, and she was breech but everything else looked fine. He was like, “Oh, you have plenty of time.” The weeks go on and she continues to be breech. He’s in the back of his head thinking, “Okay, we need to probably start looking at the calendar and thinking about dates.” I’m just in denial at this point. I’m like, “It’s going to happen.” Like all of the stories on The VBAC Link, you will it. You positively think. You do the stretches and the walking and the whatever and they’re going to turn. Baby is going to turn. 

We get to 34 weeks and he said, “You know, let’s just check you on ultrasound. I just want to make sure,” because my placenta had been anterior. He was like, “I just want to make sure that your placenta is off your scar in case we have to do a Cesarean.” We were excited because of course, it’s a really small town. Lakeview is where I live and it is a town of about 2,000 people and a county of about 7,000. You literally know everybody. We’re about 100 miles from the closest next hospital. We’re very rural. 

We know the ultrasound tech of course and she was like, “Oh, we’re going to do 3D,” so we walked in being very excited. She did the biophysical profile and I had a fluid level that day of– my AFI was a 4.1. 

Meagan: Oh. What week is this? 

Anneke: 34. 

Meagan: 34. That’s low. 

Anneke: That’s low. She was like, “You’re not leaving today.” I was like, “What?” So thank God, I was working with Parjat Deshpande. We immediately kick into all of the things to help keep my anxiety low and help keep it all out of my body. We were tracking so now I was doing biophysical profiles. I think they started every other day and my fluid numbers started to come back up. 

Our docs here consult with maternal-fetal medicine out of a town about 3.5 hours away. They said, “Okay, as long as you are trending upward, you are fine.” But at that point, we kind of knew that a VBAC was off the table because with that low of fluid, baby is really unlikely to turn. At that point, I was like, “Okay. Let’s just keep her healthy. Whatever we need, whatever we’ve got to do.” 

So we are chugging along and at about 35 weeks and a couple of days, my fluid level got all the way down to 2.1. It had come up and then it started to come way back down. The earliest that our hospital can deliver babies is 36 weeks. 

Meagan: You were a week out. 

Anneke: I’m a week out, yep. Oh my gosh. There’s all of this lore about low amniotic fluid, so I was probably drinking close to 2 gallons of water a day. There is no direct correlation. There is a correlation with hydration and low fluid, but not pathologically low fluid. But there is all of this lore, so I was drinking close to 2 gallons of water a day and also drinking these buttermilk and blueberry smoothies. It was an Indian culture thing to have buttermilk to help with fluids. They are actually weirdly good but I was drinking one of those every day. 

Meagan: Interesting. I’ve never even heard of that. 

Anneke: Yeah. I mean, all of the Google things. We were just doing all of the Google things. We made it to– when I was 36 weeks, both my OB and I breathed a sigh of relief. We’re like, “Okay, we made it. Okay, so here we go now. We’re going to keep tracking her to 37 and get her to early term or late preterm.” The MFM was like, “Nope, just go for it.” 

We ended up delivering her at 36+1 via Cesarean. What was so wonderful about that birth is because of my work with Parijat and really trusting in a medical team that was around me, I felt like that birth was not traumatic. It was scary and we were worried, but she came out of me and just started screaming right away. I was able to breastfeed. She came right to me in the OR and we breastfed in the OR. 

I mean, the one nice thing about having a Cesarean is that the spinal takes a long time to wear off and you have a catheter. I think I did skin-to-skin for 6 hours. My husband did not hold her for 6 hours. That was one of the things that really left me with some trauma from my son. So I just remembered these goldeny, autumn afternoons and she was just on my chest and I just could not have been happier. Even though it wasn’t the VBAC and it was preterm, it was still like I just had this incredible team around me that ultimately gave me the experience I wanted even though it wasn’t the method. 

Meagan: Right. That is something that I feel is so important to touch on because sometimes we hear Cesarean stories and we hear trauma. Scary, traumatic. 

Anneke: Right. 

Meagan: I don’t want to say that Cesareans can’t be scary or traumatic or that they’re not, but they don’t always have to be. They actually can be very healing. 

Anneke: Right. 

Meagan: And redemptive. You might think, “Oh, you didn’t get a redemption birth because you didn’t have a VBAC,” but there are a lot of really amazing beautiful wins that were very redemptive in her birth, right? 

Anneke: Right. 

Meagan: That skin-to-skin and being involved and having that team be supportive of the whole team and motivating you, “Okay, we’re going to get to 36 weeks.” All of these things are really awesome stuff. 

Anneke: Yeah. It was incredible. You know, we’ve had two births now that were– the first one was very scary. The second one was very scary and we almost stopped having kids. I had this dream of having four children. My husband is like, “Well, I wanted two. You wanted four so we compromised on four kids.” That’s what he says now, but at the time, he was like, “No. I can’t go through this again.” 

I was actually kind of along, especially for the first year, on the same path. I felt so grateful to have a positive experience. Everybody was healthy. Our family was wonderful. About a year out from her birth, maybe 7 or 8 months out from her birth, I really started feeling like I wanted to pursue our dream of having four kids. My husband really struggled with that so he and I both went to counseling. We went separately to counseling because we both had a lot of trauma actually left over from the first birth, my son’s birth. 

Both of us– he did some EMDR work which was really powerful and I just did some talk therapy which was really good. Ultimately, we decided that we wanted to have a third baby and then eventually go on for a fourth. It took us a little bit longer to get pregnant. At that time, I found out that in my first birth, they were tracking my labs and one of the things they track is sodium. That fluid imbalance, sodium is a very important lab value that we need. I was digging through pages and pages and pages of notes trying to figure out, “Why did they never even give me a chance?” 

Because even though my daughter’s birth was very redemptive, I still had this fire in me for wanting to know what a contraction felt like. In the meantime, I’ve developed this pelvic floor and OB program at our little local hospital here and I’m a childbirth educator and I’m just touting the virtues of vaginal birth and feeling like we have totally overmedicalized birth. So I’m digging through all of my notes and I find that my sodium had been trending over the 12 hours before even I realized that I wasn’t peeding. My sodium had been trending down. 

By the time they made the call to go to C-section, I was three data points away from being a 50/50 survivor. My sodium had gotten so low. I didn’t have 36 hours to try to labor. 

Meagan: Well, and when sodium gets really, really, really low, can’t you actually have a stroke? 

Anneke: Yeah. Yeah. 

Meagan: And a major stroke. 

Anneke: Yeah. Like 50/50 coin flip on survival. It actually gave me a lot of closure to see that. I wish they had explained it to me like that at the moment, but it was like, “Okay, that was the right call.” 

Meagan: Validation.

Anneke: Right. I hate it when you’re given platitudes about, “Well, healthy mom and healthy baby.” It’s like, “Well, obviously.” I wouldn’t wish for something different, but there’s also an experience that I’m looking for. 

So rolling into our third pregnancy, shoot. Being pregnant with two kids is no joke. I kind of had a harder pregnancy. We were able to conceive naturally again. 

Meagan: Yay!

Anneke: Yeah. This time, we started with maternal-fetal medicine. They were tracking us from 16 weeks on. I had monthly visits with them all the way up to 36 weeks. Again, everything is going swimmingly. She looked lovely. My fluid is great. My blood pressure is low. We get to 28 weeks and she’s breech. 

Along with being a pelvic floor PT and a mom of two at the time, I am a varsity volleyball coach and my husband is a wildman firefighter. If you haven’t been out west for the last couple of years, it’s been insane or I guess living under a rock because it’s made national news. So this is during the summer rolling into volleyball season. I’ve got a breech baby. I’ve got this whole plan for a VBAC. I’m going to go into labor. We’re going to drive 3.5 hours. I’m going to labor in the car with my husband driving like a grandma. We’re going to do this. 

I was back to every day listening to a VBAC Link podcast and just willing it into being. I hit about 33 weeks and I’m doing uterine ligament mobilizations on myself. I bought a Spinning Babies class and was doing close to 2 hours of exercises a day to do inversions and side-lying and all of the rebozo sifting. 

At about 33 weeks, a friend of mine told me about this postural restoration physical therapist over in Grants Pass which is about 4 hours away from here and I went. I got an appointment with her and drove 4 hours one way to go see her. I got in with an acupuncturist. We did all of the things. 

Meagan: Literally, yeah. 

Anneke: Literally all of the things. A little after Labor Day, my husband was home. So firefighters work for 2-3 weeks on and then they get 2-3 days off. Usually, in busy fire burn season, they will turn and burn and go back out. He came home after Labor Day and I was a wreck because I was so stressed out with trying to get her turned. It was the middle of volleyball season. It was a busy fire season. They were supposed to leave the next day to go on another 2-week assignment and I just burst into tears. He was like, “Do you need me to stay?” I’m not very good at asking for help, but I knew that if I didn’t leave everything out on the table, I would always wonder if she didn’t turn, I would always wonder, “What if?” 

We made the decision that he was going to stay back from what would have probably been his last fire assignment before she was born anyway and we did, like I said, 2-2.5 hours of exercises daily to try to get her to turn. I drove back and forth to Grants Pass several more times and then finally, I was really nervous about doing a version, but that was something that my OB in Medford had suggested as a possible thought and my OB here was like, “Look, we can’t offer you a VBAC here. I don’t feel comfortable doing a version here because we just don’t have the resources.” 

So at my 36-week appointment, I said, “Look. I don’t know how comfortable I feel with a version. Is that going to be too much?” This is what I love about my OB. He leaned forward and said, “I have never known anyone as committed to wanting a VBAC as you. I think you need to do everything.” 

We drove over to Medford. We took all of our bags just in case it threw me into labor or something. 

Meagan: Right, or you had to stay. 

Anneke: Right. We went over and saw my OB there. He was like, “Okay. You’re going to go to the hospital.” He explains the whole procedure. They couldn’t give me the uterine relaxing medication because I had a little cardiac event in the pregnancy earlier that was just a one-off but he didn’t feel comfortable giving that to me. For anyone who has been through a version, those are really uncomfortable. I mean, it wasn’t the worst pain I’ve ever felt, but it’s like being squished, very heavily squished by a full-grown man. 

You could see it in his face. He gets a hold of my daughter and he turns her 90 degrees and then she slips back. You can see that he’s like, “Oh yeah. We’ve totally got this.” He hooks his hands on again and turns her 90 degrees and she slips back. So he’s like, “Okay. Third time’s the charm. Third time’s the last time. We’re not going to do it anymore, but we’re going to get her.” 

He gets a good grip on her and he gets her to 90 degrees and gets her a little bit farther. I felt her jerk and her heart rate dropped to 60. We all just held up our hands and we’re like, “Nope. Nope.” I didn’t know this guy very well. He came very highly recommended. He was very friendly, but I’d only seen him a couple of times. He was just like, “Okay, well you can drive back to Lakeview and go schedule a C-section. We’ll see you later. I have more patients to see.” I really liked him, but I’m starting to get a little sniffly and teary. He was just like, “I’m really sorry,” and left. I think I cried the entire way home and then I cried the whole next day. I told my husband, “I’m not calling my local OB. I’m not calling him.” He was like, “Yeah, but the baby’s got to come out at some point.” 

I did finally see my OB the next week which would have been close to 38 weeks. I mean, the poor guy. I know he felt so bad, so he was like, “Okay, what can we do?” I really wanted to go into labor. I mean, this OB puts up with a lot of my shenanigans, but that was a hard no. He was like, “Absolutely not. You’re not going into labor. We’re not going to introduce bacteria when we don’t need to.”

I’d read a lot about a gentle Cesarean where mom gets to pick baby up or baby gets to go straight to her chest. 

Meagan: Mother-assisted Cesarean. We’re seeing it happen. 

Anneke: I know. I’m very committed to the next one to maybe making this happen. I’ve got to work on this guy for a little bit, but that was a hard no on this one. One week was not enough time to prepare him, but what we were able to do is I had good friends who were OB nurses. We were able to schedule it on a day that they could be there. Our normal procedure for Cesareans here is that baby is born and then they do the cord clamping and then baby goes to the warmer, but my OB for delayed cord clamping instead of just laying her on my legs, held her out with full arms extended, probably burning to let me see her. She was a big kid. She was almost 9 pounds. 

That’s actually the picture that I sent to go along with it. Then he took her over to the warmer and my friend, the nurse, was right behind him and swooped her up and brought her right to me. It was as close to that immediate skin-to-skin as we could have gotten. My struggle in the week between the version and her birth was that I just felt so broken. I really felt like my body had failed me and that for whatever reason, I wasn’t destined to ever feel a contraction or to even try to give birth vaginally. 

I worked with my therapist over that week and actually did some EMDR myself because I just really felt like what I had done was valuable. I did everything I could to give her a vaginal birth and I under no circumstances wanted that feeling of brokenness to be passed to her even via osmosis. I worked really, really hard to have that open, brave feeling the day of her birth. 

When she got put on my chest, I didn’t want any of my insecurities to get passed on to her. It was difficult after her birth too. I really struggled with feeling like I was worthy and like I had done enough. The other thing too is that I felt like I was going to have difficulty teaching childbirth education. Who am I to teach in this space? 

Meagan: I get that. When I became a doula, people would say, “Oh, so how was your vaginal birth? Did you go unmedicated?” I’m like, “I had two C-sections.” They’re like, “Well, how do you feel qualified to support me through a vaginal birth then?” It’s like, “I totally do.” Yeah. It was really something hard to overcome not having ever had a vaginal birth. 

Anneke: Right. Right. I had one patient. She sticks out to me. She said, “Well, okay. What do contractions feel like?” I had to be like, “Well, people describe them as–”. I wasn’t able to tell her and that tore me apart. Since she was born, I’ve taught two series of childbirth education. I’ve had a bunch of pregnant patients and I’ve helped patients labor and helped teach them positioning and counterpressure. I realize looking back, I’m a pelvic floor PT and I threw my entire base of knowledge into my drive and journey to achieving a vaginal birth three times. 

When that failed, I literally went with blind faith. Anything that the internet or anyone suggested to me, I tried. I prayed and I meditated and I positive-affirmed myself every day and it still didn’t happen. So in the end, I’ve never had that chance to be able to actively tell her or from experience tell my patients what a contraction felt like. 

Since my first birth, I’ve really asked, “Why? Why not me? Why does this keep happening and why can’t I just be like so many others on the podcast and so many others across the country? Why can’t I just will it into being?” So from these questions, I’m starting to believe that my story actually might begin at the end. 

After my belly has been cut into for the final time after the scar tissue knits back down and I can cough without pain, I’ve realized that maybe my story isn’t about the mechanism of birth at all but what it birthed in me which was the ability to see my own strength and give that to my people who are in a world where victimhood and fragility eat away at our resilience and our grit. 

I thought that not being able to labor to not meet my children has broken me but I can’t be broken. I can’t be a broken mother to them. I want my kids to be strong, confident, and powerful. I can’t teach them that if I can’t model that. 

So I didn’t get a vaginal delivery. I didn’t get to experience labor pain and comfort measures and to have my partner doing counterpressure and using a comb and work together to bring my babies through my pelvis. I didn’t get to look adoringly at my husband as I pulled my baby onto my chest myself, but what I did was I made the choice to put my child’s needs before my own desires and I sacrificed my body in order to protect theirs. 

My labor was really giving my control and placing trust in my medical team and God to bring my babies into the world. I’m not broken by my births. I really feel like I’d been remade into what a mother is supposed to be. 

Meagan: Absolutely. I’m just crying over here. That was beautiful. That was absolutely beautiful. You know, I’ve talked about this before, but the way we give birth doesn’t define us. It doesn’t say that we are a successful mom for giving birth vaginally or by a Cesarean. It doesn’t mean that our children are going to be weak or struggle because they didn’t come out vaginally. 

Anneke: Right. 

Meagan: Wow. I just love everything. I’m seriously crying here. That was just beautiful. You are beautiful. 

Anneke: Thank you. 

Meagan: Every single one of these births is beautiful. You don’t have to give birth vaginally to have a beautiful experience and to be a powerful mom. Like you said, “I’m not coming here today to share the vaginal birth that I wanted so badly and that I longed for,” but look at what you have done. Look at how you’ve grown. Look at how strong you are. I believe that our children– right now, they are little. They probably don’t really understand the magnitude of what a Cesarean birth or a vaginal birth even looks like and what that means, but I promise you that no matter what, these babies are going to be grateful for you. 

Women of Strength, as you are listening, know that the way you give birth does not define you. You are incredible. 

Anneke: It actually hit me during the last childbirth education series that we taught. We go around and we talk about all of the interventions for birth– epidural, IV meds, Cesarean, or vaginal. So often, we have people who say, “Well, whatever baby needs.” It actually struck me during this last class. I said, “Look, of course, it’s whatever baby needs. What you need is to cope. You need to know your strength and what will keep you strong because that is what takes you through this without trauma and takes you through feeling stronger and successful no matter the mechanism, no matter the medications, or the delivery method. It’s about how you approach your birth and how you are going to continue to be strong whether you are pushing them or whether you are being brave and being cut open. No matter what it is.” 

Meagan: No matter what, yeah. Well, thanks for that. That was amazing. 

Anneke: You’re so welcome. 

Meagan: Sorry for the sniffles, guys. That was beautiful. Congratulations. 

Anneke: Thank you. 

Meagan: Huge congratulations to all of your growth. Even through your journey with pelvic floor, you are going to help so many people. And with pelvic floor, tell us a little bit more about what you’ve learned even both ways with vaginal and Cesarean and how the pelvic floor actually is connected to both, and how even Cesarean mamas need guidance through pelvic floor. 

Anneke: Yeah, absolutely. I actually see a lot of the same issues post-vaginal and post-Cesarean birth. With vaginal birth, usually what happens is you’re pushing a watermelon through a quarter-sized hole so those muscles and your joints are designed to stretch. There are lots of movements and things that can help. It would be like overstretching your hamstring. It just reactively spasms and tightens back down. That’s even in the absence of tearing and things like that. 

Pelvic floor tension is really, really common after a vaginal birth but also after a Cesarean birth. Now you’ve lost stability from your abdomen. You can’t even sneeze for 8 weeks without feeling like you’re going to burst open. My nose actually wasn’t better for a year after my first son because it was just so fast. 

Oftentimes, I actually see a reactive spasm of the pelvic floor in women with Cesarean deliveries as well because your pelvic floor is overcompensating through your lack of abdomen support. I actually treat those women a lot of the same and then of course, we do a lot more of scar tissue work with Cesarean. It’s a lot more like abdominal training early on in women with vaginal delivery, but yeah. I mean, it’s almost identical. The initial recommendations are a little bit different, but by 6 weeks, I’m treating women the same. 

What I actually love, I wanted to mention this about rural hospitals. People get scared to deliver in rural hospitals, but what’s beautiful about our situation is that your OB will also likely be the one to come deliver and will also see you for the 3-day weight and color check, the 2-week visit, the 4-week visit, and the 8-week visit. They’ll see you at the 6-week visit for you too. We have so much better follow-up for mom and baby here than I got in a big, fancy hospital in the city. 

I think I see people way sooner than I would see them in the city. I’m seeing people easily 4 and 6 weeks out where in the city, it might be 6 or 8 months. 

Meagan: Right. There are so many of us that it’s 6 weeks out. That’s when we are going in for our first visit and they’re like, “Oh, what birth control do you want?” That’s what we’re asking. We’ve gone weeks and weeks and weeks with the pelvic pressure and that bulge or the leaking or that disconnect when we could have been doing something. Maybe 2 weeks out, we’re not doing the exact same things, but there are things that we can do even through breath with our scar or mobilization for a Cesarean and all of these things that we can do. 

If you are like the many of us who don’t get seen as you have which is the way it should be in my opinion, I think that we should be seeing people 3 days out or 2 weeks out and all of these things because that’s when so many things are not caught. Know that it’s okay. You can still turn to a pelvic floor specialist and therapist even while you’re waiting. 

Anneke: Yeah. I’ve started a program at our hospital where I actually try to catch C-section moms in-house. I’ll give them laying on your stomach and early abdominal work and how to get out of bed. Nobody teaches you how to get out of bed after a Cesarean. You can really screw up your scar tissue by straining on it too much or just be in a lot of pain for a really long time. 

The other really great thing about PT and insurance companies now is that you actually don’t often have to wait for your doctor to refer you. If you are 2 weeks out and you are still leaking or you have a lot of peeing, you don’t have to wait to see your doc. You can actually just call a pelvic floor PT and a lot of insurances will let you self-refer. It’s pretty awesome. 

Meagan: Right. It is awesome. I just think, like you were saying, we just don’t talk about pelvic floor after a Cesarean very much because we just don’t think about it. We haven’t pushed a baby out of our vagina so probably are okay, but the disconnect with our abs– Cesarean birth really is quite intense internally. So yeah. Don’t hesitate. Go out. Can you tell everyone where to follow you?

Anneke: Yeah, so where I talk most about pelvic floor and PT stuff is actually called @teamgriffith2011 on Instagram. If you are interested in finding a pelvic floor PT near you, if you go to the section on Pelvic Health, just Google that on the internet and there is actually a PT locator. That is how you will be able to find someone close to you. 

Meagan: Fantastic. Do you suggest people do it even before birth? I know you did with yours, but as a pelvic floor PT, do you suggest people go before?

Anneke: Especially if you don’t have a program in your hospital where PT tries to snag you before you leave, I would think it would be helpful. I do what I call a labor and delivery biomechanics visit. I’ll have people come in. We’ll talk about positioning and counterpressure and then I almost always give them vaginal delivery and Cesarean early-stage exercises. That would be something that a PT would be able to tell you what are the very first things you should start doing, when to start doing kegels, or how to get back. A lot of times, it’s just teaching you how to diaphragmatically breathe because that will teach you how to coordinate your pelvic floor to the yoga breath. 

Meagan: Awesome. Well, thank you so much for giving me a good cry today. 

Anneke: You’re so welcome. 

Meagan: And educating us on pelvic floor. Seriously, it was beautiful, and congratulations to all three of your babies. 

Anneke: Thank you so much. 

Meagan: Yep.

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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After 24 hours of laboring with broken waters, dilating to 10 centimeters, and pushing, Wendy’s first baby was still not descending. She was exhausted and consented to a C-section. When her baby came out at 11 pounds, 3 ounces, the entire medical team told Wendy that her baby would have never come out vaginally due to his size. 

Wendy’s second baby was ALSO 11 pounds, 3 ounces, and was indeed born vaginally. 

We are inspired by all of the obstacles that Wendy overcame to achieve the birth she wanted and love how she is already inspiring those around her to fight for their rights in the birth space too!

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Full Transcript under Episode Details 

Meagan: Hello, hello. This is Meagan. I have an episode. Well, we– I should say– me and my friend, Wendy. We have an episode for you today that’s all about big babies, and not all about babies. We’re going to be talking about induction and things like that but big babies, you guys. This is one of the most frustrating things to me. 

I’m sure, Wendy, maybe it would be to you because you did have larger-sized babies so maybe you heard it and felt it, but I remember when I was pregnant with my first. I definitely gained more than I anticipated. I swelled on top of that. I remember going to work and my coworker– I was going to the kitchen to get something. I don’t even know. He was like, “Whoa. Do you need a wheelbarrow?” I was like, “Jeez Louise.” He was like, “You’ve got a really big kid inside of ya.” I was just like, “Wow. Thank you so much as I am 7 months pregnant and you are telling me that I am ginormous.” Right?

I just know that through doula work, we have clients all the time being told, “You’re probably going to have a big baby.” They start the big baby fear really early on. So in our minds, it’s like, “Well, am I going to have a big baby? Do I not want to have a big baby? What do I do to not have a big baby?” Our minds just spiral and it’s not healthy for us to be stressing over the size of our baby but we do find ourselves being stressed. 

We find ourselves being stressed without being told that we have a big baby, and then when we are constantly told, “You might have a big baby,” that can be daunting or scary. If you were told or if you believe or are being told that they believe that you have a big baby today, this is an episode for you for sure. 

We talk about big babies and we’re going to talk a little bit more about what would be considered a big baby because I’ve also heard of 7-pound babies being told that they were big babies and they are not big babies. So buckle up, we are going to be talking about big babies, induction, and all of the things. 

Review of the Week

But of course, we have a Review of the Week so I want to get into that. This is from Kelly and she left it on Google. If you didn’t know, you can Google “The VBAC Link” and you can leave us a review right there. Of course, you can do it on Apple Podcasts or you can message us on Facebook or even on our personal Instagram or at [email protected]. Definitely check out Google because we love your Google reviews. 

Kelly says, “Julie and Meagan are fantastic. They are truly dedicated to providing the most up-to-date information on VBAC. A great resource.” I agree. I mean, not to toot our own horns, but I do believe that we are a great resource. We are honored to be a resource for you if you are listening. 

Wendy’s Stories

Meagan: Okay, Ms. Wendy. 

Wendy: Hello. 

Meagan: Hello. So you are from Michigan? 

Wendy: Yep. 

Meagan: You had your babies in Michigan so born and raised and stayed forever. That’s how I am. Born and raised in Utah. I haven’t ever left. 

Wendy: That’s right. 

Meagan: But you have two boys and you love being outdoors and doing all of the fun things. So yeah. Tell us more about you and how these cute little boys brought themselves into the world. 

Wendy: Yeah, well thank you for having me. I have two– I was about to say little– but as you are about to find out, they were very large. 

Meagan: Not so little when they came out. 

Wendy: Not so little, no. Although my older one now has kind of tapered out. His charts are coming down which is crazy. So yeah. I guess I can just get into it. My older son just turned two last month. My little guy is two months now so they are just about two years apart now. 

Meagan: Two and two months, awesome. 

Wendy: Yeah, and they are great together. It’s amazing to watch. 

Okay, so I guess I’ll start with the story of Isaac who is my firstborn and then I’ll get on to Levi who is my second guy. Since we already know this is about big babies, I’ll start by saying that I myself was a very large baby. 

Meagan: Were you?

Wendy: I was. I was 11 pounds, 9 ounces. 

Meagan: Okay. 

Wendy: My mom is a very, very petite woman. I was the third-born though, so I guess that’s a little bit more likely than your first being really big, but that was really shocking. She did have me vaginally. 

Meagan: I was just going to ask that. I was going to say, “Did she have you vaginally?”

Wendy: Yeah, yes. She did have an epidural though. It’s funny because after she had me, the doctors were like, “Wow. We’ve never had a baby this big. If we knew, we would have had you have a Cesarean.” She did it. 

Meagan: But why?

Wendy: It just goes to show that there are a lot of mentalities that it should be that way. So for my first guy, I planned for a home birth because I got pregnant right when COVID started. I think it was June 2020. The hospitals were crazy. In some places, you couldn’t even have your partner in the hospital. I also have never really feared birth that much so I was like, “Okay, with that and these COVID restrictions, I’m going to do it at home.”

From the beginning, he was measuring big. At the 20-week ultrasound, he was in the 99th percentile which was not concerning to my midwife. She was like, “Oh, you know. Those could be off. It’s all good.” I’m like, “Okay.” 

At 33 weeks, I had a small bleeding incident. It wasn’t anything crazy, but it was enough that I went to the emergency room and I got checked out. The doctors at the hospital said I had a marginal placental abruption. 

Meagan: Oh, okay. 

Wendy: It actually never showed on the ultrasound. That’s what they said but they didn’t really know. It was just a one-time thing that happened. 

Meagan: It was just a possible diagnosis. 

Wendy: Yeah, right. But it was scary. They sent the NICU doctors in when I was there. They were like, “Just in case. We might have to induce you.” It was scary. I talked to my midwife and she did say that she would continue to take me if I wanted but that there were risks involved so I ended up changing to a birthing center that was about an hour away. That’s the Ann Arbor Children’s Hospital. They are a reputable, really great hospital so I felt really good going there. 

My midwife became my doula. That was nice to have her alongside me. I did the gestational diabetes test. I did it at home with my finger picking and on that, it actually showed that my levels were high, so for a month, I had a really healthy diet but then I eventually did the 3-hour test and my levels were totally fine. I guess the monitor was faulty. I don’t know. That’s what the midwife said. She was like, “I guess you don’t have it.” I was like, “Okay.” 

Meagan: You’re like, “All right, great.” 

Wendy: Yeah. I was like, “I guess I’ll go back to eating–”. I mean, I didn’t eat terribly but I was not eating carbs or sugar. 

Meagan: Do you think it was because you ate so clean that time that maybe it was like you were getting rid of it?

Wendy: I don’t know. Right. I’m not sure. She just said that I didn’t and she said that sometimes those monitors can be faulty. 

Meagan: It is very true. Yep. 

Wendy: Anyway, so I felt really good. I tend to have pretty smooth pregnancies according to the two that I have so it was great. People always ask, “Oh, you must have been so uncomfortable with a huge baby.” I felt fine. 

Meagan: That’s good. How tall are you?

Wendy: I’m 5’9”. 

Meagan: Okay. Yeah. Not that tall. 

Wendy: Right, yeah. Not that tall. 

Meagan: Yeah, very average. 

Wendy: Half of me is Dutch. The other half is Japanese so it’s very petite and very large people. I think I just got more of the Dutch. Maybe. 

I ended up going– I had him at 41+6 days. So at 41+4 days, I took the midwives’ brew which I know is super controversial. 

Meagan: It is. Yes. 

Wendy: But it’s okay to do. I was so far along. I see people doing it before their due date or something. I think that’s when it becomes super risky but I won’t get into that just because it is controversial. I ended up taking it twice that day because the first time, I calculated it wrong. I didn’t do enough then I was like, “Oh, shoot. That was not right,” so I did it again, and then 4 hours later, my water broke. 

I was at 41+4 days. My mom and sister both labored really quickly. Their labors were so fast so my doula assumed that I would as well because I guess it’s typical to follow in line. 

Meagan: It’s very possible especially when it’s your sister.  A lot of people think it’s more when their mom, but through my doula work, I’ve seen that the sisters' births a lot of the time align. But if it was your mom and sister, I would have been a little bit more on alert. 

Wendy: Yeah. You would think especially because we had to drive an hour away.

Meagan: Super possible, yeah. 

Wendy: Yeah, my sister’s second birth was literally like 30 minutes. 

Meagan: Holy smokes. 

Wendy: Really fast, yeah. 

Meagan: Yeah, and her first was a few hours so she was like, “We’ve got to go now.” 

Wendy: We went. Contractions didn’t really start. I ended up being in labor for 29 hours which was unexpected and the contractions came and went. One of the reasons I wanted to go to Ann Arbor was because they had hot tubs and you could actually labor in there. In the other hospitals in Michigan, you can labor in the hot tub but you can’t actually birth in the hot tub but at this place, you could actually birth in them. 

But the hot tub did not do good things for me. It slowed down my contractions both times. They completely stopped. 

Meagan: That can happen. Sometimes it’s because it relaxes you so much. 

Wendy: I literally felt like I was drugged. I couldn’t stay awake. I just kept falling asleep.

Meagan: So tired, yeah. 

Wendy: Yes. I was very tired. So that was kind of a bummer that that happened. I don’t know if that’s the reason that things didn’t go as planned, but let’s see. Yeah. So later, I did get to push and I got to 10 centimeters. I was able to push. My little guy just did not descend. I pushed for an hour and a half and he was in the same exact position at the beginning that he was after an hour and a half. 

I had also passed that 24-hour period from when my water broke.

Meagan: Did you have signs of an infection or was it just that they were like, “Hey, you passed this mark.” 

Wendy: Yes. I think the more concerning thing was the fact that he had not descended. It was that and the 24-hour mark. 

Meagan: Were they saying anything about your position or his position? Were they talking about that?

Wendy: I don’t think that he was in the best position. I don’t think my doula was as supportive in position changes as I thought she would be. She is a midwife. I think she’s more of the medical side of it and I didn’t really think about that. 

Meagan: She was like a monitrice a little bit coming in. 

Wendy: Yeah, right. So that was a little bit of a bummer because when the doctors came to me and suggested that, she was like, “Yeah. We should do it. Do a Cesarean.” I was like, “Okay.” She didn’t even say, “Let’s try another hour.”

Meagan: Interesting. 

Wendy: She was kind of throwing in the towel. She could have also been exhausted because she had been up for over 30 hours too. We ended up going for it. 

I was also going to say that laboring for me– contractions were not horrible. I did not get the epidural or anything. This is another thing. My sister would tell me that her labors were also chill. She was like, “Oh, contractions weren’t that bad.” Before I went into labor, I was like, “Oh, you’re lying. There’s no way.” Labor is so painful. That’s all I’ve ever heard. But I do think that I did get that a little bit genetically from her too because it wasn’t horrible. 

I was checked at 10 centimeters by one of the midwives there and they actually sent another one in because they didn’t– 

Meagan: They wanted to confirm. 

Wendy: Yeah. They were like, “We have never seen a woman so calm before in labor.” I was like, “Oh, that’s cool.”

Meagan: You’re like, “Thank you.” 

Wendy: Yeah, I was in labor for so long, but it was okay because it wasn’t excruciating for me. 

Meagan: It wasn’t over the top. 

Wendy: Yeah, yeah which was nice I guess.

Anyway, I ended up having him by C-section. He was 11 pounds, 3 ounces. 

Meagan: What were they all saying?

Wendy: They were all like, “Oh, that’s why he didn’t come out. Your pelvis was too small.” 

Meagan: Your pelvis was too small. Oh yeah. 

Wendy: Yeah and all the while, I’m like, “I could have done it.” I know I could have done it because my mom did it. Just having that mentality is frustrating especially because the midwife didn’t do a whole lot. 

I wasn’t angry about it or anything. I was a little bummed. I got the healthy baby. He was all good. His blood sugar was fine. 

Meagan: You were feeling good about your decision. 

Wendy: Yeah. Yeah, I’m glad it wasn’t an emergency C-section. I was able to be aware. But I didn’t have– I had my birth plan and I didn’t have anything in there for a Cesarean which when we get to my second birth, I had a section for that because I just didn’t even think about it with my first. 

Meagan: A lot of us don’t, right?

Wendy: I’m bummed that I didn’t because I didn’t even think about lowering the drape or having a clear one. They didn’t suggest that to me at all so it was kind of just a run-of-the-mill Cesarean. It was just what the standard was. 

Meagan: Yeah. 

Wendy: Yeah, so that was my first guy. That was Isaac. Then for this second guy, we conceived about 15 months after Isaac. 

Meagan: After having him? 

Wendy: Yes, after having him. I’m sorry. Did I say Isaac? Yeah, after Isaac, we waited 15 months. 

We were kind of shooting for 18 months but it happened the first time and we were like, “Okay, we’re going for it.” It was kind of a bummer though because my home midwife can’t legally take you after a C-section unless you wait 18 months. 

Meagan: Really?

Wendy: Yeah. 

Meagan: That’s a law in Michigan. Wow, okay. 

Wendy: Yeah, so I was just like, “Okay. Well, that’s a bummer. All right.” 

Meagan: I didn’t know that. 

Wendy: Yeah. I didn’t go back to Ann Arbor because I didn’t want to do all of the long drives with the little guy. We stayed local. I found a new doula who aligned with my Christian and medical beliefs so we clicked pretty fast. I started at the basic hospital OB/GYN practice but I ended up switching after one of the doctors was like, “You’re really going to try for a VBAC after having an 11-pound baby?” and she laughed. I was like, “Okay.” 

Meagan: This is not the place. 

Wendy: We’re done here. I switched. I did a little bit of research and there was this one practice that had really great reviews on all of the local Facebook groups with these moms. Everyone just said a lot of really great things about them. So I went there. They were a lot smaller and they had 5 providers. They had a midwife who was going to be starting a month before I was due. That was encouraging too. 

The first appointment I had was with the OB. We’ll call her Dr. A just because I eventually don’t have the best experience with her so I don’t want to use her name, but this first appointment was awesome. I was like, “Oh, she is the best.” I went through all of my wishes and she was extremely supportive. She was like, “Oh, yeah. We will do that. We can do that and that.” It was awesome. There were no red flags. I felt so good after not having a great experience at the last place. 

Yeah, so this pregnancy also didn’t have gestational diabetes. Baby measured smaller. He actually measured 60% at my 20-week scan so I was like, “Man, this baby is going to be tiny compared to my 99th percentile kid.” I just was really– I don’t want to say hopeful because I don’t want to make it sound like my babies are bad but I was like, “Oh, it’s just going to be easier.” 

Meagan: Well, it’s the stigma on big babies. 

Wendy: Yeah, I just thought that if it was a small baby, my chances of VBAC would be way bigger. No complications during the whole pregnancy. It was fairly easy for me and then around 32 weeks or so, my fundal height started measuring 3 weeks ahead which is once you go past the 2 weeks ahead, they’re like, “Uh oh. Big baby alert.” 

So they suggested a growth scan at 38 weeks which I was like, “Okay. He’s going to be small though. Don’t worry about that.” 

Meagan: Right. 

Wendy: Yeah, and then at 36 weeks, I met with one of the male OBs there. I just casually asked about inductions and what my options were just because I knew with a VBAC that they are limited but they still do them. He laughed at me and was like, “You can’t do an induction.” I was like, “What? Why?” He was like, “Because your chance of uterine rupture is so high. We don’t do that.” I was like, “Okay.” I just didn’t even know what to say because I don’t know. I didn’t have any information to support myself. I was just taken aback. That was a bummer. I was like, “I’m never going to see him again.” I’d make sure he was not the one that was at the hospital. 

Yeah. I did get the growth scan at 38 weeks. He was measuring 8 pounds, 11 ounces which was the 96th percentile. Even at that time, I was still like, “Oh, the calculations are wrong. I know it can be off by 2 pounds. I’m sure it’s just off.” I also just again didn’t feel like he was big just like with Isaac. So yeah. I took it with a grain of salt. I’m like, “Whatever,” but at the same time, I was like, “What if he is big?” 

Meagan: What if he is? Yeah. 

Wendy: That’s the week I started listening to The VBAC Link religiously. I constantly had an AirPod in my ear always listening. But before that, I was just like, “I don’t need help. Small baby. We’ll be fine,” then I was like, “Uh-oh. Big baby. I need support now.” So I listened to all of the big baby stories and positive induction stories, and there were a couple that just really resonated with me. 

I wish I could remember which one it was but there was one that you had where a lady had an 11-pound baby. I don’t remember what it was but all of the things that she went through were what I was going through. 

Yeah, so that was just really awesome to hear. I’m very grateful for you guys and that I found you. I just really feel like it’s all mentally. Part of it is physical and the people who support you, but I don’t know. 

Meagan: Yeah, and when you hear stories that even remotely resonate or kind of follow the same path, you’re like, “Okay. I’m not alone. I’m not the only one in the world who is feeling this way or who is going through this or who might have an 11-pound baby or who had an 11-pound baby.” It’s like, “Okay. She did it. I can too.” 

Wendy: I can do it. Right. Yeah. Right. So that was really good to hear. 

Okay, so then at my next appointment– this is 39 weeks– it was again with Dr. A from the very beginning. 

Meagan: The one that was really supportive. 

Wendy: Yes and again this time, she was really supportive and I just felt really comforted by her. She was like, “You know, I kind of suggest an induction but no pressure. It’s okay. You don’t have to.” I was like, “Okay. Thank you for that.” She was like, “Leave this appointment today. You can call back if you want. Again, no pressure.” I was like, “Okay.” She checked me that day and I was 1 centimeter and 30% effaced. Baby was super high up. She was like, “Okay. It’s fine. Things can change.” 

I feel like I’ve done my research too and I know that can change really quickly. I was not concerned about it at all. Also, leaving that day, I felt super conflicted about an induction. I was like, “Why wait until my body goes into labor naturally? Do I do an induction?” I feel like I’ve never felt so– I don’t know. I couldn’t be at peace with either of those options. 

I talked to my doula and she was like, “Well, yeah. The longer you wait, your baby will get bigger. It could be harder.” I don’t know. Eventually, we talked about it. She was like, “Okay. Let’s just wait until your due date at least. Let’s just do a ton of natural induction methods.” I was like, “Okay.” I felt good about that. I was like, “Another week, I can do this.” 

I did a ton of things, all of the classic things– red raspberry leaf tea, dates, sex, walks, curb walking. 

Meagan: Working out. 

Wendy: Yes. All of the things, but the one thing I wasn’t going to do was the midwives’ brew because of the Cesarean. My doula was like, “That can be really intense on your uterus.” She didn’t suggest that so that’s the one thing I did not do. 

Let’s see. Okay. At my 40-week appointment, I met with the midwife who had just come on the month prior. She was super sweet. I liked her a lot. She was very down to earth and also very supportive of me but she pulled out the VBAC Calculator two days before my due date. 

Meagan: You’re like, “Really?” 

Wendy: Yeah. She was sweet about it. She wasn’t using it as a scare tactic. She was like, “This might make you feel better to see.” It was a 52% chance of success. “50/50.” She was trying to be more supportive about it, but I found out later that Dr. A was there and she was the one who had it printed out for her and brought it out to me so I was like, “Hmm, interesting.” I don’t know. 

Meagan: Dr. A was behind it. 

Wendy: Yes, she was. I feel like because the midwife was newer and Dr. A is the head of all the OBs there so that was interesting that she would do that. I don’t know. I just feel like it’s so outdated. 

Meagan: A little bait-and-switch beginning. 

Wendy: Yes. Yes. That was the first little red flag. I’m like, “That’s strange.” I was checked again. I was still at 1 centimeter, 30%. He was still really high up. She acted all concerned about that. I wasn’t because I was like, “I can go into labor tonight. That doesn’t really mean a whole lot.” I guess my outer cervix was still hard but the inner was soft. I don’t know. 

Meagan: Yeah. That is a thing too. The outer side is 2 centimeters but the inside further up is closed. 

Wendy: Yeah. Right. I just never heard of that but it was a huge concern for them I guess. I was like, “I don’t really know, but okay.” 

We started talking about an induction just because my due date was coming. They were like, “Well, maybe we can get you in tomorrow,” and then the midwife left and went and talked to the doctor who would be on-call at the hospital that day. She was like, “So, she’s not going to support you with the induction because she thinks it’s too dangerous and she thinks that a Cesarean would be the safest.” 

Meagan: So she was saying that she would induce. 

Wendy: Yeah, well this was a different one actually. I haven’t talked about this doctor. 

Meagan: Okay. This is a different doctor. Okay. 

Wendy: Yeah. Dr. B. I don’t know. 

Meagan; Dr. B, okay. We have Dr. A and Dr. B. 

Wendy: Yeah, different ones. But yeah, I was like, “Ugh.” Then we looked into the next two days because she straight up wouldn’t even– 

Meagan: Wouldn’t even consider it. 

Wendy: Yeah. She wouldn’t even consider it just because of my cervix not changing and big baby. I was really frustrated at that point, but it is what it is. We found a doctor who would support me there. 

Meagan: In the same practice? 

Wendy: Yeah. Yeah. I didn’t necessarily want a male just because I’m more comfortable with females but I was like, “If that’s the only guy that’s going to take me–” 

Meagan: I’ll do it. 

Wendy: Yeah. After that appointment, I actually felt weird and down about it. I called back to the office and I wanted to talk to Dr. A because I still had all of these positive experiences with her. I just wanted to hear what she had to say about it. She was so weird on the phone, like super short, and weird with me. She was like, “Well, you’re probably going to end up with a Cesarean. The odds are stacked against you. Your cervix hasn’t changed. Big baby.”

I was really taken aback just because I had all of these really great conversations with her. I was like, “Okay. That’s kind of crappy.” I just wanted to hear– I kind of feel like I was testing her to see where she stood on this. I was like, “What would you do if baby had shoulder dystocia?” Luckily, from your podcast and other stories, I kind of know what they do if that happens. Her first response was, “Oh, we’d have to break the clavicle.” 

Meagan: Automatically?

Wendy: Literally, I was like, “That’s your first step?” Then she went all scientific and said, “There are these other techniques and blah blah blah. We’d literally have to jump on your belly and ignore your screams.” 

Meagan: Jump on your belly. 

Wendy: Yeah. I was like, “Oh my gosh.” She was like, “And you know, you could die or your baby could die.” I was like, “Okay.” I know shoulder dystocia happens and I know it can be scary and yes you can die, but the chances of that are very slim. The fact that it was the first thing she would bring up. I’m so glad that I knew already a little bit about shoulder dystocia because if I didn’t, at that moment, I would probaby be like, “All right. Schedule the C-section because I’m not going to risk that.” 

Meagan: Well it sounds really bad. They’ll just have to jump. It sounds very scary. 

Wendy: She really said that word for word. She said, “We’ll just have to ignore your screams.”

Meagan: Jump on your belly and ignore your screams. 

Wendy: After that, I was crying. I was so distraught about it just because I was like, “Man, the one doctor who I felt was supportive the whole time just totally bait-and-switched on me.” She was just not friendly anymore. At that point, I was like, “I’m never going to see her again.” I was just really upset. 

So on my actual due date, two days later, I called back to the OB office and I wanted to talk with the midwife because she had actually been sweet and kind to me the whole time. I just wanted reassurance and just someone to talk to. 

Meagan: Yeah, someone in your corner. 

Wendy: Yeah, exactly. So I called that morning at 8:30 and the lady on the phone was like, “All right, we can get you in with a phone appointment at 9:30 because she is here today.” I was like, “Awesome. That’s great.” I’m waiting for a call. It’s 10:00 and I still haven’t gotten a call so I call back. 

Also, to backpedal a little bit, when I first called, I was like, “Let’s schedule the induction for tomorrow.” I felt at peace with that finally so that would be Friday. She was like, “All right. We scheduled you in.” Anyway, I called back at 10:00 and I was like, “Hey, I know things can get behind, but I was supposed to have the phone appointment with the midwife. I just haven’t heard anything back. I wanted to know if it was still happening.” She was like, “Well, she’s busy now. She can’t talk with you.” 

I was like, “Okay.” She just kept asking, “What do you want to talk to her about?” I was like, “I don’t really want to tell you all of my fears and concerns. That’s not just a black-and-white question or a yes or no question.” She just kept pressuring me to tell her what it was. I was like, “I just want to talk to her.” She was like, “Well, you’re not going to be able to talk to her today.” 

Meagan: Today, at all. 

Wendy: I was like, “It’s my due date.” I just wanted to talk to someone. That was really crummy and I felt like if the midwife had known that I was trying to talk to her, she would have made it happen because she was super supportive so I just felt like they were doing this behind her back. I don’t know. It just felt so weird. 

Meagan: Yeah. 

Wendy: Yeah. Very strange. 

Meagan: A little weasely. 

Wendy: So actually, okay. I’ll get to this later, but the induction method that we were going to do is Dilapan which is like a Foley balloon. I think you’ve talked about it on a couple of episodes, but it would be an induction Friday and then I’d probably go into labor on Saturday. Saturday was actually my husband’s birthday so I was kind of like, “Well, maybe we should try for an induction on Saturday so that I could give birth on Sunday just so they each have their own special day.” 

On the phone, I was like, “Actually, do you think we could induce on Saturday?” She was like, “Well, those are only reserved for emergency cases.” I was like, “Okay. What about Monday or Tuesday?” She was like, “Well, let me go ask the doctors.” She left and went and talked to them. She came back and she was like, “They said either Friday induction or scheduled Cesarean.” 

Meagan: Nuh-uh. Oh my gosh. 

Wendy: I was like, “Oh my gosh.” That was a true bait-and-switch because I’m like, “What does one or two days change?” That was another thing that was the cherry on top. 

Meagan: Frustrating. 

Wendy: Yeah, I was just like, “Fine. I’ll do Friday.” It was funny because I felt at peace with that at some point, but now I was like, “I don’t know.” I just felt so angry about it just because it wasn’t my choice anymore. I was being forced into it. 

So we scheduled that. Yeah, so the next day which was Friday, we got to have a nice family day together which was good. It was relaxing. We went into the hospital Friday night at 4:00 PM and did the Dilapan which, just for people maybe listening that don’t know what that is, is kind of like a Foley balloon, but they are tiny little tampon sticks that they stick into your cervix then they take up liquid and will expand so it manually expands your cervix or opens it up and dilates it. 

They got seven in there. They said four onwards is typical. Before that happened though, I was 1-2 centimeters and 50% effaced. I had gotten a little bit better since a few days ago. 

Meagan: Yeah. 

Wendy: That was exciting. They ended up doing that. It was funny. I actually had a very young male student do it which I wasn’t super psyched about. He was about to do it and didn’t put lubrication on the spreader things. The person training him was like, “Umm, did you put lubrication on there?” He was like, “Oh no.” So I was super tense the whole time like, “Oh, this is the worst.” That wasn’t fun.

In hindsight, I wish I would have been like, “Can I not have the student? Can I just have the RN do it?” but I’m not very good at speaking up for myself so I didn’t do that. I went home that night. It didn’t feel uncomfortable. It just felt like pressure. You can’t really feel it in there. That is the benefit, I guess, to Dilapan versus a Foley balloon because most of the time you have to be in the hospital. 

Meagan: Some hospitals will do it and send you home. 

Wendy: Yeah, that’s what I’ve heard but I don’t think it’s actually the norm. 

Meagan: It’s a little more rare. Yeah. It’s a little bit more rare. They kind of want to have you there so they can monitor you. 

Wendy: Yeah, which makes sense. I think the Dilapan is a much slower process so they can send you home. We went in that morning at 7:30 AM on Saturday. They took it out and I was at 3 centimeters and 60% effaced so it had done stuff. 

Meagan: Great progress, yeah. 

Wendy: Yeah, so I started getting Pitocin at 10:00 AM. The OB cleared me to do two units every hour. He okayed me to do 30 units which I feel is a lot. 

Meagan: Wow. Normally it’s 20 before they have an MFM. At least here in Utah, it gets to 20 and they have MFM come in and review. A lot of the time, IUPCs are placed so they can know exactly what’s going on and really manipulate that. 

Wendy: Yeah, so I was a little surprised. I didn’t reach that, but I was like, “That seems like a lot.” 

Meagan: Yeah. 

Wendy: My doula came pretty quickly after the Pitocin started. I didn’t really feel major contractions for a while there. It was nice just to have her there to talk and stuff. We did a lot of hallway walking. We took a lot of naps. I know it’s like, “You want to be active and on your feet and doing stuff.” I’m like, “I’m just tired.” I did not sleep the night prior because I thought I’d go into labor and I didn’t so I was just going on zero sleep. So we just did a lot of walking and hanging out. 

By 4:00 PM, I started having pretty intense contractions where I couldn’t talk through them then I maxed out on Pit at 18 units. That was my cut-off. They were consistent and good. 

Meagan: You didn’t need anymore. 

Wendy: Yes. I didn’t need 30 which was good. 

Meagan: Really good. 

Wendy: Yeah, so the doula and my husband did a ton of counterpressure pushes for me which was a game changer for me. I know the classic counterpressure is on your hips squeezing but for some reason, I wanted them to use their thumbs and push right next to my tailbone. That felt the best. 

Meagan: Your sacrum, yeah. Probably in that sacrum area. 

Wendy: They pushed super hard. They kept checking on me. “Are you sure you’re okay? Because this is really hard pushing.” Yeah. I was like, “Push harder, as hard as you can.” 

Meagan: I had a mom have that one time. She was like, “Can you just use your elbow?” We were like, “Okay.” 

Wendy: Yes. As hard as you can. It’s kind of funny actually, maybe not funny. My husband doesn’t think it’s funny. His thumbs are still kind of messed up from it. He has issues with his thumb now. Yeah. I’m like, “I’m sorry, but it was great at the moment.”

Meagan: Thank you so much. 

Wendy: Yeah, sorry you’re maybe messed up forever. He’s like, “I need to go to the chiro for my thumbs.”

Meagan: Just a reminder that you were an active participant in our son’s birth. 

Wendy: Exactly. So at 6:30 PM—

Meagan: A couple of hours later. 

Wendy: Yep, I threw in the towel for hallway walking. I was like, “I’m exhausted. I just want to come back.” My doula did one more big counterpressure squeeze. My water broke and it was just the classic movie scene everywhere. So that was fun. I was like, “Yes. Finally, he’s coming.” 

At 8:00 PM, I was around 7-8 centimeters. I was progressing very well compared to my last kiddo. I know the rule of thumb is that usually the time is split in half for each next child so I was expecting 12 hours and this was a lot faster than 12 hours which was awesome. 

At 9:00 PM, I was 9 centimeters and 90% effaced. I felt super pushy. Everything in my body was like, “Push this baby out,” but I wasn’t fully dilated or effaced. They were like, “You cannot push.” That was literally the most painful thing. I don’t know. When everything in your body– it was hard. I was really shaky too. I felt a little bit nauseous at some point. Yeah. I was curled up on the side of the bed. I just couldn’t even move. I don’t know how people could keep moving through labor. I couldn’t do it. It was very painful. 

My doula told me to do horse lips throughout the contractions to not push. 

Meagan: Yep. Yeah. 

Wendy: Which did help. I was surprised. 

Meagan: Just for you guys all listening, if you are not quite progressed to a 10 and ready to push but have that urge, horse-lipping is a really, really great tool to help you avoid pushing and causing a swollen cervix or something like that. It can actually help you cope in general, but yeah. It’s a really great tool. 

Wendy: It was. The only thing is that every time I would take a breath, my body would start pushing again so I would take really short breaths. That was hard. My nurse also gave me a tiny comb to squeeze. At first, I was like, “That’s stupid.” But I was like, “Okay, fine.” That was my lifesaver. I held onto that thing. 

Meagan: It’s so amazing, right?

Wendy: It is. It was a little tiny plastic one. I think it’s for the babies to brush their hair afterward to get stuff out, but maybe I should have bought one before. Maybe for my future births, I’d get a hardcore one. 

Meagan: Yeah, we have one just from the beauty supply store. We actually have a tall one and a short one in my doula bag so for people who have a little bit bigger hands, it’s taller. 

Wendy: Yeah. It is a good tool. 

Meagan: It’s really awesome. You know, your hand definitely feels it after depending on how tightly you squeeze but yeah. It’s a really, really great coping tool. 

Wendy: Yeah, for sure. It makes your brain focus on a different pain that’s a little bit more manageable. So at 10:00 PM, I was ready to go so not much longer. It felt like forever but it finally came so I was like, “Okay, let’s go.”

I wanted to be on my hands and knees because from what I’ve heard, that’s the best position if baby does have shoulder dystocia so I was like, “I want that,” but baby’s heart rate would decelerate when I was in that position. They were like, “He doesn’t like that so we can’t have you there.” Yeah. I ended up on my back with my knees up and I did the pull bar with the sheet. 

Meagan: Yeah. I call it tug-of-war. 

Wendy: I was sore for days after that. My arms were so tired because I was pulling with all my strength for an hour straight. 

Meagan: Yes. You were literally doing assisted pull-ups. Sometimes the neck muscles hurt so if you are doing that, have your birthing partner or your doula or whoever supports the back of your neck so you’re not straining your neck. 

Wendy: That’s a good point. I didn’t think about that. But yeah. I didn’t really work out that much, especially not my arms. I wouldn’t have thought of that, but I’m like, “Okay. You should work out your arms next time if that happens again.” But in the moment, I did not feel that pain in my arms at all. It was just afterward. 

So that was awesome. They gave me a mirror, like a full-length mirror in front of me which was awesome. I loved that. Every time I pushed, I could see his head coming out. I could see his little black hair. 

Meagan: It can actually reduce the time of pushing because you can see. You can connect with your eyes what you are feeling. It’s really cool. 

Wendy: Yeah, because every time you’d have a really good push, you could see him coming out a little further. It was just very empowering. It was on wheels though and it kept moving. I was like, “I can’t see him. Move the mirror back.” But no, it was good. 

I had a nurse that was there that was really intense and kept yelling at me. The other ones were very soft spoken but she was like, “Keep pushing. Don’t give up.” It was really intense energy but I loved it. I needed that. Afterward, my doula was like, “I wasn’t sure if I should step in or if she was crossing any lines.” I’m like, “Oh no. I needed that woman. She was great.” 

I ended up birthing him at 11:03 which is funny because he ended up being 11 pounds, 3 ounces. 

Meagan: Stop!

Wendy: Yeah. Isn’t that funny? The time. 

Meagan: Yeah. I was going to say the time. You were 7-8 centimeters around 7-9:00. I was 9 centimeters at 9:00. I’ve been noticing that. 

Wendy: Isn’t that funny? He was also the exact same weight as Isaac so I don’t know. 

Meagan: And born vaginally!

Wendy: And on my husband’s birthday. 

Meagan: Yes, I was going to say on your husband’s birthday. 

Wendy: Yeah, so that was awesome. 

Meagan: So no shoulder dystocia?

Wendy: No. He shot out very quickly. I guess all of the nurses were in shock that he was so giant. My doula was like, “He just kept coming out. He was so long.” She just never has seen such a big baby. She was also in shock. She was like, “This baby just kept coming and coming.” 

Meagan: Like, how did you fit him in there?

Wendy: I don’t know. I don’t know. It’s funny though because my first guy was basically 42 weeks and this one was basically my due date so I’m like, “Man, if I did go another 2 weeks–”

Meagan: 42 weeks, you might have had a 12-pounder. 

Wendy: At least, or 13 or something. Because I did have such a positive induction experience, I am glad that I went that route. It was good. 

Meagan: Yeah. 

Wendy: I know it could go bad as well. I’ve heard both sides of the induction story but it worked out for me and I got a healthy baby so it was all good. 

Meagan: So grateful, yes. 

Wendy: Yeah, so the next not-so-fun part of the story is that I tore really bad which is probably expected. 

Meagan: Because he came out so fast. 

Wendy: Especially because they were trying to prevent shoulder dystocia, as he was coming out, they shoved my knees up really fast. It was probably a good thing, but I think that also probably didn’t help with the tearing. They tore me apart. 

Note to listeners, you really don’t feel the tear. I know everyone says that and I feel like people still fear it, but you don’t feel it. Maybe later in healing and stuff, but in that moment, it’s not anything. I didn’t have an epidural either so I did feel all of it and it was fine. 

I got him on my chest right away. He was covered in blood. I did bleed quite a bit. They were like, “You’ve got a 3rd-degree tear. It’s pretty bad.” They started stitching me immediately so I had to give my baby to my husband. I didn’t get my golden hour which is what it is. I was just so joyous that I was able to have him vaginally that I was like, “Everything else is okay.” He’s here. He’s safe. 

Meagan: Yeah. That mattered to me so much that it’s okay.

Wendy: Yeah. Our time will come. It was actually the RN that was stitching me, not the OB doctor. 

Meagan: That’s interesting. 

Wendy: He didn’t even step close to me. He was off in the dark corner. They had a spotlight on me. The room was dark. 

Meagan: Interesting. 

Wendy: Yeah, so it was this RN. The stitching took an hour and a half. She did not seem very confident is what my doula said. She’s been to a ton and she was like, “She just seemed like she was stressed out about it.” She was confused that my OB never stepped in. In hindsight, she wishes she had gone to my OB and been like, “You need to take over.”

Meagan: “Hey, what’s going on here?”

Wendy: Yeah. I get that they need to learn how to do these things, but you should be watching her. 

Meagan: It’s weird. I’ve never seen an RN. 

Wendy: Yeah, well that’s great. I didn’t have the greatest experience come to find out. It was an hour and a half. I felt so much of it. I could feel the needles. They were giving me lidocaine shots. Obviously, you can feel the shot going in but it wasn’t numbing anything. I probably didn’t feel it 100% but I felt it enough that I was not comfortable at all. They were like, “Just stop moving. I’m like, “I can’t. I’m in so much pain right now.” So they did a ton of lidocaine shots then they were like, “Well, do you want to do the nitrous oxide?” I was like, “I guess so,” but that doesn’t make the pain go away. It just makes you feel high. I still felt it so they tried putting some pain stuff in my IV and that also didn’t really do anything so I just kind of sucked it up for the hour and a half. 

Meagan: Oh my gosh. 

Wendy: Yeah, it was super long. Then at the very end for some reason– I was at the very end. They checked my rectum and they were like, “Oh, you have another tear up there. We’re going to have to undo all of it and redo it.” 

Meagan: *Gasp* Oh, no. 

Wendy: Because it was so deep and internal that they couldn’t get to it. I was like, “Oh, that’s great. Awesome.” So they were like, “Well, we should probably take you to the OR to do it because it’s just too much.” Yeah, I didn’t want to go through that again. That’s what we decided on. The anesthesiologist came in. He was on the phone and sounded kind of stressed out. He looked at the lidocaine bottles on the table and was panicking about it. He was like, “I just don’t have any options left,” is what he said on the phone. 

My doula was saying that they probably gave me way too much lidocaine. There was too much in my body that he was trying to figure out the numbers. 

Meagan: How he could, yeah. 

Wendy: Right. I don’t know. How he could be able to take me into the OR? So that wasn’t fun. He came in later and he said, “So spinal tap or general anesthesia?” We went with a spinal tap so I could nurse baby right afterward. It was kind of crappy though because it felt like I was getting another C-section because I went to the OR. I got a spinal tap. It felt like it was happening again which is what it is. 

Oh, before I got wheeled off, this nurse came in and she was like, “Here’s a consent form for you to sign to give your baby formula.” It wasn’t even a question. She was just like, “Sign it.” I looked at my doula because I was like, “I don’t want that?” She was like, “Can you just give her 10 minutes to nurse her baby before we go in the OR?” The nurse was like, “Yeah, it’s fine.” 

Meagan: Oh my gosh. 

Wendy: She was annoyed by it. I was like, “Okay. It’s not going to take that long.” So I was able to nurse him. He latched really well. He was a great nurser. 

Meagan: Good. 

Wendy: That was nice. I went to the OR. It took maybe an hour or an hour and a half, then afterward, as soon as he was getting hungry, they were able to join me in whatever the room is that you go to after. 

Meagan: Yeah, like mom and baby. Yeah. Yeah. 

Wendy: Yeah, so that was great. Oh, and then the RN came to me later. She was like, “Actually, it’s really great that we took you to the OR because you did have some retained placenta in you.” I’m like, “Oh, that’s good. I just wish we had done that first instead of the other stitching.” 

Yeah, so Levi ended up being super healthy. They kept track of his glucose of course because he was big. He was fine. All was good. It was a very redemptive birth. 

Meagan: Absolutely. 

Wendy: It was way better than I could have ever imagined. It was just awesome. Now I could prove people wrong who thought I couldn’t birth an 11-pound baby with my first but I’m like, “I did it.” 

Meagan: Yes. “I did do it.” 

Wendy: It is possible. The day that I was going to be discharged, Dr. A was supposed to be there, or was there, and the whole day before, I was like, “I’m so excited to be like, ‘I did this even after you tried to scare me’”, but she never showed up so that was great. 

Meagan: Maybe she didn’t really want to be told she was wrong. 

Wendy: Yeah, probably not but I hope I see her one day so I can tell her that I did it. 

Meagan: Yes. I’m sure she knows. I’m sure she knows. 

Wendy: I know. Maybe she would still stand by what she said. I don’t know. 

Meagan: Yes. Well, congratulations. Huge congratulations. The medical term for big baby or macrosomia is so hard because researchers show that it’s 8 pounds, 13 ounces up to 9 pounds, 15 ounces, and then babies are called extremely large if they weigh more than 11 pounds. So congratulations on having an extremely large baby. 

Wendy: Oh, thank you. Okay, I want to share one more little thing. I had a friend who was due a week before me that also had a C-section with her first and then she was also trying for a VBAC so the whole time we were encouraging each other and stuff. She wrote me this letter afterward and I wanted to share it because it was really sweet. I’ve always been so passionate about birth, especially with a home birth. We are planning for a home birth with my last baby. I’ve done a lot of research and I’ve heard a lot of stories so I would always tell her those things. I thought it was just talking, but anyway, I’m going to read this little card because it just made me feel really good that your words do matter especially with birthing. 

She said, “I will forever be grateful for your friendship. I would not have had the confidence to go through the process of fighting for my right to have the birth that I wanted. I will forever credit your friendship as the reason that I had my VBAC and for that, I can’t thank you enough.” 

So yeah, that was really sweet and gave me the power to be like, “All right. I’m just going to keep sharing my story.” I was really grateful that I was able to be on your show, so thank you. 

Meagan: Thank you. Thank you so much and congratulations to you and your friend. Yeah, thank you so much for sharing this because we know that so many times, people are left in that corner of defeat of, “Oh, I guess I’ll just schedule a C-section.” 

Wendy: Right. Right, but there are options. There are always options. 

Meagan: Yep. 

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 are pieces of an important puzzle and there are a lot of pieces. Working together, we can effect a lot of change.”

Joining Meagan on the podcast today is Dr. Elliot Berlin, a renowned prenatal chiropractor based out of Los Angeles who is making a huge impact on the birth community. Dr. Berlin is extremely knowledgeable and experienced in holistic birth preparation and advocacy. He is a birth doula, hosts the Informed Pregnancy Podcast, and his most recent project is the Informed Pregnancy Plus streaming service where birth documentaries and other educational videos can be found on one online platform. 

Dr. Berlin and Meagan discuss TONS of topics that come from your questions! 

Topics include: 

• What happens during an adjustment
• When to start prenatal chiropractic care
• Bodywork
• Adjustments during labor
• CPD
• Breech Presentation
• Pubic Symphysis
• Support at home
• Breastfeeding

Additional Links

Dr. Berlin’s Website

Informed Pregnancy Plus

Pediatric Chiropractic Search Website

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hello, hello everybody. You guys, we have a very special episode for you today. We have Dr. Elliot Berlin with us today and he’s actually live with me so that’s pretty cool that I actually get to see his face live via Zoom.

 

Dr. Berlin: It feels like we are in the same room. I’ll be honest.

 

Meagan: Right? As live as you can get through a computer. I feel like this is our new norm these days. This is how live works.

 

Dr. Berlin: Yeah. And you know, we got used to it.

 

Meagan: Yeah, we did. We got used to it pretty dang fast actually. We’re so excited to have you on today and we have so many amazing questions that our listeners and followers have asked. But I first want to just talk a little bit about you and who you are so if anyone doesn’t know who Dr. Elliot Berlin is, you need to know and you need to go follow his page right now.

 

Push pause unless you are driving. You can do that later and go follow @doctorberlin on Instagram because he’s amazing and has so many incredible things and has done—I mean, for years—so many incredible things in the birthing community.

 

Dr. Berlin is an award-winning pregnancy-focused chiropractor. If you don’t know yet, on this podcast, we love chiropractic care. He’s a certified birth doula and host of the Informed Pregnancy Podcast. So again, if you haven’t followed his page or his podcast, press pause. Go follow along and go—what’s the word? Subscribe to his podcast— Informed Pregnancy Podcast.

 

He combines his passion for entertainment with his desire to educate and spread awareness about important issues in the birth industry. We know that in the birth industry, we have a lot of issues that need to be talked about. His latest project is the brand new streaming channel on Informed Pregnancy Plus dedicated to all things fertility, pregnancy, labor, and parenting.

 

Informed Pregnancy Plus

 

So, Dr. Berlin, I would love to actually start right there before we get into these questions. Will you tell us more about this new project that you’ve got going on?

 

Dr. Berlin: Thank you for having me and for the incredible work that you do. I was just telling you recently that I feel like we are pieces of an important puzzle and there are a lot of pieces. Working together, we can effect a lot of change.

 

The Informed Pregnancy Plus is a streaming platform. Everything grew organically from me really being a very medical-minded person wanting to go to medical school. Sometimes little arrows pop up. I see my son play video games and he’s not sure where to go, then a big arrow pops up and says, “Go this way.”

 

I get those arrows sometimes and it led me on a more holistic path. I fell in love with chiropractic and massage. I smooshed them together to make chirossage. I ended up with my wife and I having a fertility struggle. We ended up overcoming that with natural means when medical options ran out— and she is a psychologist. We started this mind/body program together, wellness care, with an eye on helping people boost fertility. Over time, that turned into babies and pregnancy. Again, coming from a much more medical background—I used to work in ambulances and emergency rooms—everything was brand new to me on the more natural front.

 

Meagan: Mhmm, yeah.

 

Dr. Berlin: I had never heard of doula. So I would get questions a lot that I didn’t know answers to. It still happens regularly. I would go on to research. I’d talk to experts, read, and try to prepare an answer that was not, “This is what you should do or not do,” but “These are the facts as we know them. What do you want to do?”

 

As I’d get the same questions over and over again, I started to write that as a blog. It became a magazine for a minute when people still printed stuff and then before I knew anything about podcasts, I was doing a podcast.

 

Then I made a couple of documentaries, one of them about VBAC, Trial of Labor. It’s a beautiful film and when we finished it, I realized that the only thing I know less about making a documentary is what to do with it once you have one. How do people get to see it? Right when it came out, there was this big flash of excitement about it. There were screenings and all sorts of people were buying it in lots of different ways and showing it in lots of different ways, but then that excitement fizzled out. It was out there in the blogosphere and the webosphere but people weren’t finding it.

 

I was getting these crushing emails saying, “Hey. I saw your movie, Trial of Labor, and I really loved it. I just wished I would have seen it before I had my baby.” I was like, “No, I made it so you could see it before you had your baby.”

 

Meagan: Right.

 

Dr. Berlin: So after talking to some of the other filmmakers in the space, I realized that I’m not the only one having this problem. There’s not an easy place where people can go and get iconic films like The Business of Being Born, Orgasmic Birth, The Mama Sherpas, Breastmilk, so on and so forth. So I just decided, “Why not make it easy for anybody to access from anywhere without having to pay $25 for each film?” and just boom. You can have it on your phone or your TV. That’s how Informed Pregnancy Plus was born.

 

Every day, we are working on acquiring licensing for more great content. It’s expanded from film to also web series, also mind and body like yoga and meditations and workshops. My wife has a workshop on there on relationships how to still like your partner after you have a baby together. We have one on birth plans. We have one on sleep. It’s just growing all the time. Anybody can try it absolutely free at informedpregnancy.tv. It also has apps for Apple, Android, and Roku. After that, it’s very affordable. It’s $7 a month.

 

Meagan: That’s what I was going to say. It’s $6.99 a month or $59 a year. That’s pretty dang affordable.

 

Dr. Berlin: That was our goal. If you have an internet connection, a device, and $60 for the year, you have access to all of this great content. That’s what we were hoping to achieve. I don’t know how I’m going to survive. It’s like each element of this is a full-time job.

 

Meagan: A full-time plus.

 

Dr. Berlin: Full-time plus like Informed Pregnancy Plus but thankfully we have a small crew here but very dedicated to the project and very hardworking, very savvy. It’s growing both in terms of content and in terms of viewership. The films are finally having an avenue where they can make a greater impact.

 

Meagan: Absolutely. I love that so much. I wish I had something like this back when I was in my childbearing years or having babies, I should say because even the time. In my opinion, how much time I spent researching VBAC and all of the things during pregnancy, even those courses like yoga classes and all of these things, I spent way more time than I would have money. It would have been so much more worth it to just buy a subscription like this and have it all in one great platform.

 

Dr. Berlin: I mean, that’s the goal. Especially for people who live in areas where there aren’t prenatal yoga classes. We don’t have a ton yet, but we are always adding more. We have Baby by Simone on there for people who can’t go to a prenatal workout class. She’s got great workouts. The whole idea is that no matter where you are, these tools should be accessible to everybody.

 

Thankfully, they are trickling their way through the internet and people are finding them. I’m getting fewer messages about, “I wish I had seen your film before I had my baby,” so that’s very rewarding in the way that finances can’t reward.

 

Review of the Week

 

Meagan: Okay, so we do have a Review of the Week so we are going to get into that before we jump into all of the amazing information that Dr. Berlin has. This is from 471046246me and it says, “My Labor and Delivery Nurse Told Me About The VBAC Link.” Oh my gosh, that makes me so excited. If you’re a labor and delivery nurse, thank you, thank you, thank you for the love and we would love for you to continue sharing with your patients.

 

It says, “I had an emergency C-section six months ago with my first baby. I planned and prepared my entire pregnancy for a non-medicated, vaginal birth with midwives in a hospital. I had an amazing team. Labor was going great. Hard, but I felt strong. But my son had other plans that involved wrapping himself in his umbilical cord so the sunroof exit he went. Ha ha,” she says.

 

“In my recovery room, my nurse told me that she had an HBAC and told me to listen to The VBAC Link. I am so thankful that she recommended y’all to me because I already am stoked for my VBAC and I’m not even pregnant yet. Thank you for the work you do. I can’t wait for y’all to come back from your break.” This was back in 2022.

 

It says, “These stories fill my day with so much joy when I take my son for my daily walks.” Oh, thank you so much for your review. You guys, we do love these reviews. We appreciate them so much. We always welcome them in wherever you leave them. You can Google “The VBAC Link” and leave us a review. You can do it on Apple Podcasts. You can message us. You know it. Wherever, we love your reviews so bring them over and maybe they will be read on the next podcast.

 

Q&A

 

Meagan: If you guys are wondering, we will make sure to have all of his links for his platforms in the show notes so make sure to check out the show notes.

 

Dr. Berlin: Thank you.

What Happens During an Adjustment?

Meagan: Without further ado, I mean there are so many questions. I don’t know if we’ll get to all of them today, but I was shocked, but then I thought, “Oh well, from someone that had never gone to an adjustment before during pregnancy, I didn’t know either.” One of the questions is, “What happens during an adjustment? What does that look like?”

 

Dr. Berlin: These, I’m sure, are going to be amazing questions because they come from real people who are very curious. This is a great question. The answer is it’s different from chiropractor to chiropractor. Generally, the one thing we all have in common is that we’re all looking for restriction in the bones—so where two bones come together, they form a joint. There should be good movement between those two bones, a certain amount of good movement. If they become restricted or totally locked up, they can create problems for you.

 

It may be a problem like you feel like a loss of range of motion or swelling around that restricted joint that starts to become an issue that presses on nearby things like nerves or other tissue. Or it may be a problem that you don’t feel. It might just be restriction where you should have fluid movement. If you’re talking about your low back, hips, and pelvis, those kind of restrictions, that’s the baby’s studio apartment. So where the baby should be able to move freely, your body may not be able to accommodate that.

 

So what we all have in common, really, is that we look for those restrictions and we try to release them. We try to restore motion between those restricted bones around the joint. There are a lot of different ways to find them diagnostically, a lot of different ways to restore movement therapeutically so if you go to a bunch of different chiropractors, you might have very different experiences.

 

Then sometimes, chiropractors also add on top of that other modalities that they do whether it’s a physiological therapeutic thing like electric stim or heat or ultrasound or other types of body work like massage. We tend to combine those two together in our practice. What the adjustment is a restoration of movement where it was previously restricted where two bones come together. Any two bones in the body can pretty much be adjusted but many chiropractors primarily focus on the spine and pelvis and maybe the major extremities.

 

Meagan: Yeah. Like you said, it’s the baby’s apartment. I remember my chiropractor telling me how my pelvis shifted. My right side would shift forward, so it would kind of be off. She was like, “You need to have it aligned for the baby to come out of the apartment.”

 

Dr. Berlin: Yeah.

 

Meagan: I actually wasn’t having a ton of pain. I couldn’t have told you that my pelvis was wonky like that, but she was like, “It’s so easy. You can do it getting in and out of a car or walking up stairs or putting a laundry basket on your hip.” There is so much that happens during pregnancy.

 

Dr. Berlin: That’s before the baby gets there sitting on your hip.

 

Meagan: Right. Your body can get out of alignment through pregnancy.

 

Dr. Berlin: That’s one of the interesting things though. If you come in even if you do have pain but there’s nothing restricted, then on the pure chiropractic front, there’s really nothing for us to do. Sometimes it’s the opposite. You can have hypermobility where things are moving too much. There are ways we can treat that as well, but the adjustment wouldn’t be one of them in that direct area.

 

But on the other hand, you could have restrictions that you don’t feel. We would still want to address them if that’s what you want to do.

Bodywork

 

Meagan: Yeah. You touched a little bit on bodywork. That was kind of a question that was answered a little bit farther down on our list, but what all does bodywork look like with that? You talked about massage and things like that. Is there more to it or is it just more like prenatal massage and then a chiropractor?

 

Dr. Berlin: Bodywork is a vague term, even more vague than chiropractic. There are a lot of different kinds. In our office, what we do is massage therapy. It’s more of a clinical massage therapy so it’s focused. It’s usually 25 minutes long. It’s targeted in a specific area.

 

When it comes to musculoskeletal health in general, I see myself as WD-40. I look for things that are stiff, tight, and restricted, and try to get more motion in there. The other side of that coin is duct tape where things are too weak or unstable, somebody’s got to help bring that back together again. That’s more like a personal trainer or a physical therapist. When we are working together, we can get really good balance and function and strength around the muscles and bones of the body. You can really feel wonderful even through all of the different stages of pregnancy, sometimes even with multiples all the way until the end.

 

When things are out of whack, sometimes not even a month into pregnancy, you start to feel weird things happening to your body. Bodywork can be a lot of different things. For us, it’s that more clinical medium to deep tissue, finding muscles, tendons, and fascia that are too stiff, tight, and rigid and trying to use massage strokes to elongate them, lengthen them, and restore normal tone.

 

Other things that we infuse are trigger-point therapy. Sometimes you have a tendon coming to a bone or the center of a muscle where there’s an accumulation of all of the tension in one area so we use trigger-points to release that. Back when I was doing birth work, we would also do a lot of reflexology, cranial massage, craniosacral therapy, jaw releases, and anything that’s going to release the mind and the body through the process.

 

Not so much in the office, we do craniosacral therapy a lot. We have two pediatric chiropractors that work from newborn through adolescence and they do a lot of craniosacral.

 

Meagan: Yeah, my daughter had torticollis from my C-section actually.

 

Dr. Berlin: Oh, interesting.

 

Meagan: It was literally after birth when she was little. Then it just kept getting worse and all of a sudden, her ear was touching her shoulder but her shoulder wasn’t going up. Her ear was going down.

 

Dr. Berlin: Right. Taco neck, they call it.

 

Meagan: Yeah. It was pretty dang bad. We went to PT and that was great, but ended up finding a craniosacral one. Anyway, it was amazing. They did this adjustment and suddenly she was back up. She wasn’t fussy and having acid reflux and all of these amazing things. It is really cool.

 

Dr. Berlin: It is so gentle yet powerful at the same time.

 

Meagan: Right! PT was actually hard on us. It was a lot of forcing her to get in these positions and things then just a few chiropractor adjustments of craniosacral work was a game changer for us.

 

Dr. Berlin: That’s amazing.

 

Meagan: And a lot more sleep for this mama, right?

 

Dr. Berlin: Yeah. It’s not just great for the baby. It’s great for the parents.

 

When to Start Chiropractic Care During Pregnancy

 

Meagan: Yeah. Well, awesome. So when should someone start chiropractic care during pregnancy? Is it something like, “Hey, I’m thinking about conceiving. I should start now.” Should we always be seeing? What does it look like?

 

Dr. Berlin: A lot of that depends on your goals. If you want to optimize your body for pregnancy, it would be great to know ahead of time when you’re definitely not pregnant because there’s a lot of stuff that we can work on that we can’t get to once you’re pregnant like all of the core muscles, psoas, hip flexors, and the ones that go behind the baby. Loosening that stuff up if it’s tight before you get pregnant is ideal.

 

That happens in my case more frequently either if people are on a fertility journey or they had a pregnancy that was either difficult or birth that was difficult and now they’re thinking about getting pregnant again. They’ll come in for some pre-pregnancy bodywork.

 

Once you’re pregnant, it really depends on the goals. If you’re coming for maintenance, in my view, there’s not really a time that is too early. We do make modifications in the first trimester then we make modifications again at different times as you get bigger and your body changes, but there are always ways that we can, almost always, get you comfortable, situated on a massage table and/or a chiropractic table and find those restrictions and release them.

I would say our typical patient comes in the second trimester so maybe somewhere around 20 weeks unless they are coming for something specific like sciatic pain or positioning issues or just getting ready for birth and they come later. They tend to come maybe twice a month during that middle part of the pregnancy then at the end in the last month or two, they’ll come once a week to get ready for birth.

 

We don’t prescribe a hard and fast number of visits or frequency of visits. It really depends on your goals, how you’re feeling, and what your life looks like—what kind of resources you have or want to put into it.

 

Meagan: Yeah. That’s what I did at the end of my pregnancy. I did every other week so twice a month then in the very last few weeks, like my 39th to almost 41st, I ended up going a couple of times because I started getting some discomfort and feeling some sciatica pain and things like that. My baby proved his point. He was hanging out in my back.

 

Dr. Berlin: Ouch.

 

Meagan: Yeah. In labor, he did that for 42 hours.

 

Dr. Berlin: Oh my goodness. Ouch. Ouch. I’m sorry.

 

Meagan: It was fine. I was adjusted twice during my labor.

 

Dr. Berlin: Wow.

 

Meagan: I full-on believe—I mean, I believe that my team and everything and that space I had created was an impact, but I swear that my chiropractor really did impact my VBAC.

 

Dr. Berlin: Some people swear by us and some people swear at us.

 

Meagan: I know.

 

Dr. Berlin: I’m really grateful that you were able to have the VBAC. Structure and function are important when you’re trying to get a baby through.

Can We Get Adjusted During Labor?

 

Meagan: Yeah. I mean, I saw switches in my labors with both adjustments. It’s so awesome. That was one of the questions. Can we get adjusted during labor? As a doula, I’ve been to a few births where we’re seeing this lag in this labor and the same thing. We’re working through all of the positions, but something is not quite working. We say, “Hey, let’s go get an adjustment.” We’ll go to the chiropractor with them and things big-time shift and we’ve got a baby. But yeah, are there signs that someone could use an adjustment?

 

Maybe we’ve got people in a rural area where they can’t have access to a chiropractor or maybe they’re already in the hospital and sometimes chiropractors can’t come in.

 

Dr. Berlin: Yeah, nowadays they don’t let too many people in. Always, ideally, that’s why we switch to once a week as you’re getting closer to the end so that ideally, you go into as a labor freely moving ball with enough WD-40 to carry you through. But yeah, there’s no problem generally doing adjustments during labor. Some people just schedule it and say, “Hey, will you come check on me when I’m in labor?”

 

Other times, we get called when there are some signs that labor slows if there is no progression like things don’t progress in a “reasonable time frame”, if the baby’s not in a great position, and if there’s back labor like what you were talking about. Those are all signs that it’s worth checking. Are there restrictions here in the pelvic bones? Your pelvis is not a solid bone. It is a bunch of bones connected by soft tissue. It has the ability to expand and contract and accommodate or even facilitate the baby’s movements but if everything is just in a vice grip, then it may not be able to do that the same way. It can be more resistant to the movements.

 

So we don’t do anything to the baby. We’re musculoskeletal specialists. We do things to your muscles and bones and make them more functional. That could make you a lot more comfortable. It could provide an environment in which the baby is better able to line up with the runway and things like that. Yeah.

 

So you know, it’s never a guarantee. Sometimes I’ll get to a birth and there’s really nothing to adjust. In my case, I also do body work so at the very least, I can do some body work. There are a lot of reflexology points that are just calming. There are those famous hip squeezes or counterpressure on the sacrum and lots of different massage stuff we can do to open up muscles.

 

A lot of what I do in the office I’ve learned from birth. When someone is in labor and they’re having these weird muscle spasms during contractions, you realize, “Oh, that is so tight.” I never would have guessed ahead of time that it was going to be so then as part of labor prep, I’ll explain to somebody, “Do you want to release these muscles because they can play a role?” Sometimes you can’t see what looks like the direct effect. It’s all anecdotal. No one studies on this but all of a sudden, things start to loosen up where those spasms are occurring during labor and they loosen up, then all of a sudden, you start to see a healthy progression.

 

The other thing you see a lot with bodywork is somebody, especially in unmedicated birth—I don’t think there is anything like unmedicated birth. Either you get medications or you make your own. The ones that you make look pretty cool. But if there’s someone who’s not medicated medically, there’s this major transition that you can see when a surge comes through and she doesn’t feel totally safe or relaxed and she’ll start to tighten up and sort of not consciously but fight the surge and fight herself, really. That can look pretty violent sometimes.

 

With bodywork, you can sort of help the nervous system relax to a point where it doesn’t feel like it’s in danger. It doesn’t feel like it has to fight even when intensity comes. That’s the most rewarding thing to me from being at a birth. When I see that shift is when it’s like, “Wait a second. This is more tolerable, much more tolerable if I don’t fight it.” They get the confidence to relax into it and they realize, “Okay. I’ve got this.” So it’s not always, in my case at least, the adjustments and bodywork.

 

Things that people can do on their own, there are all of the doula tricks if the baby is not wanting to come down with the peanut ball but sometimes you can actually roll different parts of the low back, glutes, and piriformis if they’re acting up. There is some stretching you can do. Some of the Spinning Babies exercises come in really handy. There is other stuff that you can do even if you can’t get a chiropractor over there.

 

Meagan: One of the clients that I went to, her chiropractor went during labor. He showed me this-- I don’t even know what it was—tight ligament or something right down next to the bone.

 

Dr. Berlin: Yeah, above it?

 

Meagan: Kind of on the side. It was honestly by the butt crack. That’s where it was, this tight thing. He was like, “Do you feel that?” I would feel it and it was so tense.

 

Dr. Berlin: A spasm, mhmm.

 

Meagan: He said, “During a contraction, press on that.” I would press and eventually, it just released and all of a sudden, we had transition coming. It was really interesting. I don’t even know what that is. He said, “Press right here.” I could feel it. It was tight. It was really interesting.

 

Dr. Berlin: Yeah. You’ll find little things like that in labor. With permission, a little trial and error, you can sometimes really find a gem that is helpful for birth or that you can do ahead of time or that you can train a partner or doula to do. It can make a huge difference.

CPD

 

Meagan: Yeah. Absolutely. So we were just talking about our pelvis and how it moves and shifts and all of these things. CPD, cephalopelvic disproportion is a common, as you probably know, diagnosis in C-sections and people wanting to have a VBAC. It’s given a lot. In my opinion, too often. I was given it myself. I was told I would never get a baby out of my pelvis.

 

Dr. Berlin: Oh wow.

 

Meagan: So that’s a big question. How can someone tell the shape of their pelvis? Does it matter? How can we make our pelvis “bigger” during birth and what can we do to help these babies navigate through this pelvis without getting this diagnosis of, “Your pelvis is too small”?

 

Dr. Berlin: Well, I think the first and most important thing always with a VBAC is to line yourself up with a provider who is really VBAC supportive, not just tolerant. If you feel really trusting that your provider is like that, then they are only going to tell you things. They know your goal and they are supportive of your goal. They are only going to tell you things that are well thought out or that aren’t just fear-based.

 

There are a few things coming together here. Number one, there is the pelvic paradox. You see someone with really tiny hips give birth to a 9 or 10-pound baby with no hiccups really smoothly. Then you see somebody who has big hips. Maybe they’ve been told their whole life, “Wow. You’re going to have great hips for birthing,” and a 6-pound baby gets stuck and doesn’t come out. How do you explain the pelvic paradox?

 

One of the explanations is that there is a big difference between structure and function. Structure is your pelvis, the bones themselves, the soft tissues themselves, and how big they are. It is measurable to a degree and your baby and how big they are is measurable to a degree. But if you’re just looking at structure without function, you’re going to see what looks like cephalopelvic disproportion a lot partially because we don’t have great measurements on these things. We have approximate measurements and partially because you’re not taking into account function. The baby’s head is not a solid bone. It’s a bunch of bones meant to smoosh through a smaller passageway than it is at its full size and the pelvis is not a solid bone. It’s a bunch of bones meant to expand and transmit something bigger than itself through while you’re in labor.

 

If those functions are working, then for sure, a larger baby can get through a smaller space even though on paper structurally, you have what looks like a baby that is too big to come through a pelvis that’s too small. Sometimes they are too big and that’s the issue. That’s why it’s really important, I think, to be with a provider who really gets you and supports you and is on board with you because if that provider is saying, “Wait a second. You have a head that is like this or the entryway to your pelvis is a concern,” then you’re really going to not be second-guessing them in the moment which is really important, I think, for safety.

 

That’s the number-one thing is if you want to have a VBAC or even a vaginal birth the first time, is to have a provider that is really supportive.

 

Number two—this is again really anecdotal. I see a lot of pregnant people every single day. What I did was a little poll on social media like, “How many people told you that your baby was going to be 9 pounds and it was substantially smaller?” A huge number of people came up. I don’t think it’s nefarious at all. I think that doctors in general and obstetricians in particular are trained to look or what might become a problem at some point which is sort of good. We want them to predict those things.

 

But then it could get carried a little too far away because it’s like, how likely is that to become a problem and what are the interventions that we take to prevent that and what are the side effects of those interventions? That’s a much more complex equation where there’s not always a clear answer. It is sometimes presented as a clear answer rather than, “These are the pros and cons, the risks and benefits as we know them. What would you like to do?”

 

I think that’s something all practitioners can learn over time. I’m certainly still a student every day 25 years later learning how I can do things better and more comfortably and more effectively. I think towards the beginning of practice for me too is that you know what you know and you want to be so helpful, but sometimes, the person on the receiving end of that doesn’t want that and that’s okay. That’s your choice. It’s 100% your choice. Even if it’s not the choice that I would make, at the end of the day, I’m supposed to support whatever choice you want to make. That’s a lesson that at least for me, took time as both a chiropractor and a massage therapist and as a doula especially.

 

Meagan: Yeah. That’s what I was going to say. It’s taken a lot of time for me as a doula.

 

Dr. Berlin: Yeah.

 

Meagan: It can be really hard.

 

Dr. Berlin: Yeah. It’s really hard. And very well-intentioned practitioners who want the best for you, who would do the same exact thing for their wife or their daughter are trying to help you, but at the end of the day, it’s an informed consent situation.

 

What happens with the measurement is that there’s no scale for the baby before it’s born. It’s a computer doing calculations. The calculations have a margin of error. Let’s say that margin of error is a pound or a pound and a half. If I tell you that your baby is going to be 7.5 pounds at birth, based on those calculations, that means it could be anywhere between 6 and 9 pounds if the margin of error is a pound and a half.

 

A) I could have probably told you that without the ultrasound. B) The problem with that is if it’s ticking upwards if the baby is measuring 8 pounds in there, now all of a sudden I’m thinking, “What if it’s 9.5? That could be too big. It might get stuck. We might have problems. We don’t want an injured baby.” Nobody wants an injured baby, so maybe we should just induce you or do a C-section or whatever to prevent that. How many of those babies are actually going to come out at 9.5 pounds? That’s the end of the margin of error on that side.

 

On the other side, you have the same issue. If a baby is measuring 6.5 pounds, you start to think, “What if it’s 5?” because of the margin of error. Maybe the baby’s not getting enough nutrition. These are all logical things to think about and important things to talk about, but we can’t forget that there is this margin of error and that there is a person who really should be the one at least involved if not making the decision. 

So that, I think is what happens and anecdotally what I see in the office happens with cephalopelvic disproportion. Either we’re doing measurements and we’re guestimating that the baby is a certain size but they may not really be that size and we’re not really looking at function. There’s a great episode of our podcast called “Labor Day Surprises” where there are two women who have both had surprises at the very end of their pregnancies and they are sisters-in-law. 

One of them had a breech baby and had quite a very interesting story there and the other one had a surprise 11-pound baby. 

Meagan: Whoa. 

Dr. Berlin: Now she is 5’8” or so. She is tall but very petite with tiny, small hips. She gave birth to the baby vaginally, unmedicated and are you sitting down? She didn’t even tear. 

Meagan: Oh my gosh. See? That’s amazing. 

Dr. Berlin: It was the most incredible thing to watch and it’s one of the few where you saw a very ecstatic birth almost orgasmic birth at the hospital. She really talks about how she got into that mind frame. Her doctor knew the baby was going to be on the larger side and said, “What do you want to do with this?” She said, “I want to try.” He goes, “Well, if you don’t try, we won’t know.” 

Meagan: Oh, that just gave me the chills. If you don’t try, we won’t know. 

Dr. Berlin: We won’t know. 

Meagan: Like you were saying, it’s informed consent. It should be up to that mama to decide if she feels that it’s a good thing to try, but we also have to respect that if we have a provider who is not comfortable with it, we have to respect them too. Maybe that’s finding a new provider or working with their partner or something but yeah. It’s interesting. 

Dr. Berlin: I mean, I know that I’m not a good match for everybody out there who is looking for a pregnancy chiropractor. I’m not a good doula for people who are looking for a doula. What’s really important is that you find providers that you feel are on the same page and that they are a good match. This happens with dating all of the time. It’s like, “You’re not for me but I have a friend and they would love you.” I don’t think– I’m never insulted if I meet somebody and they’re like, “I don’t want this type of care.” Great. Let me find someone you would love to see. 

It’s the same with obstetricians. There are some obstetricians who are very paternalistic. They make all of the decisions for you and there are people who love that who don’t want to make the decisions and who don’t want that responsibility. You guys are a great match together, but you’re not going to be a great match for my Prius-driving, vegan, hippie mom, who wants to have her baby hanging from a chandelier over a tub. You know? She’s not going to be a match for them. 

Meagan: Not so good of a match. 

Dr. Berlin: It’s not an insult. Neither one of you wants to be with someone who’s not a great match. 

I always encourage people that if you’re not with a provider that you feel comfortable with, if they’re not on the same page or your interests are conflicting, then try to find a provider who is on the same page. It makes a huge difference and you don’t get to do this very often. 

Meagan: I know and it’s worth finding that provider. Just like it’s worth dating and dating and dating until you find the one, it’s worth going out and continuing to find that provider because like you said, my best friend went to a provider that may not be the best for me. I’m happy that she found him, but I might need to find someone else and that’s okay to take that time and find that provider. 

Dr. Berlin: Totally and if you’re going a more natural route, even psychologically if you end up having a Cesarean, which I don’t think is the worst thing on the planet. I think it’s a great thing. I’ve been known to say that I think one thing worse than a Cesarean being forced on someone who doesn’t want one and doesn’t need one is not having one available to somebody who does need one. A Cesarean is a great medical marvel of our time. The doctors who learn how to do them perfect them and do them with very little risk and a lot of skill. They’re heroes to me. 

But you know, if you want a more natural birth and you end up with a Cesarean and you’re not with somebody who you felt like you are on the same page with, you’re very likely to leave that birth feeling like, “Did I really need that?” It leads to a lot of not-good mental thoughts at a time that you are already going through a tough– for most people, a big transition. 

Meagan: Yeah. 

Dr. Berlin: I can’t say it enough. Having a provider that is good for you and that is a match for you is so important on all fronts. 

Breech Birth

Meagan: Beautiful. I love that. I couldn’t agree more. Finding that provider is so important. We were just talking about these two cute sister-in-laws. They had a surprise breech and that is a question. If the baby is breech, what things could someone do on their own to help their baby turn? How soon should they start to worry? How could chiropractic care truly help that baby turn? We know that there’s not a lot. Breech is kind of dwindling away. It’s unfortunate and it’s really unfortunate that we’re not having as much support in the breech world, but we’re not. 

 A lot of people get put in a corner that if they have a breech baby, they feel like they have to have a Cesarean whether they want one or not, but they want options. How can we work with these breech babies? 

Dr. Berlin: It’s truly interesting. I think if there were more options for safe, vaginal breech delivery– not everybody’s a good candidate for that– but if there was more of an option, primary Cesareans would be down. 

Meagan: I wonder too. 

Dr. Berlin: Substantially and as a result, secondary Cesareans would be down because all of those people who had C-sections are told, “Once a Cesarean, always a Cesarean.” They don’t even get a chance. I think it would bring down the Cesarean rate greatly as a whole. The question is, what is a safe breech birth? There is a lot of debate around that but one thing is for sure. There are some people who are much better off seemingly having a Cesarean birth but they’re breech and other people who are much better off with the option to try and deliver vaginally but they’re breech. 

Meagan: You have an episode on your podcast talking about that specific topic with Dr. Brock and some other providers talking about what that looks like. 

Dr. Berlin: Yeah, we have a 3-part series called Breech 101. It’s two midwives and two obstetricians just talking everything breech from all angles. With Dr. Brock, we have another episode called “Vaginal Breech After Cesarean Breech” with a mutual patient, Dr. Donna Lou who had a breech with her first and ended up in a Cesarean because her doctor didn’t. She went into labor and didn’t have the chance to meet Dr. Brock. At the hospital, her doctor just doesn’t have the confidence or the comfort to deliver breech babies. He was very apologetic but she had a C-section. 

One of the few people I have seen over 20 years who was breech again with no known reason, with her second, Dr. Brock also equally baffled said that she is a great candidate for VBAC and a great candidate for breech birth. The two, the risks that come along with those, don’t compound each other. It’s just two different sets of risks. What would you like to do? She opted for the vaginal breech birth after a Cesarean breech birth. I have them both on and they talk about the decision-making that went into it and what the process was actually like. 

When it comes to breech, I have a premise which is that– let’s talk about a singleton baby in a first pregnancy. That’s where we have the most data. I have a premise that at the end of pregnancy, babies generally want to be head-down. The reason I have that premise is because according to Williams Obstetrics, these numbers are a little bit old, but still seemingly relevant. 

At 28 weeks into a singleton first pregnancy, about 50% of babies are not head-down yet. 

Meagan: 50%. 

Dr. Berlin: 50% at 28 weeks. Now, at 32 weeks, about 10% are not head-down yet. You go from 50 out of 100 babies that are not head-down to only 10 out of 100 babies in a 4-week period of time. 

Meagan: That’s a lot of babies that turn in a very short period of time. 

Dr. Berlin: It’s a big migration and it’s seemingly because they run out of space. When they have space to move around, they can move all over the womb. It doesn’t really matter. Nobody really cares. They are exploring so no big deal. As they start to run out of space, they have to pick a position that is most accommodating in the space that they have and generally in a typically-shaped uterus for a typically-shaped baby, that is head down. That is where they try to go. 

At birth, at 37 weeks and beyond in that first pregnancy, the breech rate is 3-4%. So it goes all the way down to 3-4 out of 100 from 50. That’s where the premise comes from at the end of pregnancy, babies generally want to be head-down. If they don’t go there, there must be a reason for it. There’s usually a reason. It could be something structural. It could be something functional. Sometimes when we have no idea why, like in the case of Dr. Donna Lew. Why would babies structurally? Well, there’s a lot to consider. Maybe the cord is wrapped around them funny. Maybe the placenta is in the way especially when it’s on the front wall, it seems to pose more of a getting-in-the-way factor. 

None of these, by the way, are absolute factors. I have a lot of people that come in with a placenta in the front and the baby does turn. But it seems like of the ones that don’t turn, more of them have the anterior placenta. 

Amniotic fluid seems to play a role. So if the amniotic fluid index normal is somewhere between 8 and 24, with all of those being normal is a big range. 8, 9, and 10 are healthy but not so much fluid volume for baby to move around. 18, 19, and 20 are also healthy but so much fluid volume that even after 32, 33, and 34 weeks, your baby may have a lot more room to move around than other babies and not have a trigger to pick a position and get head-down. 

If you add other things to that like it’s your third pregnancy so there’s more room in the uterus anyway and if you’re tall and if the baby’s measuring small, you can take all of those things into account. Not all breeches are exactly the same. 

The shape of the uterus is a big deal too. Sometimes if the shape is different, it seems not conducive for the baby to get head-down or for the baby to be able to. Functionally, it’s your body. Your lower back, hips, and pelvis are supposed to be pretty loose, relaxed, and open at the end of pregnancy. Your body is doing that hormonally in several different ways but if everything is stiff, tight, and rigid for various different reasons– injuries or excessive workouts or other things like that without enough stretching, then especially if you’re strong, you can have a pelvis that is strong, tight, and rigid. As the baby’s running out of space, maybe down there is not where they are being invited to go. Maybe the end of the rib cage is a lot more inviting or if they’re trying to move as we said before, the body may not be able to accommodate the movements the same way. 

When I work on breech, I’m not doing anything for the baby itself. I’m not doing anything to the baby. I’m not trying to turn a baby or move a baby. I’m working on the musculoskeletal structures of the baby’s surroundings which is the mom and if they’re stiff, tight, and rigid, we’re creating more functional space using massage to loosen up the soft tissues and chiropractic adjustments to open up those restricted joints and maybe gravity. We have tables that invert so maybe a little bit of gravity if something is really stuck trying to give the baby an opportunity to move naturally with gravity. 

We also in our office have acupuncture so we also do moxibustion which seems to stimulate more natural movement so it’s synergistic. I can create more functional space and they can create more movement in that space. It gives those babies a chance to turn more naturally. When do we start? Usually around 32 weeks but I always tell people, “Look. At this point in that first pregnancy, 10 out of 100 babies roughly statistically are breech, and in birth, it’s only going to be about 3.” If I was a betting person, I would still bet that your baby’s going to turn. The stuff that I’m doing is really insurance. It’s going to be helpful for birth anyway but I tell them not to panic at that point. And then of course, you have to look at all of those factors that we mentioned to see who is more or less likely to turn and you can tell based on the fluid, the uterine shape, the placenta location, and so on. 

Meagan: My VBAC baby kept going breech. At 32 weeks, he was going breech. She would motion him and he would flip then the next visit, I was like, “His hiccups are up here again.” He would be breech. He did that until 36 weeks. I think it was 34.5 or 35 and she was like, “We have to trust this baby. We have to trust that this baby needs to be head-up for whatever reason” and I was kind of grouchy because I was like, “I don’t want to have another C-section just because I had another breech baby.” I really wanted this VBAC, but yeah. At 36 weeks, I went in and he was head-down and he stayed head-down. 

Dr. Berlin: Do you remember if your fluid was toward the more generous side, middle side, or lower side?

Meagan: It wasn’t super high, but it was on the higher of the normal. He did have a shorter cord when he came out, so I don’t know if maybe something was bugging him there, but yeah. He flipped head-down. It was great, but it was hard. It was hard not to get panicky. 

Dr. Berlin: Sure, yeah. That’s the thing. A lot more people have to think about breech than actually have breech at the end. 

Meagan: Yeah. Yeah. 

Dr. Berlin: So if there are 4 million births in the United States every year and 10% of them are breech at 32 weeks, that’s 400,000 people every year thinking about breech but only about 3-4% are breech at the end like 160,000. 

Meagan: Yeah, I even had a client. I’m going to jump off of the breech topic, but I had a client who was breech and was scheduled for a version the next morning but went into spontaneous labor that night. We went in at 1:00 AM and baby was head-down. She was 9 centimeters when we got there. Her body just needed contractions to finish rotating the baby. I have no idea but sometimes it can happen. 

Okay, so let’s see. Post C-section. This is in regards to cupping fasical release and stuff like that that you guys do in your office as well. Is that something that you would suggest? This is another type of bodywork essentially. 

Dr. Berlin: New mama TLC. I think whether you have a Cesarean or a vaginal birth, it’s a lot on the mind and body, and nervous system, so I try to do a longer session soon after usually by two weeks regardless of the mode of delivery unless there is some kind of injury then you are good. We can do most things. The goals are to– sometimes there are smaller injuries from birth like injury to a tailbone or pubic bone or something like that. We can address those right away. I’ve had people pop a rib out pushing so hard so we obviously can pop that back in after a vaginal birth right after birth. 

Meagan: Wow. 

Dr. Berlin: The goal is if there are any injuries, we deal with them right away. After that, it’s sort of like the sports massage when you’ve run a marathon. Just wear and tear on the body and trying to move that excess fluid around and have it be reabsorbed so we do some lymphatic work and finding those overworked muscles and to relax those muscles and at the same time, if we can work it in, a little sensual nervous system relaxation work to help reboot the system. 

Meagan: Yeah. 

Dr. Berlin: And to come back online with calm and quiet. So either a little meditation and/or some cranial work. While our normal visits are 25 minutes at that point, we do an hour-long session to try and get all of that in during the first one or two postpartum visits. There’s also a great opportunity at that point, especially for people with more chronic things that they deal with pain-wise. You still have the pregnancy relaxation hormone for a bit. You don’t have the baby inside there pushing on you 24/7. You’re kind of more moldable clay. I’ve had several instances of somebody who had a lifelong chronic thing from an injury and during that period, we have a better shot at making a lifelong correction there. 

Meagan: I’ve never even thought of that. I’ve got this long-term back issue. I’ve got this relaxin and great stuff in my body. Let’s work with that. 

Dr. Berlin: Yes. Let’s use that advantage. I had a patient who was really eager to do that and then she got COVID and she couldn’t come back. It created a whole bunch of problems for her and she’s like, “Damn. I’m going to have to have another baby.” 

Meagan: I was going to say. That’s what I would say. Now I have to have another baby. That is really awesome. Like you said, it doesn’t matter. C-section or vaginal, our bodies go through quite an event and take a lot of shifts and changes so chiropractic care can be beneficial after as well. We’ve talked about it with babies as well. They go through a lot and that can be impactful. My little boy didn’t poop forever. It was 9 or 10 days. We got him adjusted and he had the biggest poop in the world. 

Dr. Berlin: We see that all the time. 

Meagan: He passed out and slept all night. I woke up all engorged and I was like, “Oh my gosh.”

Dr. Berlin: I know. It’s the number-one feedback. “My baby slept so well after the adjustment.” 

Meagan: I know. We need it. Babies need it. It’s so impactful. Back in the day, way, way, a long time ago, I didn’t love the idea. Chiropractic care scared me. It can be scary because you can hear some people talk about it. Like you say, someone is yelling at you. It can be scary sometimes how people talk about it but it doesn’t have to be scary and if you find that really good, skilled chiropractor, they’re going to take care of you. They’re going to help you through this process. 

Pubic Symphysis

They’re going to help you with pubic symphysis which is another question. I know we’re running out of time but if you have anything you’d like to share on pubic symphysis, that is a really big one. The more babies we have, sometimes it starts earlier. 

Dr. Berlin: Yeah. And then it’s weird also. Sometimes it doesn’t happen at all. It’ll plague somebody in the first pregnancy and then not be there. Just a comment on the scared about chiropractic bit, certainly chiropractic isn’t for everyone, but it comes back to finding a good match. As I said at the beginning, there are a lot of different ways to find and release those restrictions. Some of them are very, very gentle. It doesn’t have to be that cracking noise that a lot of people are off-put by or violent-looking maneuvers. If you want the benefits of chiropractic but that’s what’s holding you back, find someone who does a low-impact technique or network or activator. 

Meagan: Drop table. 

Dr. Berlin: Drop table. 

Meagan: Yes, I was going to say the activator. 

Dr. Berlin: Sacro-occipital technique. There are so many that are gentle. The neuro-emotional technique. Okay, so in terms of the pubic bone, there is a right and a left side to the pubic bone. They are separated by pubic cartilage. I’ve learned over time that there are different types of pubic pain and they present differently. It’s still definitely a work in progress. I’m learning new things all of the time. 

The most common one that presents during pregnancy is pain on sort of the lower pubic bone, the underside of the pubic bone where the fine meets the bone. It’s usually only on one side or substantially worse on one side and it’s like when you separate your knees. When you bring that pubic bone apart, that right and left side apart, so if you get out of bed one leg at a time or if you get out of the car one leg at a time or when you engage it to roll over in bed if you haven’t been moving for a while. 

A very common one is to lean over to put on pants and lift one leg then ouch, it’s very painful. What seems to be happening there in most cases is that you have an imbalance in the right and left side of your pubic bone. Let’s say that you have the muscle coming up your thigh attaching to the underside of that pubic bone and pulling harder on one side than the other side. When you’re totally stable, your body can accommodate that. But as the relaxation hormones kick in and they kick in pretty early, the pubic cartilage that is holding it together maybe can’t compensate for that imbalance so the right and left sides end up not lined up with each other anymore but they torque so every time you engage it and pull them apart, it’s very painful. If you could get them to line up again, then it would be either not painful at all or less painful. 

The combination that I use in that case that tends to work pretty well but not always is either massaging out the upper adductor like a deep massage to lengthen that adductor so it’s not pulling so hard and then a trigger point right where that adductor inserts to the underside of the pubic bone. It’s sort of an act of release trigger point as I’m pressing into it. They engage the muscle and then release the muscle. Engage and release a couple of times and then there’s a little test that I do for it also which is if you’re laying on your back or in a semi-reclined position and your knees are bent, feet on the massage table, or a yoga mat, or anything like that, I’ll try to gently pull the knees apart against resistance from the mom. If that is weak, first of all, it doesn’t really have a lot of strength. It elicits that sharpness in the place where the pain has been bothering them. That’s a pretty good sign that this is the mechanism and that doing that combination of massage and trigger point and then adjusting the pubic bone with a drop table will give significant relief. 

Meagan: Wow. Okay, so that could be a test to say, “Okay. This could be impactful if you do this technique.” 

Dr. Berlin: Right. Then if it’s not, I wouldn’t do it necessarily because it’s not the most comfortable thing. It’s always up to them. I could still offer it and see if they want to do it even if it’s a long shot or not do it even if it’s a sure bet. 

But other types of pubic pain that I have identified are definitely the pubic symphysis cartilage itself sometimes gets inflamed. It’s not one side or the other. It’s right in the middle and it’s higher up on the pubic bone. Oh, that’s you. 

Meagan: That was me. It was ow. 

Dr. Berlin: I find acupuncture and I’ll tell you something else in a second. Acupuncture, icing, and a support belt that lifts the belly up off of the pubic bone are some of the things that are more relieving there. 

The third type is the round ligament. They attach to the soft tissue right near the pubic bone on sort of the top ledge of it towards the outside, the upper corners of it. If you have a round ligament that is tight and pulling all of the time, then that becomes very sensitive. In those cases, we try to massage out or gently stretch the round ligament until it relaxes. That usually takes the pressure off there. 

One thing I would also say if you’re feeling it there in the pubic symphysis cartilage and especially if you’re also feeling it in the back by the sacrum or tailbone is to look for hyperactive pelvic floor muscles, a hypertonic pelvic floor. The pelvic floor runs from the back of the pelvic floor to the front of the tailbone. When it gets really tight, it will pull on both of those areas. Especially athletic women but not only– sometimes you have a hypertonic pelvic floor from all of the activities to strengthen and tighten. You might also be doing that to your pelvic floor. 

Up until not that long ago, all we knew about pelvic floor was that it can get weak so everybody is instructed to do these kegels and strengthen them but if it’s already hypertonic and you strengthen it, you might be making it worse. So thankfully, we have these pelvic healthy physical therapists as a specialty now. People are just training on that and how to strengthen the weaker ones and loosen the tight ones, making pregnancy and birth more comfortable, more functional, and postpartum wellness. Postpartum sometimes can be treated. 

Meagan: Yeah. So as you are saying this, I have a weird question. I had all of that during labor and then since, I am really active. I am a road cyclist and I like to lift and all of these things. I get adductor pain now where it’s not as tight and burning right in that pubic symphysis but right in that adductor. Do you think something could still be connected through that pelvic floor?

Dr. Berlin: It’s always worth checking if you haven’t had it checked. The adductor by itself could just be the adductor. Sometimes just from the workouts that you’re doing– lifting especially could make it really tight and it just needs to be rolled out or dug out and you might benefit from those trigger points too on the ends or the inserts on the top and the bottom. Pelvic floor could be a factor. There sometimes are other factors too. Even a little drop incontinence when you get the urge, it’s like, “I’ve got to go right now.” 

Meagan: Yeah. 

Dr. Berlin: Or pain during intercourse or things like that or if you jump on a trampoline or you sneeze and you pee, those are signs that something is up with the pelvic floor. It’s not functioning quite right and worth investigating with a specialist. 

Meagan: Yeah. I think a lot of people don’t even remember that even C-sections can impact that pelvic floor and our whole body and create that tension and restrict us from having good mobility. 

Dr. Berlin: That is an amazing point because it is absolutely true. The end of pregnancy puts a lot of strain on the pelvic floor no matter how you deliver. 

Body Support at Home

Meagan: Yeah, so again, definitely check out the chiropractors in your area. So for those who maybe can’t have chiropractors or can’t have access, are there any tips or maybe places on the Informed Pregnancy Plus channel where people can learn not to adjust themselves but do stretches and do those things that can help create that mobility and help them have these vaginal births that they’re wanting? 

Dr. Berlin: Yeah, there are tons. Spinning Babies has a whole bunch of great exercises that you can do. It’s a good idea. We have a course that we do called Labor Kneads. We only do it live right now, but it’s where we’re teaching partners and doulas and other support people to do bodywork before, during, and after birth. That’s a great idea for us to shoot that and put it up on the streaming service. I can’t promise it for one, but I will certainly try to do that. 

The other thing is that there is a great listing of chiropractors with separate post-graduate training. You should know that anybody who is a licensed chiropractor can work on pregnant people. It doesn’t have to be a specialty. 

Meagan: Or Webster-trained. 

Dr. Berlin: Yeah, it doesn’t have to be Webster-trained or it doesn’t have to be somebody who is a prenatal chiropractor. There are some chiropractors who don’t feel comfortable working on pregnancies. Some don’t have all that much experience, but there are a lot who are not prenatal. They are just family chiropractors and as a result, they see a lot of pregnancies. You don’t have to have a specialty to do it. So unless there’s no chiropractic in your neighborhood, then there might be people who can work on you even if it’s not a specialty clinic like in our case, we call it pregnancy-focused chiropractic. 

The other thing is that there’s a great website by the International Chiropractic Pediatric Association that does a lot of postgraduate training in pediatric and prenatal chiropractic care. They have a listing by zipcode and their website is icpa4kids.com. You can search by zip code in the United States and Canada and maybe some other international options. 

Meagan: We’ll make sure to also put that in the show notes for everyone listening. Last but not least, the big question is does anybody not qualify to receive chiropractic care? 

Dr. Berlin: Yeah, I mean, I would almost say that there are some conditions during pregnancy that come up that are delicate. During those very delicate conditions, I love to work together with the obstetric provider. At that point, it’s usually going to be an OB/GYN or a maternal-fetal medical specialist and just access their comfort level with the things that we do. Almost always, it’s going to be modifications. It’s not that we can’t adjust them at all or do any bodywork with them, it’s going to be modifications. Sometimes we’ll just wait a couple of weeks and then do the treatments but for the most part, you can do something for everyone who has things that are stiff, tight, and rigid and are either uncomfortable or want to improve their function. 

Meagan: Awesome. Well, thank you so much for taking this time out of your day with all of your projects. You’ve got so many hands in buckets. You wear so many hats these days so it’s really been such an honor to have you on the show and answer all of these amazing questions. I full-on believe in chiropractic care. Like I said, a long time ago, I was like, “Ah!” and then I started getting into chiropractic and I’m like, “No, this is really impactful on so many levels.” 

Dr. Berlin: It is. 

Meagan: I mean, I’m not even pregnant or planning on conceiving but I still go to the chiropractor because it really does impact my life in a better way. 

Dr. Berlin: We have moms come in here and they make an appointment. They say, “I want to make a postnatal appointment with Dr. Berlin.” The reception team will say, “Oh, how old is your baby?” They’ll say, “13 years old.” I’m like, “Yeah.” You don’t have to only be pregnant or postnatal to come here. 

Meagan: A postnatal visit. How old? 13. Okay. That’s just called a chiropractic visit. That’s all that you have to say. 

Dr. Berlin: It is, but once you have the baby, you have all of the bending, lifting, holding, feeding, emotional stress, and things like that. The maintenance during that active phase of life is important. 

Breastfeeding

Meagan: Yeah. Oh my gosh. I just said I’m going to end. I feel like I could talk to you all day. 

Dr. Berlin: Same. 

Meagan: But something I feel that impacted me and I know a lot of our doula clients is breastfeeding. When we’re breastfeeding, we’re hunched and curled. Our neck is down and we’re in wonky positions then we’re out and we’re stretching then we’re like, “Oh, this is painful” or all of a sudden, my milk supply is not that great, and weirdly enough, chiropractic adjustments can help your body and you nurse better and help your production because your baby is going to nurse easier. You’re going to nurse easier. Everyone’s going to be better. 

Dr. Berlin: When you’re in a lot of pain, the stress hormones put you more in emergency mode, and making milk is not an emergency function. There’s that and there’s literally just the– here’s one tip I would say that seems to help a lot of people. If you have a nursing station, especially in those early couple of months, you can put a full-length mirror in front of you so you can see what’s happening without looking straight down. That seems to be helpful for a lot of people. 

Meagan: Absolutely. Yeah. To just be able to see and not be curled over. I mean, you are looking at your baby, but you can look down at your baby versus– 

Dr. Berlin: Across. 

Meagan: Yeah. 

Dr. Berlin: Yeah. One thing that gets a lot of people is that you’re trying to get some sleep and the baby is in a comfortable position and it’s not comfortable for you but you don’t want to move because you don’t want to wake them up. That’s gold for the chiropractors. 

Meagan: It is. It is. Oh, well thank you so much again. It’s such an honor. We’re going to make sure to have all of the links to your channel, to your page, and to your website. This chiropractic search forum and everything. Everything will be in the show notes so everybody will be able to find you. 

Dr. Berlin: Thank you. 

Meagan: Like I said, if you’re listening and you haven’t been able to yet, hopefully now you’re not driving if you were driving. Stop and go follow Dr. Berlin. 

Dr. Berlin: Thank you so, so much for having me and the incredible work you do. I could also talk to you all day and I’m going to have you back on our Informed Pregnancy Podcast and I can’t wait to hear your full story. 

Meagan: I would love to share it. It’s quite the story. 

Dr. Berlin: Awesome. Thank you. 

Meagan: Awesome. 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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Today on the podcast, Sarah joins us from Minnesota. Sarah got COVID-19 very early on in her first pregnancy during the height of the pandemic. The protocol at her practice was to recommend a precautionary 39-week induction. Sarah trusted her doctor and consented to the induction along with other interventions that were suggested. Her birth ended in a Cesarean under general anesthesia. 

During recovery, Sarah’s knees would buckle to the point where she needed assistance walking and fell until the problem slowly resolved. When she achieved her VBAC, Sarah was able to immediately walk unassisted. She wasn’t groggy from just having had anesthesia. Her throat didn’t hurt. She got the immediate skin-to-skin she missed the first time.

Sarah is such an amazing example of how powerful a VBAC birth can be, especially with the right prep and the right team. We just love how hands-off and supportive her doctor was. Sarah went into her birth mentally and physically strong. She labored hard, stayed calm, and pushed her baby boy out in 20 minutes!

Additional Links

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How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Welcome to The VBAC Link. We have a story for you today coming from Minnesota. We have our friend, Sarah. And Sarah, tell me. Did you have your babies both in Minnesota or have you moved since then? 

Sarah: Yes, both in Minnesota. 

Meagan: Both in Minnesota. All right, so Minnesota parents, listen up. This is a wonderful episode in your area. 

Review of the Week

As always, we have a Review of the week but first I want to talk a little bit about COVID-19. Sarah and I were just talking about how we have seen so many COVID-19 stories coming through. They had their C-section through COVID-19 or even had their VBAC during COVID-19 and then now they have gone on to VBAC. 

There is definitely a trend of situations that we are seeing so I’m just so curious today. Go comment on today’s episode and let us know if you have any relation, but a lot of providers are wanting to induce if you have the virus, COVID-19. Sarah, that was kind of the case with you, right? They wanted to induce because you had COVID-19. 

Sarah: Yes. That was kind of the standard of care at that point. 

Meagan: Yes, which is kind of interesting to think about the new standard of care. I really am curious to see one day what the Cesarean rates did during COVID-19. You know, there is some evidence here and there on it, but I’m really curious to see what the Cesarean rate did because we do have a lot of people saying that they were induced because they had COVID and then they ended in a Cesarean. So we’re going to talk a little bit. She’s going to share her birth and her induction story that then led to her VBAC. 

But of course, we have that review. It is by Raving Abbeh and the title is “Confidence.” It says, “I found this podcast at 34 weeks pregnant and it helped me gain the confidence to fight for my chance and get a VBAC. I hope to submit a success story in a few weeks.” 

And guess what? This was also during 2020, so Raving Abbeh, if you haven’t submitted your story, we would love you to and as always, you guys, we’re always accepting stories. We definitely record in chunks, so know that if it takes time, that doesn’t mean you haven’t been chosen or you will never be chosen, but if you want to submit your story, go to thevbaclink.com/share. 

Sarah’s Stories

Meagan: Okay, Sarah. Welcome to the show. 

Sarah: I’m so excited. 

Meagan: I’m so excited. I’m so, so excited. Well, tell us more about this 39-week induction and why they were saying it was the new norm. It was the protocol, right?

Sarah: Yes. So at this time, I was working full-time in the hospital where I gave birth as a radiographer– an X-ray tech. I was kind of in the world a little bit. It was definitely not a fun time to work in the hospital. I actually tested positive when I was 8 weeks pregnant, so very newly pregnant. 

I was seeing family med for my provider and what they were doing at that time, they said, “Okay. This is what’s going to be different. You’re going to meet with a high-risk OB who specialized in COVID.” I would have growth ultrasounds every 4 weeks and then also, they were recommending this induction at 39 weeks. 

When I asked about that, what she said was that they had seen issues with the placenta. That was the reason that they had. I actually looked back on it now and I think in the study, they really only had 16 pregnant people so that was what they were basing this all off on. 

Meagan: Which is really nothing to start making a protocol so wide-ranged. 

Sarah: Right. Right. And actually, right now, my sister-in-law had COVID and she’s pregnant. She had COVID at the same time I did at 8 weeks, but now it’s 2023 and her doctor is not doing the growth ultrasounds. They’re not recommending induction. There actually is nothing different with her current, right-now pregnancy which I find interesting. 

Meagan: Interesting, right? Right? 

Sarah: But again, it can range. 

Meagan: In 2020, it’s interesting because they were like, “Oh, we’re going to have you with this provider who specializes in COVID pregnancies,” but how does someone specialize that fast? 

Sarah: Right. The person that was the specialized person was the highest-up person in the department of OB. 

Meagan: Okay, so definitely a specialized OB. Okay. 

Sarah: Right. I actually only ended up meeting up with her one time because if there was anything abnormal, that’s when I would go to her but my pregnancy was completely normal. I had no issues related to COVID or related to anything else which was obviously a blessing, but kind of also a bummer because now, I’m going to have this completely unnecessary induction at 39 weeks.

Meagan: Yeah. 

Sarah: She did mention at the time that if I wanted to go past 39 weeks, I could definitely make that choice but she would do NSTs. Now after learning so much and being where I am now, I would have been like, “Okay. Let’s go longer and do NSTs,” but at the time as a first-time parent, I was like, “That sounds kind of weird. Let’s just do what you think.” 

Meagan: It sounds intense with all of these extra visits. It’s a lot. It sounds like a lot. 

Sarah: Yeah. Otherwise, about that pregnancy, being a first-time parent and having this medical background, it’s no surprise probably that my attitudes towards the doctors were that I completely trusted their knowledge with the COVID stuff because it was so new. 

Meagan: Oh yeah, and scary. 

Sarah: Yeah, definitely, but I was completely unaware that there was such a wide range of ways to treat pregnancies and so many different attitudes on how to birth babies. I was just clueless to the whole thing about the cascade of interventions and why do inductions have an increased risk of C-section? I was completely clueless to it. I am just used to with a doctor, you have a certain condition and there are ways to treat it. It was very narrow. 

But with birth, there are midwives. There are doulas. There are so many different ways to treat someone’s birth and pregnancy that was just over my head. When people would ask me, “Oh, why are you having an induction?” and tell me that maybe I shouldn’t do that, I was like, “Oh, well why wouldn’t I when they say that is the best thing to do for this COVID situation?” For me, it was like, “Well, they know better than me.” 

Meagan: Right, yeah. 

Sarah: I think you say all the time that you don’t know what you don’t know. 

Meagan: You don’t know what you don’t know and you can’t judge yourself for not knowing what you don’t know. 

Sarah: Yes. I definitely had to work through forgiving myself for sure. 

Meagan: Yeah. You have to take the information. I think I talked about this too. My husband had said this. We took the information we were given and made the best choice that we felt we had with the information provided. 

Sarah:  Yes. 

Meagan: Right? And that’s what you did. 

Sarah: Right. Honestly, it’s funny now. Even just preparing for birth in general, take away the COVID part, it’s kind of funny how I did basically nothing to prepare for birth. I just focused on my registry and other things like that after the baby got there. 

It was kind of because I had this, “Oh if I go with the flow, I’ll have the best outcome. I don’t want to put too many expectations on myself. I don’t want to pressure myself. I’m just going to go with the flow. I don’t know how my body is going to handle it,” which does have a place. There is a goodness to that, but I think I was a little too extreme where I was like, “My mom had C-sections. I know if that happens, it happens.” It was just very, “Whatever happens, happens.” 

Now, I look back and I’m like, “Well, now all I did was have no tools in my toolbox to deal with pain, labor, or resources to help make those hard decisions that I was going to have to make.” I had nothing in the background to help me with that. 

Meagan: No tools in your toolbox. 

Sarah: Exactly. That’s why it was very different for my second birth but at that time, I was like, “Okay, whatever happens, happens. I don’t know what’s going to happen to me or how my body is going to take it, so we’ll just see what happens.” 

I was scheduled at 39 weeks on a Monday and actually, that Friday before, they called me and said, “Hey, do you want to come in early? We have a lot of people scheduled on Monday.” I was like, “Oh, I’m excited to meet my baby. I’ll go in even earlier,” which is like, oh. Okay. 

That weekend, we were actually moving into our new house an hour away. 

Meagan: Oh my gosh. 

Sarah: We actually spent one night at our new house and the next day we drove back to Rochester to have our baby but we were so excited. 

Meagan: Yeah. Absolutely. 

Sarah: I wasn’t even thinking about anything else. We were scheduled for a 7:00 PM Saturday appointment then. When I got there, I was completely 0% dilated. Closed. 0, 0, 0, -3 station. Furthest from ready. 

Meagan: Not ready to have a baby, yeah. 

Sarah: No. So they started me with Cytotec overnight and in the morning, they placed the Cook catheter then they started Pitocin right after. I faintly remember watching Beauty and the Beast bouncing on a ball, but that was the extent of any movement in my labor. Like I said, I didn’t prepare for anything. I just was like, “Oh, bounce on a ball. Everyone says that’s good.” I didn’t do much. 

But what did start happening was the baby was having decels, not liking the Pitocin, so I had to get moved from side to side. I was lying on the bed– not the best position to have the baby not be so high up. 

Meagan: Right. 

Sarah: But then by 10:00 AM, they took out the Cook catheter. I was 4 centimeters dilated. Things were moving along. 

But then at 11:00, they had to turn down the Pitocin because again, the baby was still not tolerating it very well. Then I felt a big pop in my belly and I was like, “Oh, is this what it feels like when your water breaks?” I was excited. I’m like, “Oh, that sounded like a balloon popping.” 

So they came in and they were like, “No, we don’t see anything. Your water didn’t break.” I was like, “Oh, okay sure.” 

Meagan: I felt something. 

Sarah: So then a half hour later, they came back in because they had to actually turn off the Pitocin because the baby still wasn’t happy. They checked me and they’re like, “Oh, there’s all your water,” and it gushed out on them. So I was like, “Okay, well at least I know that I can trust my intuition even though you didn’t quite believe me.” 

Meagan: Yes. 

Sarah: But I’m not crazy. It did break. 

The contractions were getting really intense at this point. I tried laughing gas. It didn’t really work. At that point, I decided, “Okay. I’m ready for an epidural. I feel like I’ve gotten as far as I can with what I prepared,” which was nothing. I actually found out this after the fact, but at this point, they actually gave me medicine to stop my contractions. 

Meagan: Like terbutaline or something?

Sarah: Yes, exactly. They gave me that at this point. I actually have no recollection of this, but I was able to look at my records after the fact and I was like, “Oh, I never knew they even gave me that.” Apparently, they gave me that to stop things or slow them down or whatever. 

I was about 5 centimeters dilated at this point and they placed the epidural. Everything went smoothly with that and then an hour later, they were like, “Oh, we’re going to start the Pitocin again.” I was like, “Okay.” I was 5 centimeters at that point and then 40 minutes later, they checked me and I was 9 centimeters. 

Meagan: Whoa, so your body went into total relaxation mode and dilated. 

Sarah: Yes. Yes. I was like, “Cool. That was fast.” They had just sent away the doctor. They had to call her back. Shortly after that, I was at 10 centimeters, ready to go. This is when they had me start pushing. One important part that I know now is that I don’t remember ever feeling pressure or the urge to push or anything like that. They were just like, “Okay. It’s time to push.” I’m like, “Okay.”

I did end up pushing for about 3 hours. They did let me try a few different positions. They tried to turn down my epidural to help too, but she never really progressed past that zero station. So nothing was happening. I was mostly on my back for all of it.

I remember them saying that they would let me push for the most at 4 hours, but at the 3-hour mark, I was exhausted. I felt like we had made no progress. I was just like, “Nothing’s going to change in another hour at this point for me. I don’t know what I’m doing. You try to tell me how to push. I still don’t know.” 

Meagan: Yeah. You’re just like, “I’m tired.” 

Sarah: Exactly. The contractions were beginning to be really painful. Again, I didn’t really have a way to cope with them. The pushing wasn’t working so I consented to the C-section. I just remember feeling so defeated and just crying, being wheeled into the OR. My doctor stayed right by my head and talked to me until my husband was supposed to come in because I kept saying, “Hey, I feel these contractions. They are strong.” They were trying to give me all of the medicine to numb me enough. They were doing the prick test to make sure that I couldn’t feel it and I just remember it was really hard because my nose was plugged up from crying. I felt like I couldn’t breathe anyway. I wasn’t sure about the pokes. I was like, “They are sharp to me. I feel them. They don’t feel like pressure. They feel sharp.” 

They were like, “Okay. Well, we’re going to have to put you under.” They put the mask on me. I breathed in and went to sleep. 

Meagan: And you were gone. 

Sarah: Yep. Then I was gone. 

Meagan: Your husband probably never came in then? 

Sarah: So he did get to go into the OR. She was born. They let him go in so he was all gowned up. He was in the OR. He kind of tells it like, “Yeah, it was so weird. I looked over and there you were on the table.” He wasn’t so close to me. 

Meagan: Sleeping. 

Sarah: But yeah. I was sleeping. He did get to do skin-to-skin. They let him do that in the OR which was really nice. They got a bunch of pictures of her getting weighed and him cutting the cord in there so it was nice to have some of those pictures that I can look back on. 

Meagan: Right. 

Sarah: That’s something. 

Meagan: Right, yeah. It helps you relate, too, when you’re not awake. 

Sarah: Exactly. It was definitely a weird experience. But when I did come to, apparently, I had been awake longer but you know how that works. When you’re waking up from anesthesia, it’s kind of weird. But apparently, when I woke up, they told me that I was just like, “Where’s the baby? Where’s the baby? Where’s the baby?” They rushed me back. 

I don’t remember any of that, but what I do remember is when I woke up, my throat was so sore and hurt so bad. But she was on me and she latched immediately and started feeding so that was really special. 

Meagan: Yes. 

Sarah: Just how she was able to eat right away and I didn’t have any problems with that which was really nice. I know that can happen sometimes. That’s basically that birth. 

Meagan: An unexpected ending and a less-ideal situation, but then to come out and have things work out really nicely was probably really healing and comforting. 

Sarah: Yes. Right away, I was definitely happy. She was healthy. I was okay. She was eating. But I remember just recovering from a C-section, you’re in a fog. I remember my legs being in those machines to keep the blood flowing, having a catheter, having my sore throat, and whispering to talk. That kind of thing was definitely not a fun recovery in that aspect right immediately after. 

Meagan: Yeah. 

Sarah: I actually had a really weird thing. I had problems with my knees. 

Meagan: Oh. 

Sarah: I have never heard anyone else talk about this. 

Meagan: Interesting, like wobbly and strong? 

Sarah: So what happened was once they took out the catheter and then they give you the, “Okay, it’s time to try to go to the bathroom for the first time.” When I tried to stand up, my knees would just buckle. The first day, I had to have two people assist me to the bathroom. The second day, it was also a two-assist. Slowly, they started to not always buckle. I was in the hospital, I think, for four days. Four or five days. 

Eventually, they wouldn’t buckle but when I got home, they would buckle when I went upstairs. I did fall twice but slowly, they did get better. It was fine. It was just if I unexpectedly took a step. My cat scared me and I stepped and then I would fall because my knee wasn’t expecting it. 

Meagan: I just looked it up because I am legitimately curious. It says, “Acute lower limb compartment syndrome after a Cesarean.” 

Sarah: Oh. Hmm. 

Meagan: Interesting. So it can happen. 

Sarah: Interesting. I was just kind of assuming it was a mix of me being numbed from the waist down for hours and then my legs being up in the air for hours and then being in the C-section, and then also laying down. Do you know what I mean? Something with that, but no doctor or anything ever said anything to me about it. They were just like, “Oh, okay. That’s weird.” 

Meagan: Yeah. Really, really interesting. It says that it’s rare. 

Sarah: Oh. 

Meagan: It’s pretty rare, so you get to be in one of those rare groups. Thank you for sharing. 

Sarah: Yeah, so otherwise, I hadn’t really fully processed the birth but every time I would tell my birth story, I would choke up or cry and that’s when I realized, “Oh, maybe I didn’t really like that very much” because at first, you’re just happy the baby is okay and you’re okay. I actually remember right afterward, I was like, “Oh, okay for any other baby, I’ll just schedule a C-section. This time it will be planned and I’m going to be awake for it.” 

I honestly wasn’t even thinking about VBAC right away. I was just like, “Oh, the future will be easier. It will be fine.” But when my daughter was around 6 months old, I started to listen to The Birth Hour and I found myself searching C-section stories, looking for things like mine which led me to hearing VBAC stories, searching those out, and then finally finding The VBAC Link. That was the big game changer. 

I am so appreciative of you guys having this podcast and keeping it going on and all that. 

Meagan: Absolutely. 

Sarah: Such an inspiration. I learned so much even from both podcasts about interventions, doulas, birth teams, and most importantly, trusting in a woman’s body. It kind of leads me to this big thing. It’s like, why do we have to go through some sort of trauma to become an advocate for women and educate ourselves? 

Meagan: Right? 

Sarah: I feel like that’s such a theme. 

Meagan: It’s so true though. It’s so true. Why do we have to go through a really crappy experience? It doesn’t always have to be crappy. I’m not saying C-sections are crappy, but a big experience to have passion and to feel that motivation behind that.

Sarah: Exactly. Yep. Sometimes, it’s so hard because it’s like when you talk to someone who hasn’t been affected by this kind of situation where it doesn’t go their way in the hospital, it sounds like a conspiracy theory. “You can’t trust the doctors.” That’s not what we’re saying. It’s so much more than that. 

Meagan: It is. It really is. It’s not even just in birth. Truly, right? My husband does not do what he does, I think, mainly just because he didn’t want to do it one day. It was like, “Hey, this really unfortunate situation happened to someone I love and I want to be available in a different manner to help them or help anybody else.” So he took on his profession. It’s like IBCLCs– I’m sure a lot of them have had unfortunate or poor nursing experiences and are like, “We want to help other people have better experiences.”

Sarah: Yes, because it’s the information that, “Oh, wow.” It makes complete sense that, “Oh, things might go a little bit better if you let your body naturally do it.” Oh, well yeah. That makes sense. It makes sense that, “Oh, if I have someone who’s trained in positioning, maybe if I move my body in this way, then I can get my baby in a better position to come out better. Oh, that makes sense. Why didn’t I know that? Why didn’t my doctor say, ‘Hey, there are some positions that can help.’” 

It’s confusing to me. It’s like, well that makes sense. 

Meagan: Yeah. 

Sarah: Yeah. So obviously, I just dove right into all of the VBAC stuff and learning all about that and listening to different stories. I was super excited for my next pregnancy because I had made the decision, “Yes. I’m going to go for a VBAC and I’m super excited about it.” I was ready to do all of the things to make it more successful. 

We got pregnant when my daughter was around 15 months old. We wanted a two-year age gap and they’re both two years apart in April so that worked out for us. 

Meagan: Perfectly, yeah. 

Sarah: So the things I did to make it more successful– they are all things that people on this podcast talk about. For physical things, it was workouts that focused on birth prep. I didn’t do anything crazy like walking for miles and miles every day. I just did the minimal which was doing some exercises every day for hips opening, cat/cow, and all of that stuff. I did the Miles Circuit later on in pregnancy every day. I ate my dates every day. I drank my tea.

Then I think the biggest thing, too, is mentally preparing. For mentally preparing, I got my doula. I really love that the doula does the meetings before the birth. I didn’t even know that when I had heard people talk about doulas but meeting before and talking about what birth plan I wanted, what things– 

Meagan: Your desires. 

Sarah: Exactly and what things could happen. I’m like, “This would be so helpful for a first-time parent to know all of this stuff.” I wish I had gotten her with my first. Also, just talking about coping mechanisms, what are some positions that we are going to do, talk about scenarios. It was great. 

Then I also, for mentally preparing, I looked up a bunch of different coping mechanisms. I actually did Hypnobabies. I wasn’t consistent with the meditation, but it was very helpful to practice the breathing and visualization. 

Meagan: I did too. I did it as well. 

Sarah: I was really bad at the meditations so that didn’t stick with me, but it was really, really great to practice the breathing and all of that. And honestly, just listening to birth stories is mentally preparing because I would really only focus on positive stories toward the end of my pregnancy. I was like, “Okay, now we are in the home stretch. We are just going to stick to all of the positive ones.”

The big thing, too, was finding my provider. I joined The VBAC Cesarean Support Group on Facebook way earlier and everyone had all of the recommendations of who to go to. My provider is actually family med, but he is more like a midwife. Actually, my doula said that he’s actually more crunchy than a midwife as a family med. 

For all of the births that she attended, she said, “He is more hands-off than a midwife.” I’m like, “Wow.” 

Meagan: Wow, that’s cool. 

Sarah: And what’s great is that he attends all of his births so there is no rotating call schedule. 

Meagan: Which is huge. 

Sarah: There’s no, “Who’s going to be there?” He’s very trusting of women’s bodies. I did my due diligence and I asked him, “How often have you personally seen a uterine rupture? How often do you use the vacuum? How often have you done episiotomies?” You know, so just asking him all of the things. He had really great responses and I felt really solid with him. 

Meagan: Which is really important, right? To have those conversations also. We know that when they come in and they say, “Hey, do you have any questions?” It’s really okay to ask questions. 

Sarah: Yes. That’s the big thing. So because he’s not an OB, I had to go do a consult with the OB that he works with in the hospital. The OB who works in the hospital definitely wasn’t making me fearful, but there’s a certain form you have to fill out that says, “Hey, obviously if you’re successful with your TOLAC, that’s going to be the safest option for you. But if you’re not successful, that’s the least safe.” 

It’s easy to plant doubt, but after I saw him again, I asked my provider, “How often do you see it?” It was such a small amount and since he’s one of the VBAC go-tos, I felt very confident with him. It was really nice to have that fear taken away in that way. 

Meagan: Yeah. Yeah. 

Sarah: And then this is kind of interesting. Just for fun, I did message my old provider at my previous hospital just to see what she would say about my chances for VBAC. I actually messaged her before I was pregnant. I said, “Hey, I am kind of processing and struggling from my C-section. What do you think about my chance for VBAC?” It was just on a message. 

What she said was, “You did everything you could at that time to have her vaginally, but she just didn’t fit your pelvis for whatever reason. We think of fitting as a lock and key situation. Both pieces have to work together to open, so there’s no way to know if a future baby would ever fit your pelvis better than she did.” Then she kind of went on. I thought, “Nope.” I’m like, “Nope. I’m not taking that in.” 

Meagan: Yes. 

Sarah: It was interesting. 

Meagan: Thank you so much, but no thanks. 

Sarah: Exactly.

Sarah: Exactly. I’m like, “I don’t think she didn’t fit my pelvis. That’s not a thing.”

 

Meagan: But you know, it’s an easy thing for people to say or diagnose. It’s like, “Oh, well your baby was perfect. You were perfect, but the two together didn’t really match that time.”

 

Sarah: Right.

 

Meagan: That doesn’t necessarily mean that’s true. We just don’t know.

 

Sarah: Again, we can’t go back in time and have me try something different.

 

Meagan: Yes, yes.

 

Sarah: But I think it’s interesting that she said that.

 

Meagan: It is.

 

Sarah: Again, I talked to my doctor. He’s like, “Oh yeah. Great. Let’s do it.”

 

Meagan: Yeah.

 

Sarah: He said, “You’ve got this.” So you know. Otherwise, I’m preparing. This is the funny thing too, again. At first, I didn’t have any intention of trying to go unmedicated. At first. I was like, “I definitely want to VBAC,” but I wasn’t trying to do that. I was just focused on the VBAC part. But once you hear enough birth stories, you know that if I do all of this preparation and I go as long as I can without this intervention, I’m going to have the best possible chance of a healthy vaginal birth. If it still ends in a C-section, it’s because that was what had to happen not because I didn’t know any better.

 

Meagan: Right.

 

Sarah: So that’s when I was like, “Yes, okay. It makes sense for me to try. I should just try to go unmedicated. I should just do it. Whatever happens, happens.” I still am keeping my go-with-the-flow but with a lot of preparation. It was kind of funny because when I would tell people that, “I’m trying to go unmedicated,” people will say the craziest things to you.

 

Meagan: Right? “I could never.”

 

Sarah: Yes, or “I know someone who did and it was the worst thing they ever chose to do. They said, ‘Never do that.’” It’s like, I know and I’ve heard many, many stories of people doing it and are very happy with the outcome. So definitely right before, I was 37 weeks. I was like, “I’m going to read Ina May’s Guide to Childbirth.” Everybody talks about it, but I just wanted to hone in and focus on those unmedicated birth stories and just say, “How did you guys do this? How was it successful?”

 

That was really helpful. I really liked that book. That was really good.

 

Meagan: Yeah. I really like it too.

 

Sarah: Yeah. Otherwise in this pregnancy though, I physically felt really good. I got Braxton Hicks contractions which I didn’t have in my first pregnancy. That was definitely new.

 

Meagan: Yes. Probably exciting.

 

Sarah: It was exciting. I was like, “Okay, yeah. Every birth is different.” That was one of the Hypnobabies thing that stuck with me. Each baby is different. Your birth is going to be different. Don’t let that fear creep in on you. But at 33 weeks, I found out the baby was breech so that was scary.

 

Meagan: Yeah. It throws you for a loop, right?

 

Sarah: Yes. When I found out that he was breech, I immediately messaged my doula. She gave me Spinning Babies exercises to do every day. I was making sure I was sitting forward and all of that stuff. Then I went to see a chiropractor first and then she also gave me this massage therapist who was trained in breech balancing massage. I went to both of those and the baby was flipped at my next appointment at 35 weeks.

 

Meagan: Yay.

 

Sarah: So I was very happy. The coolest thing with the massage therapist—in our state, I’m pretty sure she is maybe the only one who does this breech balancing massage. She told me because I actually went to do a follow-up appointment. Even though he was already head down, I was like, “Let’s just go again to make sure.” She said that she was treating six other breech moms at that time and they had all flipped when I came back from my second appointment.

 

Meagan: Oh my gosh.

 

Sarah: Yeah. I’m always in the groups. I’m like, “If anyone is breech, try this specific breech balancing massage. Yeah.” It’s really interesting just listening to her talk about it because she is so knowledgeable about, “Hey, your baby is breech for a reason. You have these muscles that get tightened. Your pelvis is this bowl and if things are in the wrong position, the baby wants to be head down. If I can release all of these muscles and make more space in there, even if the massage might not on its own make your baby flip, but giving your baby that space, then your ECV is more successful if you do that.

 

Meagan: Right.

 

Sarah: I was very happy because I had done all of this work and hyped myself up. I wouldn’t want to have to schedule a C-section for this reason after all of that but if it happened, it happened.

 

Meagan: Yeah.

 

Sarah: So everything was going good then until my 39-week appointment. I had a high blood pressure reading so I was like, “Oh great.” But my doctor was not worried. He had me do an NST, labs, and monitor at home. I came back in a few days and everything was good. That was nice.

 

Actually, the day that I went back for my follow-up for my high blood pressure was the day that I got my birth records. They had my birth records there for me. I had gone this whole time. I was almost 40 weeks and I was like, “I still really want to see.”

 

Meagan: You had requested them?

 

Sarah: Yeah, and it just took a really long time to get them. When I had that appointment, I was able to get my birth records earlier than I thought. I didn’t think I was even going to get them by the time I had the baby. I was able to read through them and kind of work through it. My doula was like, “Oh, do you want to call and talk about it?” I was like, “Yes.” It was kind of like a fear release for me because that night I went into labor.

 

Meagan: Yeah. Did you find anything in there that you didn’t know before?

 

Sarah: I mean, that one thing was that terbutaline. I didn’t know that. And then I was just curious about some of the dilation. Also, I saw on my records too that the surgeon who did my C-section put, “This patient is a candidate for a TOLAC.”

 

Meagan: Oh yeah.

 

Sarah: It was nice just to have that and to see that the surgeon who did my C-section would put that on my note like, “Yeah. They are a candidate.”

Meagan: Yeah, it’s helpful.

 

Sarah: Just working through it too was nice to see it in a timeline.

 

So that night was the night I went into labor. At 2:00 AM, I woke up with my contractions. Right away, they were 3-7 minutes apart. I had the same situation three weeks before where I woke up and had contractions that were 3-7 minutes apart, but they fizzled out and didn’t come back. I only had that situation one time earlier. So I was like, “Oh, this could be another practice. This could be the real thing.”

 

But they were stronger than the last time. That’s the biggest thing too. Even though they were so close together, I was handling them so well that I was like, “I think I’ll just wait this out,” which is interesting because if you’re a first-time mom, you’re like, “Hey, this is 4-1-1. I’m having them.”

 

Meagan: You have to go!

 

Sarah: And they’re long. A lot of them were long like at least a minute, but they just weren’t strong so I was like, “Okay, well I’ll wait.” Then my husband woke up at 4:00 AM. I was like, “Hey, I’m having these contractions.” His response was, “I’d better hurry up and go work. I’ve got some work to get done.” He’s like, “Oh no. I gotta go.” So then he went away to go work on stuff.

 

Then by 6:00 AM, I was like, “Okay.” I had a couple really strong ones so I was like, “Oh.” Then I was also getting back labor so I was like, “All right. Time to text the doula.” I was like, “Hey, this is what’s going on.” She was like, “Well, your back pain might be because of the baby’s position, so try to do the Miles Circuit. Eat a good breakfast. Hydrate. I’m preparing you for possibly a long day.” I said, “Okay, sounds good.”

 

I had my bagel with cream cheese. I got my Body Armor drinks out, but when I tried to do the Miles Circuit, it was so intense. I could not. The minute I laid down and I had a contraction in the Miles Circuit position, the laying down one, it was like, “Whoa, no.”

 

Meagan: Not gonna happen.

 

Sarah: I’m like, “I think this is time for me to start going into some prep mode here.” So I dimmed the lights in my room. I had my ball but I actually didn’t like bouncing on it so I never bounced on it.

 

Meagan: Was it uncomfortable?

 

Sarah: Yeah. For me, that seated position was uncomfortable. For me, I was in a forward-leaning position. I’d lean against the wall and sway or I’d have my husband come. I’d hug him and sway. I’m like, “This is working out okay.” The back labor was a different aspect that was like, “There’s got to be something I can do for this back labor.”

 

I messaged her and she’s like, “Okay, well obviously have him try to do hip squeezes,” but he wasn’t really getting the job done with the hip squeezes. She recommended the shower to also help us see if it’s going to calm down or if it will keep going. I got in the shower and it was magic. The heat on the back was perfect. My favorite thing ever, but the hot water ran out after 15 minutes and I was so sad.

 

Meagan: Oh shoot.

 

Sarah: So the hot water ran out and I was like, “Oh man.” I got out of the shower and I was like, “Now we might just have to go to the hospital right now because I need hot water. I want to get in that tub.” That was my dream was getting in the tub.

 

Meagan: Right.

 

Sarah: So my doula checked in with me at this point and asked about the shower. I was like, “Yeah.” I think I was kind of in denial because I was like, “Oh, it’s medium intense,” but they were still happening. She was like, “Okay, well maybe you should start heading in as long as they are staying 3-4 minutes consistently for an hour. Go ahead and start heading in.”

 

At this point, she also tells me that she is actually in another birth. Then she joined me with the backup doula so she was at another birth. I was like, “Oh bummer.” But my backup doula ended up being amazing as well. But you know, when you’re preparing with someone—

 

Meagan: Can I just say right there that is a real thing? It’s usually if you have to have a backup doula, it usually works out so well. Right?

 

Sarah: Yeah, it was so good.

 

Meagan: But like you were saying as I was cutting you off, as you were preparing with someone else, it’s hard.

 

Sarah: Yeah, it’s kind of a bummer because you know this person so well and you had worked with them, but it worked out perfectly fine too. I really like my backup doula. She’s great as well. She told me, again because I was like, “Hey, what can I do for now? We’re going to head in probably soon but what else can I do for this back pain?” She was like, “Do you have a heating pack?” I’m like, “Ooh, yes.”

 

I was putting a hot pack on my back which again, wasn’t hot enough for me.

 

Meagan: You needed a hot tub.

 

Sarah: It did something. At this point, my daughter had actually woken up because we were still at home. It was about 8:00 and she was so sweet. Every time I’d have a contraction, I’d go into my room. I’d have my calming music on and my swaying but then I would leave and I’d come back out with her. She was just so sad. She wasn’t crying, but she had these big tears welling up in her eyes. I would hold her and she would pat my back. She was like, “It’s okay.” It’s like she knew that something was going on.

 

I was like, “I’m okay. It’s okay.” She was just kind of like, “What is going on?” I wasn’t making loud, loud noises but I would be doing horse lips through them or moaning.

 

Meagan: Coping.

 

Sarah: Yeah, nothing too crazy, but for her, she could tell that something was going on. Luckily, my mother-in-law and sister-in-law came over shortly after that around 8:30ish. My sister-in-law took my daughter and was like, “Let’s go play,” so she was good. She was good. My mother-in-law saved me because she said, “Oh, I will boil hot water.” So she got a big pot and boiled hot water. She put cloths in them and put those on my back. That was amazing.

 

Meagan: I bet that felt really good.

 

Sarah: Right. So at this point, my husband probably should have been getting the cars ready for us to go to the hospital, but instead, he was cleaning the house frantically.

 

Meagan: That was probably his way of coping. “Oh my gosh, this is happening. I’m going to go work and then I’m going to go clean the house.”

 

Sarah: Yes. Yes, so we’re like, “Okay, it’s time. We’ve got to get going.” I’m like, “Yeah. I’ve got to get going.” So finally, we get in the car. My back is soaking wet from these hot towels but they are saving me. Luckily, the drive was only 10 minutes. I had my hot towel in there. It wasn’t the most comfortable, but we got there. They checked us in and they moved us to triage.

 

At this point, again, the sitting position was not my position for labor. It was, “Nope, not happening.” I was always kneeling, facing the back of the bed. The back of the bed was up. I held onto it. Then when I was in triage, though, I didn’t have my coping mechanisms. I didn’t have my hot towels. My next plan that I had was the comb technique.

 

I had packed a couple of combs. I was telling my husband, “All right. Your hip squeezes—” he was trying to find the combs and of course, he couldn’t find the combs that I brought. But he did remember that he brought his own comb.

 

Meagan: Hey!

 

Sarah: So I was able to take his comb which I can say RIP to his comb. I used it. There were little comb tings, whatever they are called, the teeth of the comb were everywhere at the end of my birth but it definitely worked. So then every time I would have a contraction, I was pushing on the comb and breathing as they were checking me into triage. But they were able to kind of get the band on me. They gave me an ultrasound to make sure the baby was head down while I was in triage.

 

Then they checked me. The nurse checked me and when she was down there, she was like, “Oh, it’s really hard to tell how dilated you are because you have a bulging bag of waters and I really can’t tell what you’re doing.” She was like, “I think you’re almost complete.” I’m like, “Okay.”

 

Meagan: Whoa.

 

Sarah: I’m like, “Okay.” This whole time, she’d been trying to call someone on her radio, but they were really busy. At that point, she was like, “Okay, let’s get this room.” She was like, “I’ll just wheel you on this bed unless you want to walk.” I’m like, “Actually, I want to walk.” I was actually thinking, “You know what? I think I want the bed that is in the room. The triage beds aren’t probably as comfortable.” That’s where my mind was so I was like, “Let me just walk.”

 

Meagan: No.

 

Sarah: So they get me in the room and again, my doula is on her way but she’s not there yet. It’s about, I think, 10:00. My doctor comes in. They put the little IV on my arm in case I need any medicine. All I’m doing right now-

 

Meagan: Hep lock.

 

Sarah: Yes, exactly. All I’m saying is that I just wanted to get in the tub. This is me the whole time in triage.

 

Meagan: I just want the water.

 

Sarah: I want to get in the tub. I want to get in the tub. The comb is helping, but I want to get in the tub. So he comes in. I’m like, “Hey, can I get in the tub?” He’s like, “Well, you can but I should probably check you first if you want me to. If you’re really close like the nurse thinks, then you’ll have to push soon possibly.” I’m like, “Yes. Check me because then, if I’m not, I can get in the tub.” That was in the back of my mind.

 

He checked me. He’s down there for a while and I’m finally like, “Okay, you’ve got to get out.” He’s like, “I understand why they are having a hard time. Yes. You have a big, bulging bag of waters. I can tell why she had a hard time and I think you’re maybe 7 or 8 centimeters but I can’t tell. As soon as the water breaks, you’re going to be fast.” I was like, “Sounds like I can get in the tub.” He was like, “Yes, you can.”

 

Meagan: You’re like, “Perfect.”

 

Sarah: Perfect. This is when my doula came around this time. She helped get the tub in motion because they were like, “Well, it’s going to take a while. We’ve got to get you on these mobile monitors.” She went in and she got the water going and I was able to get in the tub. The only problem is that once I got in the tub, I was like, “Oh, I think I have to poop,” which is the magic—

 

Meagan: Means you’re going to have a baby!

 

Sarah: She was like, “Well if you want, you can sit on the toilet and see if you actually do poop.” I was like, “Sounds like a plan.” I sat on the toilet facing the back of the toilet. I had my hands on my comb. My comb was with me everywhere. That’s when I had the scary, scary transition contraction. I was so happy I had her there because she was saying all of the right things and at this point, I can’t remember any of them except for her saying to me, “This is the hardest part, but it’s also the shortest. You are in transition.”

 

When I heard her, I was like, “Okay, that makes sense.” I was a little shaky. You just feel so out of control. I was like, “Whoa. I don’t know about this. I’m not sure about this.”

 

Meagan: You start questioning. It’s weird.

 

Sarah: It is really, yeah. But she was saying all of the things I needed to hear, so I was good. So then I was like, “Okay, no poop is coming. Let’s get back in the tub.” So I got back in the tub, and then I had probably one contraction and then a lab person came to the door and was like, “I’ve got to take your blood.” We’re like, “Uh, okay. Let’s just wait until she’s in between contractions.” I’m like, “That’s a good idea.”

 

So she comes in. She turns on the light. I’m like, “This is throwing off my vibe.” She sits down next to me and she scans my band and then they were like, “Okay, let’s wait for the next one.” The next contraction came and it was the, “My body is pushing! I’m pushing. Help!” I had that fetal ejection reflex, but my water was still intact so it was more of the water ejection reflex.

 

Meagan: It was pushing that, yeah. Exactly.

 

Sarah: My body did the thing where it pushed on its own. I’ve always heard about this when I’ve listened to the podcasts that this happens. I was always like, “Oh, I want that. That sounds nice. Do it for me,” but I did not like it. Nope. Especially because I was in the tub, maybe that’s why, but I just felt so out of control. I was like, “Whoa. I’m not controlling this pushing,” but I was also very excited because I knew that meant it was time.

 

The lab person promptly left the bathroom and they never got my blood. I don’t know why they needed it, but they never got it.

 

Meagan: I know. It’s so weird, “We need your blood right now.” It’s like, “Really? Why?”

 

Sarah: Yeah. Especially when, “Oh, I’m in transition about to have a baby.” I think you’re okay.

 

Meagan: Seriously.

 

Sarah: I had that. So that happened and then my doula was like, “Well, do you think you want to get in the bed?” I’m like, “Yes. If a baby is coming, I need to be on the bed.” So again, my favorite position—even my tub position was my hands and knees. I was draping my hand on the back of the bed kind of in that—I wasn’t really hands and knees because I started that way and then I ended up hugging a pillow and kind of squatting back.

 

Meagan: Yeah, okay.

 

Sarah: Yeah. I started pushing. Again, my waters hadn’t broken yet which was obviously, this is a big thing with my provider. He is hands-off. Any other provider would have said, “Do you want me to break your water?”

 

Meagan: Absolutely.

 

Sarah: That would have been a thing. It was kind of interesting that “Nope. I’m just doing it all on my own what my body wants to do.” I was pushing for about 10 minutes and then my waters exploded. They all knew it was coming, so no one got drenched, but it was so loud.

 

Meagan: Everyone was probably a little sensitive in that area. They were probably like, “I’ll walk over here.”

 

Sarah: Yes. They expected it. My doctor was like, “I might get drenched, but I’m ready for it.” But he didn’t.

 

Meagan: That’s okay.

 

Sarah: It was so loud. I was shocked. It was like a gunshot. It felt like it was just like BAM when I pushed it out. So that was great. Then about 5 minutes after that, he was born. I pushed the waters out and then pushed him out. His head was right there and they were like, “Oh, you can reach down and feel the head.” I’m like, “I can’t.” I had to reach down. I’m like, “My arms are too short.” So then I pushed him out. It was about two pushes I think.

Yes, as soon as that water was done, yeah. He was two pushes after that. It was about 20 minutes of pushing total.

 

Meagan: Whoa. That’s like nothing.

 

Sarah: Yeah, then I got to flip around. They put him on me and they didn’t cut the cord until it was done pulsing. They did delayed cord clamping. They did the golden hour. He was just on my chest the whole time. I birthed my placenta which was fine. I did have a small tear which was just something I was scared about with an unmedicated birth. I’m like, “Oh, that will be not pleasant. I hope I don’t but again, no idea. I probably will. Most people do.”

 

It was a very small, I guess, second-degree tear but he numbed it. It just felt like a bunch of little bee stings. He numbed it and stitched it. It was fine. Baby was on my chest for that whole hour. What was crazy to me—I also consented to having the Pitocin drip afterward to get the—

 

Meagan: The uterus to contract down, mhmm.

 

Sarah: Yes, yes. I had that. Once that was done, I was able to just stand up and go to the bathroom.

 

Meagan: Amazing, right?

 

Sarah: I could just get up to go to the bathroom. I felt good. I felt fine. This was about 10:50 in the morning, so yeah. I was at the hospital for an hour and a half before he was born. Later that night around 5:00, we had family come over to see the baby that night. I felt as great as could be with still normal postpartum stuff.

 

Meagan: Right. You did just push a baby out. But you weren’t knocked out and coming too and all of those other things.

 

Sarah: Yes. So yeah. That’s about it for that.

Meagan: Aw, yes. Well, congratulations. I’m sure that was a very different experience. I mean, I’m sure both babies were, right? We all cherish our babies’ births but to be more present in your baby’s birth, I’m sure definitely left an impact.

 

Sarah: Yeah. Even my husband told me that for this time, he actually teared up and felt like it was just such a more of an emotional experience even for him which is completely understandable. It was actually really scary for him with the C-section he told me. They tell you, “Hey, we’re going to go put your wife out. We’re going to come back and get you and then you’re going to come and be part of it.” He’s sitting there waiting, waiting, waiting. They just kind of say, “Hey, you can’t go in anymore. We knocked her out. You have to wait here. It’s going to be a while.” Then he’s just like, “Oh, is she going to be okay?” It was a little scary for him too, that first one. This was a lot, obviously, more emotional and just a really cool experience for both of us.

 

Meagan: Yeah. I’m sure it was very healing for both of you like you said. That couldn’t have been easy for him walking in and seeing you in that manner. I mean, the fact that he even brought it up. “It was weird when I walked in and you were laying there but then I’m over here doing skin-to-skin with this baby.”

 

Sarah: Yep.

 

Meagan: I’m sure it was so healing for both of you. Huge congrats.

 

Sarah: Yeah, thank you. Oh, and one thing to mention with the doctor is that because I gave him all of my birth plan too, at no point in this hospital situation was I ever offered anything. They knew what my preferences were. They never said anything about any interventions at all. They never said, “Do you want us to break this water?” Everyone was on board. It was great.

 

Meagan: Yeah. You really didn’t feel like you had to fight along the way.

 

Sarah: Yeah. It was all supportive which is what I wanted.

 

Meagan: Yeah, and what you deserved.

 

Sarah: Yeah. It was really great to have that. Honestly, the thing I also really liked about pushing in that position where you are facing the back of the bed was that I didn’t see all of the people staring at me. It was nice because—and not that it would have mattered—but I’m kind of socially anxious in that situation so it was nice to just be focused on my husband’s hand holding me. I’ve got my comb. I’m breathing. I’m totally in it. I’m not looking around. With the C-section, that labor was like everyone was staring at you. You’re pushing and trying and nothing is happening. It was so nice to just be here in my world. I never even saw anyone.

 

Meagan: Yeah. Sometimes you see people’s faces and they are not wanting to communicate with their mouths so they communicate with their faces. So when you are just staring at all of these people surrounding you, you find yourself, “What are they saying?”

 

Sarah: Yeah, exactly.

 

Meagan: You start questioning it. It pulls you out of that space. It sounds like you were really able to stay in that space because maybe you didn’t see any of that.

 

Sarah: Yes, exactly. When I was pushing, it was really hard. I’m not saying it was easy. “Oh, unmedicated in 20 minutes.” No. It was hard work. There were times when some doubts would creep in and I was like, “What if he’s in the canal too long? Will he be okay?” It would be easy for those doubts to creep in, but my doctor and my doula were all saying the things that I needed to hear. “You’re doing it. Your body knows what to do. Keep pushing this way. Push like you’re going to poop.”

 

They were saying all of the things to keep me focused. It would be so easy if you’re not ready to give birth to a baby, that feeling would be very scary. You would feel very out of control. I could see how easy it would be for that to be very, very scary. Having the people there that knew what to say to me was very helpful.

 

Meagan: Yeah. Absolutely. The team is really that powerful though. It really, really is.

 

Sarah: Mhmm.

 

Meagan: So get a team. If you’re looking for a doula, we’ve got doulas on our website that are VBAC-trained and certified. Get a good provider who is supportive and loving and willing to just like Dr. Ryan, just yeah. “Let’s do this. Let’s do it.” Super supportive from the get-go. “Yeah, we have to have this consult, but I’m not not supporting you by sending you to this consult.”

 

Sarah: Exactly. Yep. He’s like, “This person knows that I do a lot of VBACs. They’ve been through this before.”

 

Meagan: Yes. Yes.

 

Sarah: Yeah.

 

Meagan: Well, huge, huge congrats.

Closing

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