The VBAC Link

We have a very special guest on the podcast today, Julie Sawaya, who is one of the co-founders of Needed, a company that focuses on providing women with the highest quality of vitamins needed during the entire perinatal period.

Julie shares with Meagan the research behind Needed's prenatal vitamins and supplements. She talks about why you need a prenatal vitamin in the first place, the optimal dosage and forms of specific vitamins in pregnancy, how supplementing proper nutrition in the best ways can positively impact your entire birth experience, and so much more!

Use the code VBAC20 to receive 20% off at www.thisisneeded.com

Additional Links

Needed Website

What to Look for in a Prenatal Vitamin

Folate vs Folic Acid. What's the Difference?

Ryann Kipping: The Prenatal Nutritionist

Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details

Meagan: Hello, Women of Strength. We have a very, very special episode for you today. We have our friend, Julie Sawaya, and she is the co-founder of Needed. If you haven’t heard us talking about Needed yet, go listen to the other episodes and get on Instagram. You guys, Needed is incredible. She is a mama of two young girls. We were just talking before the episode and her youngest is nine months. 

She is a lifelong nutrition nerd. I love that she calls herself this, a nutrition nerd. I’m a birth nerd. When we find ourselves passionate about something, we just nerd out, right? It’s so amazing. Julie grew up in a family of medical doctors and learned at a young age the power of nutrition and how it can influence or help. Julie went on to study the issue of nutritional access in college and got her Master’s in business from Stanford where she met her Needed co-founder, Ryan 

Of the most nutritionally aware of their friends, Julie and Ryan were shocked to realize that through nutrient testing, they were seriously major deficient in key nutrients. We don’t think about it, Julie. We just don’t think about this, I think, enough. We think we’re taking something and we think that we’re good. 

They found out that there was really much more needed for a healthy pregnancy. They dug into the research and they realized that they were not alone. 97% of women take a prenatal, yet 95% have nutrient deficiencies. Let me just say that again. 97% of women take a prenatal, yet 95% have nutrient deficiencies. 

Most prenatal vitamins just weren’t cutting it and Julie and Brian started Needed to create a new, higher standard for perinatal health. Working alongside a collective of more than 3,000 perinatal nutrition and health experts, together they have redesigned the products, education, expertise, and experience that women need. 

Welcome to the show, Julie. I seriously am reading this and I’m like, “Oh my gosh.” This is amazing because like I was saying when I was pregnant years ago, I did not pay attention to anything. I got the bottle. I took it. Check mark.

Julie: Yeah. No, I mean, I think it’s a problem. The core underlying problem that we’re solving at Needed is that women are nutritionally deficient in this life stage. It’s a problem both with the products that are available. Most prenatal vitamins are designed to meet just the bare minimum nutrient needs, not to set you up for optimal health, and it’s also an awareness or an education problem because, in some way, it’s a problem that you don’t know you have until you feel the effects of it. 

We’re told it’s normal to feel depleted, that it’s normal to not feel your best, to feel like yourself during pregnancy or postpartum. So many of the complications of pregnancy have a nutritional root to it whether it’s gestational diabetes or preeclampsia or hypertension or nausea even, or more severe nausea like hyperemesis. There is a nutritional component to it. Not to say that nutrition is a cure-all, but it’s a reasonable first step in supporting your body optimally. 

Meagan: It’s huge. 

Julie: What Ryan and I found when prior to starting the company is that despite how important nutrition is and yes, I am a lifelong nutrition nerd. Ryan and I are also trained nutritionists. It was truly and utterly shocking to us that we had these deficiencies but what we realized once we looked under the hood is that this problem is widespread and part of the problem stems from the fact that it’s so common for women in the U.S. to see an OB. I come from a family of MDs and I have huge respect for the medical profession. 

But most doctors aren’t trained in nutrition. It’s actually not a requirement in most med schools. I think somewhere in the range of 50% of med schools don’t require one nutrition course. The average OB appointment time in the US is 7 minutes long so even if an OB is trained in nutrition and has the intention to help educate their patients. OBs are generally very well-meaning. They’re just people who are constrained on time and with the curriculum as we like to say, the curriculum is flawed, not the people. 

But even if all of the stars align in 7 minutes, you can’t get all of your nutrition questions answered. What we hear again and again, the most common recommendation is, “Take a prenatal vitamin,” and then you ask, “What kind?” and then they say, “It doesn’t matter. They’re all the same.”

Meagan: Just take one, yeah. 

Julie: “Just take one. Make sure it has folic acid in it,” which I’m sure we’ll get into. That particular nutrient and nutrient form. But there is so much more to prenatal nutrition than vitamins and minerals. But even if you just focus on vitamins and minerals, it’s really hard to pick a prenatal. There are over 100 on the market. There is a vast difference when it comes to quality. The quality of the nutrients, the quality of the nutrient forms, and dosages. We spent over three years formulating our first products with a collective of health and wellness practitioners that study perinatal nutrition and looking at all of the available clinical research on nutrient dosages and forms, and what pregnant and lactating women need. 

The reality is that there are a lot of nutritional gaps. That’s where this collective of practitioners that are testing women’s nutrient and hormone levels every single day really, really matters to understand in practice what does it take to dose? What dosing of Vitamin D do you need to give your patients to be in optimal nutrient ranges? 

It seems like such a basic question, but no prenatal company had done that legwork to understand what’s actually optimal. 

Meagan: That is what I was going to say. There are so many things about Needed that I love. Honestly, one of them is how this company came about. It’s two women that found that there was something lacking out there and had a passion from themselves and had passion to share it with the world. That’s how The VBAC Link started. Myself and my old partner, Julie, same thing. We just found this passion so I love the heart that comes behind this company and then really what you guys have done. 

You’ve built it from somewhere where it was really mediocre if you could even call it that is incredible. Like you said, not only getting ingredients but the optimal amount. As I have compared in the past, there are so many out there that are even recommended on Amazon or wherever and they don’t even have the ingredients at all let alone that optimal amount. 

I am so excited and honored for you to be here today and be talking to our community because I think that it is so important. Like you were saying, it’s not that my provider had any ill intent to not give me that information, but it really was as I was walking out, he goes, “Oh, and by the way. Make sure to start a prenatal right now.” I was like, “Oh, okay.” That was it. That was it. I did. I found myself Googling it and found one. I was like, “Okay, cool. That one has some okay reviews.” I got it and I really didn’t know the impact that it was leaving or lack thereof. 

Julie: Yeah, totally. I think some of that comes from there is misunderstanding that a prenatal vitamin is for the baby. By and large, unless you have massive nutrient deficiencies, the baby’s going to get what he or she needs to develop properly, but often at the expense of your own nutrient reserves. 

As a mom of multiples, you know that oftentimes, women experience and understand the pain point more as a second-time or third-time mom than as a first-time mom because once you’ve been through pregnancy and birth and if you choose to breastfeed or pump, you can feel it viscerally how depleting that experience is maybe more so than a first-time mom that hasn’t yet been through it all. In some ways, it’s an experience that has to be lived to fully appreciate the problem probably much like the topic of VBACs. 

You go into a first birth maybe not fully understanding how one birth choice or one birth outcome will impact the second birth choice or birth outcome. What we’re really trying to do at Needed is to raise awareness so that you can make the best choices possible with the information that you have. That’s all that it’s about. It’s not about what I would have done differently with one pregnancy versus another. It’s not at all. Any of the information we share is not in any way meant to shame or add guilt. There is so much of that mom guilt, so much of that fear-mongering out there. That is the antithesis of who we are as a company. 

But we find that when you’re empowered with the right information, you can make better-informed decisions so that’s a huge part of what our mission is here at Needed. 

Meagan: Yeah. Yeah, I mean we can relate to so much of that over here. I didn’t know what I didn’t know when I had through perinatal care to birth to recovering after a C-section. We grow from our journeys. Yeah. There’s never any more shame. Mom guilt is way too thick. We lay it on way too thick, especially with social media. 

So here we are today to have this episode so you can start learning and growing and finding that information so you can make the best choice for you and your growing baby or maybe through your fertility journey or nursing journey or whatever part of the journey that you are in, Needed has so many incredible things, really it all. I’m sorry, but you kind of have it all out there. It’s just amazing. So thank you so much. Yeah, let’s get into some of these questions. 

Julie: Yeah, I’m excited. 

Meagan: Me too. 

Okay, so one of the questions is what is the importance of a prenatal vitamin? Really, why? We’re being told to take these prenatal vitamins and we were just a little bit talking about how there are a lot of things that we need, but why do we really need them and does it matter if we don’t take them?

Julie: Yeah, that’s a great question. I like to answer it with a look back at context from nature because first and foremost, I think people are right to have skepticism about supplements in general. Do I need them? Why do I need them? Is it just snake oil in general? 

I think something that was an aha moment for me as someone who was a little bit of a, “Food is my medicine, not supplements.” That’s the perspective I came into before starting Needed. I think it’s really helpful to understand that one of the main reasons we need supplements generally and then specifically at the life stage of pregnancy or the perinatal stage is because our soil is depleted. Food isn’t as nutritious as it once was and it tends to take a lot longer to reach us than it used to. 

We’re not generally growing our own food. We don’t necessarily know who is growing our own food. Even if you shop at the farmers market as Ryan and I did at the time. We were testing our nutrients way back 6 years ago when we started Needed. Your food can still be depleted because the soil quietly is depleted. 

We’re also subject to a lot more environmental toxins which that toxic load increases baseline nutrient requirements. Your body has to consume more nutrients to operate at homeostasis because of the burden of toxins it’s trying to process effectively. 

Meagan: Yeah. 

Julie: We have a great book posted on our website. The title is “Why Your Grandmother Didn’t Take Prenatal Vitamins But You Should.” It’s really talking about these factors that are an evolution of modern life.

We also now know as we didn’t previously how important some nutrients are, especially nutrients like folate which is vitamin B9. It’s really critical for babies’ brain and neural tube formation. Folate’s sister nutrient is choline. It’s a super important nutrient for many of the same reasons– brain development, cognitive function, neural tube formation. Those are nutrients you don’t want to skip out on in that even with your best intentions, you might be deficient it. 95% of women are deficient in– sorry about that. I have a rowdy dog. 95% of women are deficient in the nutrient choline. 

It’s most abundant in eggs, liver, and foods like that but in the first trimester, many women have a food aversion to eggs. I certainly was not consuming any liver in my first trimester. 

Meagan: Yeah, I was going to say that liver never crossed the path of my pregnancy, unfortunately, or fortunately. 

Julie: Yeah, not at all. Yeah, but in any event, at a high level, prenatal vitamins are there to fill the gaps in your diet. I think that a misunderstanding and the way that prenatal vitamins have been formulated historically is that they’re dosing around a concept called the RDA level which is basically a dosage framework that came out of World War II when the government was trying to determine how to set nutrient levels to avoid serious diseases like scurvy, like a significant deficiency of vitamin C. 

The entire concept of an RDA is rooted in this idea of, what’s the bare minimum amount of a nutrient I need to give someone to avoid a disease or worse like famine or starvation. Minimalistic, not optimal. There’s a big order of magnitude of difference of what amount of vitamin C your body needs to avoid scurvy versus what it needs to support postpartum tissue healing and repair and optimal immune health during pregnancy or optimal reference ranges. 

But at a high level, basically, prenatal vitamins are there to fill in the gaps in your diet. They are, unfortunately, a necessity because of our modern food system and they are especially important at a life stage like pregnancy and breastfeeding when your body will never have higher nutrient needs than it does in these life stages. It’s really, really critical that you’re getting the right nutrients. 

As I said earlier, it’s not just for the baby. It’s for you too. I think that a concept that we’re really passionate about is centering women in this journey because ultimately, your baby is most likely going to get what they need but you might be left depleted and that depletion can have long-term impacts. If you want to have two kids or three kids or ten kids, your body has fewer nutrient reserves to give to the next baby with each sequential baby unless you are replenishing those nutrient stores. 

If your family feels complete, it’s still important to supplement throughout the postpartum and a time period thereafter to support your hormone health and your thyroid health. Just general vitality and overall well-being. I think it’s super common for women to say that it took them several years to feel like themselves post-pregnancy and a lot of that can be tied back to nutrient deficiencies. 

Meagan: Yeah, something that you said that resonated with me is that through each pregnancy, my life became busier because I had little toddlers and newborns. You know, all of these things around. So like you were saying at the beginning, you were like, “I can get it through my food. I can get it through my food.” Yes. Food definitely is impactful but obviously, as we know, is not as great as it used to be. 

Not only was it not as great as it used to be, but when I was really, really busy running around, I’m going to tell you right now that I was not eating correctly. I wasn’t even getting enough calories at the time let alone the right foods. I was like, “Oh. There’s a Nutrigrain bar. Let me just grab that because I’m hungry.” I wasn’t grabbing the right things or enough. It just goes to show that as we keep going on too, it’s so important. 

Julie: Yeah. That’s absolutely the reality. I think where it’s almost more important to take supplements with each subsequent pregnancy for that reason or even in the postpartum period because when you’re pregnant with your first, you generally speaking have more time than you do in postpartum with your first. And in postpartum with your first, you generally have more time than pregnancy with your second or third or fourth so that’s absolutely right. 

Meagan: Yeah. I would also remember breastfeeding my baby even in the middle of the day and just feeling sucked. Literally dry of energy and everything. 

Julie: Hydration and nutrients. 

Meagan: Hydration, yep. My mouth was getting dry. It just goes to show that you are feeling it. You are literally feeling your body change right there. 

Okay, so now we know it’s definitely important to take prenatal vitamins in the perinatal/postpartum stage and everything. But what ingredients should we focus on? We talked a little bit about folate and choline. What should we be looking at when it comes to the back of our bottle? Are those really the two main ones or are there more ingredients that are like, “Hey, we really need to be focusing on these and if we don’t see them on the back of our prenatal, we should have our alarms going off”? 

Julie: Yeah. There are really 24 vitamins and minerals that Needed has chosen to include in our prenatal vitamins because they are the ones that have the most clinically validated need for them. Choline and folate are two really important ones. I think they are really easy ones to scan a bottle for or a supplement facts panel and see not only does this have choline in it, but what’s the dosage? The most common dosage of choline– it’s a nutrient that has had an RDA. We talked about RDAs. It’s a minimum amount. It’s at an RDA of 450mg in pregnancy for 20+ years, 550 for lactation. 

The most common dosage of choline in a prenatal vitamin is 0, followed by 55mg which is 1/10 of the breastfeeding RDA. RDAs are the minimum. They’re taking 1/10th of that in most prenatal vitamins. The reason for that isn’t because you’re getting all of the extra from your diet. It’s because choline is a bulky nutrient that is hard to fit into a one-a-day prenatal. It’s hard to fit into a gummy. You just really can’t effectively do so. 

To dose it optimally, you need to include it in multiple capsules or in a powdered form like we offer. One of our options for a prenatal vitamin is a powder which is really, really great, especially for those bulkier nutrients like choline. 

The other bulky nutrients that are really important are calcium and magnesium. I would look for dosages of at least 200mg of those two ingredients. Ideally, magnesium and other minerals are in the glycinate form. Sometimes that’s on a label as magnesium bis-glycinate or magnesium bound to glycine. Glycine is an essential amino acid that just helps with absorption, keylation basically, the usability of that nutrient in the body so that’s a really important one. 

Other nutrients I suggest scanning a panel to see if they are in there– vitamin D is a telling one. I think nearly every prenatal vitamin will have vitamin D in it but the dosage matters and the form. Some prenatal use a less-absorbed form called vitamin D2. We recommend the D3 form. We also suggest looking for at least 2000 international units, IUs or more optimally would be 4000. Our prenatal vitamin capsules and multi-powder have 4000 and then our essentials multi which is a paired-down version in only three capsules has 2000. Those are the ranges that we typically like to see for vitamin D. 

Vitamin D is best absorbed with vitamin K. Make sure that vitamin K is on that supplement facts panel and 90 is the dosage that we tend to look for vitamin K. It should be in the K2 form. That’s the best-absorbed one. Those are some key ones. The other things to look for are– I think we’ll probably get into the question of what form of folate so let’s have that’s conversation. 

Meagan: Yeah.

Julie: If you’re told nothing else about prenatal nutrition, you’re probably told to take folic acid which is the manmade synthetic form of the nutrient folate. Folate is naturally occurring in food. It’s an essential nutrient. We talked about its use in the body. It’s really important for babies’ neural tube formation so for spina bifida. That’s why it’s emphasized usually in the first trimester because the neural tube fully closes during the first trimester. 

It’s a nutrient that is so, so important and many women don’t know they’re pregnant until well into the first trimester so it’s pretty common to hear that you should start taking it preconception which we definitely agree with, with one caveat which is that the synthetic form of folic acid is not readily used by the body. 

Many women have a genetic variation, MTHFR which makes it impossible for their bodies to convert synthetic folic acid into the usable form of folate. Instead, Needed uses methylfolate which is a naturally occurring form of folate. It’s the active form meaning it doesn’t have to go through the conversion process. It’s been shown in clinical research to be better utilized by the body, especially for those with the MTHFR. 

There is controversy out there of folic acid versus methylfolate. Primarily what the controvery stems from is the fact that the clinical studies on folate for neural tube defects was done with folic acid. That’s because the research is old. It’s 30 years old. Now that we know how important folate is to neural tube defects, it would be unethical to do a clinical study with a double-blind placebo controlled study where you’re putting women on a placebo that has no folate in it versus one that has folate in it. We know the risk factors. We don’t want to induce spinal cord issues or neural defects. 

So a lot of those who are pro-folic acid are relying on stale research. Really, this argument is that all of the clinical research around neural tube formation is on folic acid. We’re not arguing with that. That’s actually a true statement. But there’s a huge wealth of research showing that head-to-head comparing methylfolate versus folic acid, methylfolate is better absorbed by the body. 

96% of the circulating folate in your body is methylfolate so that’s pretty clear evidence in support of it. Mechanistically, in the body, how we’re preventing neural tube formations is the serum folate status of mom. There is research showing that methylfolate raises serum folate status in mom in the same way or better than folic acid does. 

We have a really well-researched blog post on this topic on our website. It’s dense. Maybe we can link to it in the show notes for those who want to learn more, but there is a reason why many of the higher-quality prenatal vitamins are including methylfolate, not folic acid. I would tend to distrust– there are some out there who are saying, “Oh, it’s a designer prenatal vitamin. They’re just trying to charge you more.” 

The reality is that methylfolate is so much more expensive than folic acid. You could make a lot higher profit margin if you used folic acid than methylfolate. I think it’s around 100 times more expensive which is also why most of the clinical research is relying on folic acid. Folic acid is a nutrient that is often fortified in cereals and bread, so there’s also a food lobby that has an interest in keeping folic acid in things and not methylfolate because it would be cost-prohibitive to include methylfolate in a $3.00 box of cereal. 

Meagan: Interesting. 

Julie: Yeah, there are a lot of factors. I don’t want to bog listeners down in all of this information, but this is a really good nutrient to highlight how much information and nuance and research goes into selecting optimal nutrient forms and optimal nutrient dosages. It’s a quick way of saying that we did a tremendous amount of research and there is a lot of evidence behind what we’re including in the Needed prenatal. 

We include references for every single nutrient that we use for those who are, like me, nutrition nerds that want to go many layers deep. For those of you who are like, “Oh my god. This is over my head,” I would say that the core message is that we’ve done extensive research and these nutrients have been utilized in practice with perinatal nutrition and health experts for decades. This isn’t newly redesigned. We did design our prenatal vitamin from the ground up, but the insights, expertise, and recommendations behind it have been put into practice for many, many decades. 

Really, what Needed did was bring together all of this inside of a single product instead of previously how practitioners were having to say, “Okay, go take this magnesium and this vitamin D and this prenatal and this amount of choline,” because no prenatal had everything that you needed in one package. 

Meagan: Right. That is another reason why I love and trust you guys so much. Literally, it’s all of the research that has gone into creating such a solid product for the birth community so I love that. Thank you so much for explaining that because yeah, it definitely is a hot debate sometimes. 

Julie: Yeah. I think it’s good to have that. We love a healthy debate. We work with practitioners. We actually have now almost 4000 practitioners in our community. It includes OBs. It includes reproductive endocrinologists but it also includes a lot of registered dieticians and naturopathic doctors and functionally-trained practitioners. We’re collaborating with all of them when designing products. We appreciate that some people come from different training backgrounds. 

Some people might have different skepticism and all voices are welcome. We want to have a construction conversation on this specific topic of folate versus folic acid, sometimes, the status quo argument is unwilling to hear the other side. It’s nuanced and that’s why we have a great blog post on the topic. 

Also, if you’re just early in your research and want a basic primer on what to look for in a prenatal vitamin, we also have that free resource available on our website as well as a review of over 75 of the prenatal vitamins on the market. It compares the pros, the cons, and overall recommendations. So if you love your prenatal, but it doesn’t have choline or it doesn’t have magnesium, we’ll give you those recommendations on how to supplement or how to get more of those nutrients from your diet. 

Again, we’re really not trying to tell you, “Everything you’re doing is wrong.” It’s really about how you can upgrade what you’re doing or make small changes on the margin that can have a huge benefit for you and your baby. 

Meagan: Yeah. I was going to say, All I can see is that it’s an improvement. We’re making improvements. We grow and make improvements in everything in our day-to-day lives. This is one that is really important so that’s why we’re doing this today. We’re sharing this so we can make improvements. Sometimes just it’s just small tweaks to benefit ourselves. 

Okay, so now we’re talking about all of the things that we really should be looking for nutrient-wise during pregnancy. Are there any nutrients we really should be avoiding taking during pregnancy and through your guys’ research, have there been some of those ingredients even in prenatals out there? We were just talking about folic acid and folate, but are there any where you are like, “Okay, if you see this, this is one of those tweaks that you really should make”?

Julie: Yeah, it’s a great question. We talked about folic acid. We would suggest avoiding that nutrient. The other very common nutrient form that we suggest avoiding is a form of B12 called cyanocabalamin. It’s easy to remember because it’s actually derived from a cyanide molecule. 

There is just not research to substantiate. It’s a synthetic nutrient form. It doesn’t exist in nature and there’s not safety data to suggest why you’d want to consume cyanocabalamin. We’re leveraged the two naturally-occuring active forms, methocobalamin and adenosylcobalamin. We use those in a 50-50 ratio. 

Try to avoid cyanide if you can. Try to avoid synthetic folic acid. We’re always using nutrient forms that exist in nature and we think that that’s the best way to make sure that we’re on the side of safety. It’s often contrary to cost. Those synthetic nutrient forms tend to be cost-effective but they really don’t necessarily perform as nature intended. 

Meagan: Right. 

Julie: And then another one that’s maybe a little counterintuitive or nuanced is the nutrient iron. Most prenatal vitamins have iron in them. We chose not to include iron in our prenatal for a few reasons. Iron is absolutely an essential nutrient for pregnancy and postpartum. It supports your blood volume. Your blood volume effectively doubles in pregnancy and you lose blood postpartum. It’s a super important nutrient for avoiding anemia and for just overall blood volume expansion during pregnancy. 

The reason to not include it in a prenatal is that your needs vary by trimester or by stage. We wanted to make a prenatal vitamin that was safe to take before, during, and after pregnancy and safe for all women to be taking. Iron also competes with calcium and other nutrients for absorption in the body. Oftentimes, prenatals will just include both calcium and iron and you can be pretty well-assured that the calcium that you’re taking isn’t going to be absorbed in that case. Or sometimes they just leave calcium but they don’t tell you that you should take calcium at a different time of day. 

We’ve kept calcium in our prenatal and we offer iron as a separate add-on. The advantage of that is that you can take exactly what you need. If you’ve done any iron testing, which is pretty common in pregnancy, you can tailor the dosage to your ferritin levels. That’s the type of iron testing we recommend. 

And then taking it at a different time of day ensures you’re absorbing all of the calcium that you need as well as all of the iron that you need. We like delivering iron in the kelated form bound to glycine. It’s much gentler on the stomach. A lot of prenatals have a really high dose of iron in a form that’s not well-absorbed. It can cause GI issues and then women will stop taking their prenatal because they say it makes them nauseous. 

Meagan: Yes!

Julie: There are many reasons why we think that iron in a prenatal is suboptimal. I think if you don’t know that information, you might scan prenatals like Needed’s and say, “Oh, it doesn’t include iron. That’s a problem,” and it’s actually a really intentional choice so I like to call that nutrient out. 

Meagan: I love that you talked about that because as a doula, we actually do have a lot of clients who pee on a stick, see it’s positive, and start looking for a prenatal. We have clients that do hire us in that stage and we’re always there for our clients. They’ll be writing us and be like, “We’re just so sick and it seems to be after I take my prenatal,” so they stop taking their prenatal because it makes them sick or their nausea gets so intense when in fact, it’s not what we should be viewing. Again, not to shame anyone if you’ve stopped taking your prenatal. We should be taking our prenatal, but we don’t think about that. 

I love that you guys have done that. I’ve been sharing it since I learned about this. I’ve been sharing that with my clients really early on because I think it’s really important. Something also I love about your products is that there is a lot that can help with nausea as well. 

Julie: Yeah. I’m glad you mentioned that because that’s one of the key reasons why it’s really, really beneficial to start taking a prenatal vitamin before you try to conceive. We suggest up to 6-12 months before conception getting on a high-quality prenatal vitamin for a couple of reasons. One is that it can support cycle regularity so ovulation and healthy ovulation. It can also support egg quality. We have now a separate add-on, egg quality support, which is amazing in helping your egg follicles as they mature into egg cells before ovulation which is great. 

And then it can help you to build up your nutrient stores. Oftentimes, and I’ve been there. I’ve had first-trimester nausea despite all of my best attempts and taking all of the right supplements. Sometimes it just happens. You can minimize nausea by having adequate nutrient stores prior to conceiving. And then if you do find yourself with severe nausea in the first trimester, if your nutrient levels are optimal pre-conception, it’s more tolerable to skip a day or two of your prenatal vitamin because your levels were already in a great range before so your body has enough nutrient stores. 

I’m not advocating not taking your prenatal in the first trimester, but if life happens and you skip some days, the fact that you started early on means that your body is going to have enough of those nutrients to draw upon to get you through to the second trimester when hopefully you’re feeling much better. 

Meagan: Right. If we have really bad nausea and vomiting and we’re throwing up all of the time, we’re also losing nutrients, so it’s a whole cycle. It all goes together. 

Julie: Yep. It sure does. It sure does. Not to push our products, that’s not what this is about, but I would say hydration, hydration, hydration for nausea. We have hydration support if you are interested at all in trying it, I suggest trying it. It has the right nutrient ratios for pregnancy. It’s made without artificial sweeteners. It just has monk fruit which is naturally occurring. It comes in three flavors, three very first-trimester-friendly flavors. They are citrusy so grapefruit, lime, and lemon. 

But you can also make hydration stuff at home. You can just take a glass of water and put in some sea salt. You can add a squeeze of lemon. You can add in– you probably have your own recipe for a labor aid, but that’s another use of our hydration support during labor. Hydration can really impact. It’s like the chicken and the egg. “I’m nauseous. I don’t want to drink water. Water makes me nauseous,” but also if you’re dehydrated, nausea is worse. I would really recommend trying to stay hydrated during the first trimester if you can. 

Meagan: Yeah, absolutely. From the first trimester to the end, sometimes we can have early prodromal labor and stuff like that when we’re actually dehydrated. 

Julie: Exactly. 

Meagan: It’s just so, so, so important the whole time. 

Julie: And just to support that blood volume expansion that we were talking about that takes place in the second and third trimester. It has to come from nutrients but largely water. Your amniotic fluid levels increase. Sometimes they decrease too and they risk you out of a VBAC or a home birth and the things that you want for your birth outcome. So yeah. Hydration is key. It’s your mom’s advice, “Make sure you’re drinking enough water,” but it’s really true. 

Meagan: It really is true. My kids all roll their eyes at me. They’re really big into sports and I’m like, “No, your body, your muscles, and everything needs that hydration.” 

Okay, so we’ve talked about when it’s good. We’ve talked about taking it before. One of the questions is, “Oh, I’ve had my baby. I’m done with my prenatal vitamin, right?” But we talked a little bit and skimmed the surface about why it is important to take it during breastfeeding. We talked a little bit about how it’s still depleting our bodies, but after having a baby, how long should we be taking these? Then if we want a close baby, is it something that we should just continue?

Julie: Yeah. Yeah, great questions. The minimum that we would recommend is 6 months after delivery and that is whether or not you are breastfeeding. So from your choice or from how things turn out and you aren’t lactating, it’s still beneficial to give your body that time to replenish because pregnancy and labor are really depleting events on the body. It just takes time to rebuild those nutrient stores. That’s the minimum. So yes. Please, keep taking a prenatal vitamin postnatally. 

There are postnatal vitamins on the market. Generally, that is a marketing differentiation, not a product-quality differentiation. Most postnatal vitamins are almost identical to their prenatal counterparts except for a couple of nutrients where they take maybe 25mg more vitamin C which is less than you would get from one strawberry. It’s basically a marketing play. 

We skipped that step and we just offer one prenatal vitamin that’s appropriate for the entire perinatal, before, during, and after stage. And then if you are breastfeeding or pumping or otherwise producing milk, we recommend staying on a prenatal vitamin for that full duration of time. If you can give your body a couple of months once you stop lactating, that’s really beneficial for the same reasons we just discussed. It gives your body a chance to recuperate. 

There is a concept known as the recuperative interval when we’re thinking about pregnancy spacing if you’re having multiple kids. I myself did not do this. I breastfed my first daughter basically until the day my second daughter was born. Maybe not optimal– optimal in some ways, not optimal in others. 

Meagan: Really common, though. 

Julie: Really common. Yep. 

Meagan: A lot of people do it and then they want to feed both babies. 

Julie: Exactly. Or maybe you can breastfeed until you’re pregnant with the second. In any event, that is a reason why you should keep taking your prenatal vitamin because it ensures that your body has enough nutrients to give to your baby. Basically, the order of operations is going to be growing baby gets first, older baby gets second, and mom gets last. 

So if you are nursing while pregnant, if you are tandem feeding, that’s what your body is going to do. It’s evolutionary. Your body is really smart. Except for in the example that we talked about in the recording about severe postpartum hemorrhaging, your body’s first priority will be surviving but second to that, your body is going to give to baby before it gives to older baby before it gives to itself. Make sure to take your prenatal vitamin all throughout. 

I think that’s a general misunderstanding. A lot of women are like, “I’m not pregnant anymore.” Men, when looking at the category when Ryan and I were starting the company, they’re like, “It’s 9 months. You’re going to have a customer for a maximum of 9 months.” We were like, “Just frankly, you’re wrong,” because this is a life stage that women are in for five years, or seven years, or ten years. It’s a much longer life stage when you account for trying to conceive, pregnancy, postpartum, breastfeeding, trying again, or preparing to conceive again. That’s why this is a consequential decision and taking care of your body during those five or ten or one or two really intensive nutritional years can set you up for long-term health and your babies up for long-term health for the rest of their life. 

Meagan: Yeah, absolutely. I was one of those after my first. My provider didn’t say, “Continue taking these vitamins.” That wasn’t even a discussion. It was, “How are you feeling? What birth control would you like?” That’s really the conversation that we had. Again, we’re not shaming the provider for that but that’s just following the script. “Okay. We’re six weeks. This is what we’re doing.” I just needed so much more. 

Julie: At six weeks, honestly, nutritionally depletion-wise, you are nowhere near recovered even if your scar is healing well from a Cesarean or if your stitches are healing well from a vaginal delivery. Emotionally and physically, we are very much postpartum at that point. Even at the stage I am now at 9 months postpartum, this is still postpartum. We call it the fourth trimester sometimes which at least allows for three months, but in a lot of years, it’s two years after having a baby that your body is still returning to homeostasis, whatever that homeostasis is for you. 

Meagan: Right, and then by then, we’re kind of entering that prenatal stage again. 

Julie: You could be. Exactly. 

Meagan: Right? A lot of people are. I love this. Okay, so a couple more questions. I know we are kind of running out of time, but collagen is a big thing that I never really heard about when I was pregnant. The words didn’t even come out of anyone’s mouth. I honestly didn’t even read it online. You guys have prenatal protein collagen or collagen protein. I think it’s important to talk about that too because it can impact us in a really positive way not only during but especially after healing from surgery or anything. We’ve got tissues that are healing so I don’t know if you’d like to share a little bit about the protein. 

Julie: I’d love to. I think that this is something that we are super passionate about and something I learned a lot about when we were in the formulation stage. We know that protein requirements increase substantially in pregnancy. You need 80-100g of protein a day. That is the low end of the range. There is newer research showing that you need upwards of 140g of protein a day. That’s a lot to hit when you’re pregnant. 

Those needs are there because you’re growing a baby obviously. Amino acids are the building blocks of life, the organ that you’re growing, the placenta, and blood sugar regulation. Especially as your blood volume is expanding, protein is really important for stabilizing blood sugar and for a lot of other things. We love collagen proteins specifically because it’s a single ingredient. It’s really cleanly sourced. Plant-based proteins can be high in heavy metals whereas we don’t find that to be the case with collagen protein. 

The amino acids in collagen protein are specifically really beneficial for pregnancy. Two of them, glycine and proline, are conditionally essential meaning that your body can’t synthesize them on their own. They have to be consumed by food and many of us are not consuming the foods that are high in glycine and proline like the carcasses of animals and the skins and bones. It’s just not very common, especially in pregnancy. We tend to eat boneless, skinless chicken breast. Maybe some even have animal protein aversions during pregnancy. 

Collagen is an awesome form of glycine and proline and overall meets your protein needs. It’s effectively flavorless. You can blend it into smoothies. It blends really well with our prenatal multivitamin powder. You can mix it, especially for those first-trimester mamas, into mac and cheese. You can mix it into just about anything to get some protein in even when you’re feeling a bit nauseous. 

Then for postpartum, why it’s beneficial is that your skin tissue stretches. It needs to recover whether that’s because you had a vaginal delivery or a Cesarean. Collagen can be really, really helpful for tissue healing and repair and recovery in that regard. 

The last thing I should mention is that the placenta is actually comprised of collagen so it really makes a lot of sense to be consuming those building blocks when you’re making your new organ for pregnancy. 

Meagan: Yeah. I want to share with you guys that I love it in my oatmeal. 

Julie: Yeah, that’s awesome. 

Meagan: I put it in my oatmeal. I’ll put some apples and a little bit of cinnamon and it works really well. I actually put a little bit of yogurt. It’s amazing. 

Julie: I sneak it into my daughter’s oatmeal. She calls it sprinkles. Kids have lower protein requirements than adults of course, but it helps to balance out their blood sugar too in a really beneficial way. Making sure she’s not bouncing off the walls more than necessary. 

Meagan: I love that. I love that. That’s something too I love. A lot of this is really good for kids. We could go into it. There are so many other products. There are a lot that my kids love as well. 

Okay, so the last question, we kind of talked about this in the beginning how we can get this through food. It’s hard to get that because we’re not typically eating carcasses and skin and liver, right? 

Julie: Yep. 

Meagan: So what are some foods that we can drop for this audience to eat that help us during pregnancy just in general and in postpartum that will help us in addition to Needed and other products? 

Julie: Well, I would say that in general, we are huge advocates for food. You can’t out-supplement a bad diet. Food should be a critical component of your nutrition plan. It’s just really hard sometimes to eat optimally. But foods to focus on during pregnancy, are lots of organic if you can, leafy greens, vegetables, and fruits. Eat the rainbow. I think some people tend to be afraid of fruits because of the sugar content and gestational diabetes but there is fiber in fruit. Unlike fruit juice, there is actually fiber in fruit. You can pair it with something like nut butter to add a little bit of protein and fat to help with blood sugar stability. 

Other things to focus on are prebiotics and probiotic-rich foods like kimchi and depending on your stance on it, I drink kombucha during pregnancy. There is a tiny, tiny, tiny amount of alcohol in it but the benefits to me outweigh any potential risk of alcohol content. Sauerkraut is another really great one and fiber. A lot of women during pregnancy have hemorrhoids or they’re constipated so foods that are rich in fiber are generally very good for you and your baby. 

Probably one of my favorites when I’m pregnant– I tend to fall off the wagon a little bit postpartum because you have a newborn and whatnot, but I’m usually really good at smoothies during pregnancy. Smoothies are a great way. You can put our collagen in it or our prenatal multivitamin powder. If you are not a capsules fan, you can even take our pre-probiotic and add it or vitamin D. You can add in a lot of our capsule products. Just break open the capsule and dump the powder contents into the smoothie. 

That’s a really great way to put in greens and fruits and whatever else– nuts, seeds. That’s a great way to get in your fat content. That’s definitely one of my favorites as well as depending on the season. If you’re pregnant more in the winter months, you can make soups. Stir the collagen protein into the soup. Try to load it with those other fruits, vegetables, and fiber-type-rich foods.

But I think we’re really, really passionate about debunking some of the concerns around pregnancy like pregnancy weight gain. You are eating for two. It doesn’t mean you should go load up on ice cream and pretzels and chips. Some of that in moderation is totally fine, but think about nutrient density. That’s what you’re going for both for you and your baby. It’s going to help you avoid depletion, to feel better. 

Pregnancy, even if you’re eating well, is pretty uncomfortable so I think eating foods that are going to nourish you and leave you feeling good is definitely the priority. We do share some really great recipe ideas over on our Instagram. A couple of people in our network that you can check out if you’re looking for more food recommendations, the prenatal nutritionist, Ryann Kipping, has a prenatal nutrition library that is full of really great food-based nutrition ideas. We also love the work of Lily Nichols. She’s really popular with midwives and doulas also. 

She wrote a book called “Real Food for Pregnancy” that has some great, practical tips for nutrient-dense meals. A lot of what she’s recommending is going to sound familiar from this podcast like collagen and eating more meat than you might think you need and eating more. 

Honestly, I say this coming from the perspective of having been a vegetarian and a vegan for a long time. I think that you can do that during pregnancy but you have to be really intentional about protein and about nutrients like vitamin D and choline. It’s much more difficult but it’s possible. I would not advise undergoing a vegetarian or a vegan pregnancy without working with a dietician or a nutritionist to help you figure out what those nutritional gaps could be. 

Meagan: That’s a really good point because we do. We know we all eat differently and we all have different allergies and things that have developed so that is really, really important to know. We are going to have all of these links that she is mentioning like the blogs, the recipes, all of this linked in the show notes. So if you want to go and dive in–

Julie: Nerd out with us. 

Meagan: Nerd out and get your teeth sinking into this, then check it out because you guys, Needed is just amazing. Really, it’s such an honor to have had you on today to be talking about this. 

Julie: Thank you for having me. 

Meagan: Because it is so important. With my first and second pregnancies, I was healthy-ish but each pregnancy got better because I learned more. 

Julie: Isn’t that amazing that there is this concept of, “Oh, you’re too old or you’re subsequent.” If I have a third, I’ll be a geriatric mom but it’s so much more about your health span or your health status than it is about age in some ways you can have your healthiest pregnancy at 40 if you’re doing the right things and taking care of your body in the right way. 

Meagan: Yeah. Yeah. My best pregnancy was the older one. The oldest that I was. I was the oldest in my pregnancy and it was my best pregnancy. It just impacts. I wanted to touch a little bit on what you said that sometimes we hesitate to eat or we are eating the right things. Women of Strength, if you are listening, I know that as a person wanting to have a VBAC and as a mama wanting to have a VBAC, sometimes we get scared of the world out there saying, “Your baby is too big and you can’t have a vaginal birth.” 

I saw just today three posts in our community, “A doctor said that my baby is too big.” Then we sometimes tend to hold back and not get the right nutrients, right? Not purposely, but purposely because we’re trying not to make too big of a baby because we really want this vaginal birth. It’s all twisted and I don’t love it, but it’s really important to remember like she was saying, get these nutrient-dense foods in you and don’t be scared to supplement. Don’t be scared to supplement because our bodies and babies deserve it. We deserve it. 

Julie: Yep. And on the other side of birth, I tend to feel that bigger babies sometimes sleep better. They sometimes eat better. My second daughter was almost 9 pounds, but the first daughter was late. She was born almost at 42 weeks. I was so nervous about it, but she was a champion sleeper and feeder. I think there is a lot of natural wisdom in that your body knows how big of a baby to grow and your body knows how long to carry that baby for. But I loved this conversation. I think it’s so important. It might not be immediately intuitive why nutrition and birth outcomes go so hand-in-hand, but they do.

Oftentimes, what risks women out of the birth that they want whether it’s a VBAC or just a primary first-time vaginal birth is a factor that can be traced back to nutrition like preterm labor or gestational diabetes or whatnot. We are very aligned on the idea that nutrition for prevention and for optimal outcomes. 

Meagan: Yeah. Yeah. I had a client during COVID who had pre-eclampsia. She got it at 18 weeks. She had a home birth planned and all of these amazing things planned. She had to completely shift gears. The second one, she was like, “I’m going to start trying soon and I’m going to dive in.” She did. She dove in and changed so many things and had an incredible, incredible home birth with her second. She was like, “I really do feel that because I fed my body and fueled my body, it gave back.” 

We know that sometimes we do all of the right things, everything, and still, we have undesired outcomes. But if we can do everything within our control, if we can do what we can within our control– 

Julie: That’s exactly it. Yeah, I’m nodding my head here because we keep saying to ourselves and are starting to say more externally that there is so much on this journey that you can’t control. You can do everything right and still have things not go as you want. That’s just a reality. But nutrition is a big one that you can control so why not focus on the things that you can control and let go of the rest? 

Meagan: Right. Absolutely. Well, we will end on that note because I think that is such a powerful ending point. I want to share with everybody that we are going to have the link in the show notes, but if you want to go check out Needed and all of the amazing products because we just barely touched on a few today, you can go to thisisneeded.com to learn more about Julie and Ryan and go learn about their partners. There are a lot of partners that we’ve actually had on the show. We just love you guys. We appreciate you so much so thank you for taking the time today.

Julie: Absolutely. It was really fun.

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

We are joined today by Dr. Barry Brock, aka “The King of VBAC” along with one of his VBAC-hopeful patients, Kara. Kara and Meagan ask Dr. Brock VBAC-related questions similarly to how we hope you interview your providers during your VBAC preparation. 

Dr. Brock touches on topics such as gestational diabetes, big babies, preparing for your VBAC, induction, placenta previa, preeclampsia, HELLP syndrome, VBAC after multiple Cesareans, and vaginal breech delivery. 

Additional Links

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, everybody. Welcome, welcome. We have a really cool episode for you today, an episode that we have been really anxiously waiting for and so honored to be having. We love having birth professionals on the podcast and today we are so honored to have Dr. Barry Brock chatting with us today about birth and VBAC and all of the things.

 

And then we have an extra special cohost today, Kara Sutton, who is actually one of Dr. Brock’s patients. Hello!

 

Kara: Hi guys. I’m so excited to be here.

 

Meagan: So excited to have you guys. I just wanted to share a little bit about the amazing Barry Brock before we get going into all of these amazing questions that this community has asked. Dr. Barry Brock has been a doctor for over 30 years and has experience in obstetrics and gynecology. He has been attending as a doctor at Cedars and I believe Dr. Barry Brock, you had your residency there, right?

 

Dr. Brock: I did.

 

Meagan: That’s really cool so you’ve been there for a while. Dr. Brock is amazing and takes pride in giving quality care to all of his patients. Seriously, one of the coolest things—I mean there are a lot of cool things—but especially with me in the VBAC world, one of the coolest things to me is that you have an outstanding Cesarean rate. It’s very low. I think that’s one of the things that you are very well known for along with helping people have vaginal breech deliveries which we know is kind of trickling out in the world and vaginal twin deliveries and of course, VBACs. So welcome, Dr. Brock, and thank you so much for being here with us.

 

Dr. Brock: It’s my pleasure.

 

Meagan: Oh my gosh. Yes, and as I mentioned, we’ve got Kara who is a patient of Dr. Brock. Kara, tell us how it is to be a patient.

 

Kara: I am a mom of two. I had an emergency and I had a planned C-section due to PTSD from that first emergency C-section. Now I am four months pregnant with my third baby girl and Dr. Brock is my doctor. I’m excited to try and achieve a vaginal delivery with this one. Dr. Brock has the LA rep as the go-to VBAC doctor if you’re trying to achieve VBAC so that is why I am seeing him. I switched doctors specifically for this pregnancy which I think is super important to find the right doctor. I feel really excited and comfortable with Dr. Brock for this particular delivery, especially after the trauma from the first two.

 

For those of you guys who don’t know, Cedar Sinai is a really famous hospital in LA. We’re in Beverly Hills here today. Everyone from Kylie Jenner allegedly and Jay-Z and Beyonce and all of the people have delivered there so he’s kind of a rockstar. So I’m excited.

 

Meagan: Yes. Oh my gosh. It is such an honor. Such an honor so thank you both for being here.

Kara: Yeah, so I kind of wanted to jump in right away and wanted to ask Dr. Brock, why do you think the national average C-section rate is so high and why do so many doctors just schedule a C-section?

 

Dr. Brock: Well, the docs are very concerned about a healthy baby and a healthy mother. It takes the stress off of the doctor if there are any problems getting the baby out, but there’s no evidence that we’ve improved the Cesarean section. We have massively increased the Cesarean section rate and we have not improved the fetal outcome.

 

So obviously the system that we’re going with here needs to be tweaked a little bit. But they also need experience. To do a vaginal breech delivery, you have to have the skill and expertise to be able to do that and if you’re not doing that, you don’t have the skills so for a lot of doctors, for them, it’s safer to do the Cesarean section than to do a vaginal breech delivery.

 

I understand that. You’re not skilled. Among the criteria that the American College of OBGYN recommends is that if you’re doing a vaginal breech delivery, you have to know how to do it. Of course, if you don’t do it, you don’t get it done. 

Another thing is that doctors are very concerned with fetal monitor tracing and they are concerned about the baby’s health and well-being. So when the baby comes out, the other side of the coin is that we do lots of Cesarean sections for fetal distress but most of those babies come out screaming. Well, you can say that we saved this baby from getting in trouble or we did an unnecessary Cesarean section. 

Remember there is also the mother’s health and the baby’s health. There’s a higher risk to the mother’s health– ten times greater having a C-section than a vaginal delivery– but extremely rare. So that’s not a major factor. You say ten times greater but the incidence is so low. It’s much greater that you walk outside when it’s raining and get hit by lightning. But still, in LA, it’s a very rare thing so I’m not concerned about that. 

Doctors want the best for the baby. It seems like this. A lot of the time they can get away with a Cesarean section. Some insurance companies pay for more Cesarean sections. You don’t have to go ahead and spend hours and hours in labor. 

My philosophy is a little different. But you need the skill and expertise. That’s when obstetricians can deliver a healthy baby vaginally. 

Meagan: Yeah. Wow, I love that. I feel like we could do a whole podcast just on this question alone because it is such a big question. Like you said, I love that you touched on what if we’ve got a Cesarean but the baby comes out screaming? We’ve had people say, “I’ve had this emergency C-section but then my baby had an 8/9 APGAR so was my baby in distress?” So thank you so much for touching on that. 

Another big question that we have that a lot of people ask is the big baby question. What if I’m being told that my baby really is too big to give birth vaginally? Is that really a thing? What’s the accuracy on that and how would I know if choosing a Cesarean is the right choice versus going for a vaginal birth after a Cesarean? What’s the safety there for the baby?

Dr. Brock: Well, a major concern is– the American College addressed that. It is with mothers that are diabetic and have gestational diabetes. If the baby’s over 4500 grams, which is a very big baby, then consideration should be for Cesarean section for the risk of shoulder dystocia. But that’s it. At 5000 grams, if you do not have gestational diabetes, that’s a huge baby. 

Kara: What is that in pounds? 

Meagan: It’s like 9 pounds. Is it 9?

Dr. Brock: 12 pounds or something like that? It’s a huge baby. 

Meagan: Yeah, anything over 11 is an extra large baby, and then at 9 pounds, 15 ounces is where they start paying attention, right? 

Dr. Brock: Yeah, but the biggest problem with shoulder dystocia is if you have a very large baby and you do a mid-vacuum or forceps, then the incidence of having shoulder dystocia is very high, like 25%. 

But most of the time, mother nature goes ahead and plants the hat and wants a vaginal delivery. It’ll tell you. Maybe it’s stuck or something like that. But to me, it’s always worth a try because basically, you’re saying that mothers who are diabetic would have died in labor. Mother Nature knows what to do. When you give it a chance to prove it, I’ve seen it all. I’ve had a mother who had two Cesarean sections for a 6-pound baby so she really wanted a vaginal delivery. I waited and waited and waited and she delivered her 9-pound baby. 

 Mother Nature knows what to do. 

Meagan: Right. So for gestational diabetes, maybe if they are controlled and everything is looking good and the baby doesn’t look like it’s 12-13 pounds or a really large baby, you still feel that it’s reasonable to go for a vaginal birth? 

Dr. Brock: I practically always think it’s better for a vaginal birth. I mean, there are exceptions. I do VBACs after two Cesareans. I don’t do it after three. The incidence for you to rupture after one Cesarean is 0.5-1% which is very small. For two Cesarean sections, it’s 5% but then it climbs dramatically after that so I don’t do that. 

Obviously, you have to look at if the placenta is implanted properly. If the patient is of an abnormal presentation of the placenta with placenta previa or accreta. Accreta is when the surface of the placenta digs itself into the wall of the uterus and that presents a major problem. That’s a good idea to get a good center who knows how to handle it. 

Meagan: Absolutely. 

Dr. Brock: But Mother Nature– give it a chance. 

Meagan: Give it a chance. 

Kara: I’m interested. So why won’t all doctors induce VBACs? What’s the best method for induction and what should I do if my doctor refuses? 

Dr. Brock: I induce for medical reasons. When someone has a previous Cesarean section, we don’t give prostaglandins because that has shown an increased chance of rupture. I much prefer all my patients to go into labor spontaneously. I sign for a lot more testing after 40 weeks. It depends if we find medical problems but they’ll test twice a week to make sure the fluid’s normal, the Doppler flows are normal, and the NST are non-stress tests where we see baby’s heartbeat. 

I consider 42 weeks as normal. If someone’s, like I said, diabetic, I’ll do 40 weeks unless there are other problems. But I prefer them to go into labor naturally because I think it’s easier on the mother and it’s a higher success for a vaginal delivery. But saying that, this week, I’ve had a mother who had a baby who was abnormal and it was going to be fine. He needed heart surgery. She had two previous Cesarean sections. We induced her and she had a vaginal delivery. The baby, thank God, is doing fine. We will do heart surgery probably in 3 or 4 months. 

Each person’s different and we have to take everything into consideration. Right now, I like to wait for Mother Nature to do its thing. Keep an eye on Mother Nature, but let mother nature do its thing. 

Meagan: I love that. Keep an eye on mother nature, but let Mother Nature do its thing. Because we do, we have so many people writing in saying, “My doctor says I have to have a baby by 39 weeks spontaneously or my chances of VBAC are completely out the window and I have to schedule a Cesarean.” It puts people in a fight or flight mode where they are out there trying to do all of the things to try to be induced but it’s not working because their body is not ready when really what we need to do is step back and let Mother Nature do its thing. 

Dr. Brock: Well, there are exceptions. Obviously, someone who is sitting in my office and is 3-4 centimeters dilated and she’s 39 weeks then she’s an easy induction. If you’re closed and high, then don’t rush to an induction. 

Meagan: Right. Right. 

Dr. Brock: For each person’s safety, individually you have to do that.  

Meagan: And that is one of the most important things I think any provider out there should view is that everyone is an individual. I’m not the same as Cara and Cara’s not the same as this mom that just had her VBAC after two Cesareans. We’re all individuals and have different situations. 

So one of the big questions is breech. If we have someone that is having a breech baby or their baby is breech and not turning, a lot of people just have these repeat Cesareans and we know that you are really big in supporting that. Obviously, there are again, things that have to pan out. But why do you think breech is really going away? If someone is having a breech baby, what can they do to help avoid that C-section if they don’t have a provider like you that’s maybe more supportive of having a breech delivery?

Dr. Brock: Well obviously, because in today’s society of birth, people don’t have the skills to do a breech delivery. You can’t have a breech delivery unless your provider knows how to do it. The first thing I want to do is try to turn the baby. At 37 weeks, we will schedule you. We do it at 37 weeks because statistically if the baby hasn’t turned at 37 weeks, there is less chance that he will do that. Also, the fact that if something happens in a version– I’ve done hundreds of them and I’ve never had a problem but theoretically if something happens and we do a Cesarean section, baby is at term at 37 weeks. 

That’s the first thing I would do. With the breech delivery, I treat a breech delivery– I don’t care if it’s a first-time mother or a second. I do the same thing. Just like Kara, when she gets around 6-7 centimeters dilated, which means the active phase of labor– she can labor at home or wherever, but once she gets to 6 or 7 centimeters, I want everything to go quickly. What I mean is that I want her to dilate quickly. I want the butt to settle down quickly and I want to push her out quickly. You’re not going to push for 3 or 4 hours. I’ll do that for first-time mothers or with any mother head-down but not with a breech. I want it to go quickly. 

A lot of babies don’t do that, but that’s where I stay safe because if it flies out, it flies out. The biggest problem with breech delivery is that the head is coming last. The cord is beside the head so you’ve got to get the baby out quickly. Using those criteria, I’ve had very good success and no problems, but I’ve done many Cesarean sections because obviously, I remember one patient who came in. She was 9 centimeters. It was fantastic. She was doing great. She started pushing and all that came down was the testicles. 

So I sectioned for a 10-pound baby. So mother nature is telling you, “Just because you’re committed to a vaginal delivery, you don’t drag the kid out.” The idea is to let the baby do its thing. The reason we want butt down, especially in first-time mothers, is that if it’s not his feet coming out, the cervix may dilate to 6-7 centimeters and the feet come out and the body comes out and the cervix is not fully dilated when it gets to the head and it gets trapped. 

The cervix never clamps down. It just never fully dilates. That’s why we usually don’t do footling breech. We don’t do vaginal delivery. There are exceptions, but rare exceptions. If a multiparous patient comes in and the feet are there and the cervix is completely dilated, the baby just falls out. That’s really an exception to the rule. 

The other concern with a footling breech is especially if the mother is dilated, that patient is concerning because if the water breaks and she’s dilated and just the feet are there, the cord may fall out. It’s called a cord prolapse. That’s a contraindication to try to do something at home. If someone is dilated and footling breech, that’s the kind of patient I would bring to the hospital and do a C-section for cord prolapse. 

Meagan: Yeah, which makes sense. There are not a lot of you out there that will support or is trained and educated in vaginal breech delivery and from what we’re gathering is that it’s not really being taught a ton in medical school anymore. Is that correct? 

Dr. Brock: Well, not in my residency. I mean, I may offer to do that but it’s easier. I mean, you schedule a C-section. You walk in. It’s an hour. You’re done versus spending 8, 10, or 12 hours laboring this patient. So the incentive isn’t there to do that. So the skills are disappearing. I mean, I’ve offered to come in and assist anyone who wants to do a breech delivery and I’ve done that but not that often. 

The residents are always invited. They can do that but just because they do it in residency, it’s a big staff to get through. They may do one or two breech deliveries but they don’t feel comfortable to keep on going out in the private practice. It is dying out. 

Meagan: Yeah. It makes me sad. It makes me sad. 

Kara: I have a question because I have had two C-sections. How long should somebody wait to conceive after a C-section? I’ve heard mixed things about this. I’ve been told mixed information about this and I just would love to hear your point of view on that. 

Dr. Brock: Well, there’s some data to show that ideally it is two years apart but everybody’s facts come into play. For someone who is much older and has trouble getting pregnant, if someone had a baby at 40 and wants another child if she is waiting until 42, she may never get pregnant. 

I’ve not found it to be a big factor but statistically, it does seem to be safe. I would do psychologically what’s better for you how far apart you want to have your kids. Besides, mother nature does help. It takes some time to get pregnant as you get older. 

Kara: Great. Is the thought that the longer you wait, the more healed your C-section scars are and your uterus is stronger or is that not real? 

Meagan: Like is there less chance of rupture that way? 

Dr. Brock: Literature is in my mind, not that clear. Statistically, it’s probably true but it’s like saying you’re at a greater chance of dying if you’re driving at 58 miles an hour instead of 55. It’s true, but statistically, is it really a factor? 

Meagan: It’s not substantial. It’s not anything that’s a concrete yes or no. Okay, and talking about VBAC after two Cesareans or more, what are the complications surrounding a C-section or even a repeat C-section? We talk here a lot about the risks of VBAC– rupture and things like that– but we don’t talk a lot about complications, especially even years later. Are there complications for people who have had Cesareans even years later? 

Dr. Brock: Years later, I don’t know much about that. I do know the higher the Cesarean section rate, you’re going to have an increase of abnormal implantation of the placenta from accreta or things like that. It goes up. Instances of rupture with more Cesarean sections go up. I’ve done Cesarean sections, 5, 6, and 7 Cesarean sections. It depends. The doctor who goes in there with all of the scarring, while it’s very, very difficult and dangerous, it may pass on to the next time, but most of the time, it’s not a problem at all. 

I have no limitations per se on how many Cesarean sections someone can have. I have a patient right now. She had a Cesarean section then I did a VBAC. Now she’s pregnant again but she wants a repeat Cesarean section because she had anal problems and she had surgery so her surgeon recommended that she doesn’t try for a vaginal delivery. I’m not 100% in agreement but I have no problem respecting her wishes and we set her up for a Cesarean section. Each case has to be individual. There are no absolute rules for anything. 

As far as consequences, most of the time for later on, there is but it’s more related to how many times you get pregnant, not how you deliver. Bladder dropping and things like this, each pregnancy puts a toll on that. I think mother nature plans for you to have your first kid when you get through puberty. I think it’s a very bad idea for 13-year-old kids to have kids. But mother nature, that’s the whole plan. That’s the animal kingdom. That’s what we do. Of course, for millions of years, you were dead at 20 but that’s a different story. 

Meagan: So kind of piggy-backing off of that question too, we had someone write in talking about how she had a Cesarean and then they went in for a second Cesarean but they didn’t use the same incision so she’s got two incisions which I had never actually heard of, in her uterus. In the uterus, they cut a different spot is what she said. She’s asking– okay, so now she’s got two incisions in her uterus. Is that something that would be suggested for her to VBAC because she’d really like a vaginal birth? 

Dr. Brock: No, that’s fine. First of all, the patient doesn’t know about the scar on the uterus. It’s the doctor. When I go in there unless someone had a vertical incision and there’s no such thing as a classical. They call it a classical incision, but that was done 100 years ago and they went up and down incision on the belly and they went up and down incision on the uterus. The top of the uterus is the fundus is what we never do. That’s at a much higher instance of uterine rupture. 

We used to do that. Somebody added, “Once a section, always a section.” That’s where that falls. I would say 95% of Cesarean sections are low-transverse. They are very low on the uterus. But when I go down and do that, I see the bladder there. I don’t know where the last Cesarean section was. I can’t see. I just tape down the bladder and make an incision so I have no idea in the uterus. But we do know that, like I said, during Cesarean sections and repeat, it’s not a problem. We do know that.

I’ve given it to patients that had previous fibroid surgery. The American College recommends, what is the indication for the surgeon? Does he recommend you for vaginal? He should tell you that. My philosophy is when I do that, it depends on if I enter the cavity of the uterus and whether I would recommend a Cesarean section. Sometimes the fibers outside of the cavity, I have no problem recommending a vaginal delivery. 

I’ve done vaginal deliveries after another doctor did multiple fibroids laparoscopically. They sewed it up and I asked him. He said, “Well, it should be fine. We did multiple scars and she did great.” Yeah, individuals.

Meagan: Exactly, yeah. Thank you. 

Kara: I have a question. I did not have supportive providers in regard to my first two deliveries. I had an emergency C-section and then a planned C-section and nobody brought up that I could deliver vaginally or any of that. I just felt like I had a C-section so I had to have one the second time around. So I wanted to know what are the ways to really help someone find a provider who actually tries for that? I think a lot of women can’t find the right doctor who can do that. 

Meagan: Yeah. 

Dr. Brock: It’s hard to say. Some hospitals publish the C-section rates of their doctors. That’s one way to look into it. But blogs and things like this, you have to talk to your doctor and see what’s comfortable. You can’t force your doctor to do something he’s not comfortable with. Many years ago, one of the doctors, an old-time doctor, refused someone to do a VBAC because he had a bad outcome with a baby. Your personal experience comes in. Everyone’s trying to do the best thing. They’re trying to do what’s safe for you and your baby. You just have to find a match that works for you. 

Kara: When you’re interviewing your doctor, what are the types of questions you can ask to get a sense of his or her skill level with it or comfort level with VBAC? 

Dr. Brock: Well, I’ve had a patient come in. She had three previous Cesareans sections. She wanted me to do a vaginal birth. I said, “Don’t. My limit is two.” They have it out to think that it’s the same but it’s not. It’s about talking to your doctor and asking them personally. “I’m thinking about having a VBAC. What do you think about it?” You want to be comfortable with your doctor and listen to his advice, but there are different opinions out there. 

If you’re comfy with your doctor and you trust your doctor, I have no problem if he feels that he did a section and recommends another section, I understand that. We do know that certain things that change behaviors. They talk about measuring the thickness of the scar, of the uterus, and things like this. A study just came out that found no correlation whatsoever. 

Meagan: I was going to ask that. That is a huge question too. “My doctor said I can’t because my thickness isn’t thick enough.”

Dr. Brock: Well, there was no correlation. It made me nervous. I had one who had a scar. They said she had a window in the ultrasound. She had two previous Cesarean sections. I delivered her baby vaginally no problem. After that article came out saying there was no correlation, and my experience showed there was no correlation but each case is individualized. I may have a previous rupture and that’s a different story. There is no good literature on that and it’s probably not worth the risk. 

Meagan: Right. What about single and double sutures?

Dr. Brock: The data shows that I will always use the double closure. The only thing I would make an exception for is that sometimes when they get their tubes tied and it will save some time while having a C-section or vaginal delivery. But no, literature says that double closure has lower chances of rupture. 

Meagan: Would you support someone wanting to VBAC if they had in their op reports a single-layer suture? 

Dr. Brock: Yes, I would. A higher instance doesn’t mean it’s going to happen. As all patients, with this one especially, when you have a previous Cesarean section, I don’t want you to deliver at home. *Inaudible* Usually, it’s not unreasonable to place an epidural catheter in. Not actively, but if something happens, we can just give you some medication so you don’t have to put them under general anesthesia. Just to be prepared.

Meagan: Right, right. Be prepared. 

Kara: You prefer that they labor at the hospital and not at home? *Inaudible*

Dr. Brock: Yes, yes. Right, because that’s a concern we have. The baby will tell us something. I did a VBAC last night and she’s not that tall. She’s only about 5 feet. This baby seemed huge but it was way out of bounds. The reasons are that the pelvic, mother nature doesn’t know about these Cesarean sections. So first-time babies go down low in the pelvis. The cervix is firm and holds the babies in there prematurely but after the first delivery, the cervix can get soft so mother nature keeps an eye until you go into labor otherwise you’ll deliver prematurely. 

But that’s when the head is high. The higher the head is, that’s going to put pressure on the scar. I feel much more comfortable as the head drops in the pelvis, it’s getting below the scar, and the chance, I think, of rupturing drops dramatically when the head drops. But mothers may not drop until they go into labor. 

Meagan: Right. Talking about preterm, if someone had a preterm Cesarean birth, are they a candidate in your eyes for a vaginal birth after a Cesarean? 

Dr. Brock: It depends on how premature. Babies vary with premature. We talk about if she didn’t go into labor, and they had to have it done. It depends on the thickness of her lower uterine segment. The doctor goes in. He may feel like there’s not enough safe room to make a transverse incision so he has to do a low vertical. The low vertical is associated with a lower instance of rupture. Mind you, before we say you have to find your records and find exactly what type of scar on the uterus it is. But now, American College says, “No. If you had a previous Cesarean section, unless you know that it’s a low vertical, then you can try for a vaginal.” If it’s a high vertical, definitely. Low vertical, it is a little different but we have to wait and see. 

I’m not against going for a repeat Cesarean section if someone had a 25-week Cesarean section. If the lower uterine segment was not developed, the doctor did it appropriately. There is no harm to the baby coming out low vertically extended up. 

Meagan: Right. That makes sense. Cara, did you have another question? I know that we were talking about it before. 

Kara: I was just wondering if I’m preparing for a VBAC, which I am in four months. Is there anything you recommend that patients should do to prepare for a VBAC? That’s something I think about all of the time. Is there anything that patients should do to prepare for that? 

Dr. Brock: There’s nothing. There’s really nothing that you can do.

Kara: No running?

Dr. Brock: You don’t want to gain too much weight during pregnancy. The more weight you gain, the bigger the baby so that’s a major factor. If you start gaining 40, 50, or 60 pounds, then the baby may be bigger and things like that. Most things to prepare are like with any pregnancy. Get yourself into shape before you’re pregnant. Get your weight down before you get pregnant. Those are major things that you can do. Once you get pregnant, we tell you not to gain too much weight, but we don’t want you to lose weight. 

Exercise can always be done during pregnancy, but I always prefer getting into shape before you get pregnant. 

Kara: No one ever tells you that. I swear. Or at least no one’s ever told me that. I think that’s a good thing to know. 

Dr. Brock: Yeah, because you’re slim. 

Meagan: Yeah, well just being healthy overall and overall healthy. That’s not even just for VBAC. It’s just if you’re going to have a baby, try overall to be healthy in general every day. Even if you’re not having a baby. Good nutrition and all of that. Preeclampsia is something that is sometimes developed. Is that something that someone could TOLAC and have a VBAC with? 

Dr. Brock: Yes. It really depends but nowadays, with previous history, we give baby Aspirin and try to lower the incidence of recurring. We keep track of the blood pressure throughout the pregnancy. But yes. If I knew the cause of preeclampsia, I’d win the Nobel Prize. It’s the mystery of mankind. We know it’s associated with first-time mothers, elderly mothers, and twins, but we don’t know exactly the cause. All we can do is keep an eye on it and make sure it doesn’t occur. Now if it does occur, unfortunately, the delivery for that and the treatment for that is delivery. 

Meagan: Right. This is a spinoff but HELLP syndrome. If someone develops HELLP syndrome and their platelets are good and everything, are they still candidates for VBAC or is a Cesarean delivery really safer? 

Kara: Can I ask, what is that? 

Dr. Brock: First of all, it’s a subset of preeclampsia hypertension *inaudible* where the mother can get elevated liver enzymes and low platelets. That is an absolute indication that we have to deliver the baby. Okay? Now, people go ahead and say, “Oh, well you were *inaudible* delivery. We should do a Cesarean section.” I have nothing against doing that but if a patient is, it may take a long process because she’s not ready, but I think that she has to be managed in a hospital, her blood pressure is under control, and she has to go for delivery. 

Now, it may take a day or two and maybe she’s not willing to wait that long or her doctor isn’t or things like that, but I have no problem as an independent event to have a vaginal delivery if you have HELLP but it’s definitely an indication. 

Meagan: Yeah, isn’t that really the only way to help is to get the baby out? 

Dr. Brock: Correct. The only way to help HELLP syndrome is to get that baby out. 

Meagan: The only way to help HELLP syndrome is to get that baby out. Yeah. Okay, that is so good to know. It’s not as common in our community, but we have definitely seen people ask and then they worry about the platelets and surgery. They never know what’s safe or not. 

Dr. Brock: The other thing is that if the platelets are low or under 100,000 the anesthesiologist is very leery of putting in an epidural. The reason that over a spinal is because platelets are used to clog your veins and if he hits a blood vessel in your spine putting it in, then it can cause damage and cause paralysis so they really don’t do spinals. They do general anesthesia, not regional anesthesia if someone has low blood platelets. 

I had a patient who had very low platelets not from HELLP, *inaudible* and she couldn’t get an epidural. We definitely didn’t want to do a Cesarean section because she had low platelets so we did it the old-fashioned way. She didn’t have an epidural. She had a vaginal delivery and it hurt. 

Meagan: Yeah, well that’s good to know though. That’s really good to know. So as someone who’s had a vaginal birth after two Cesareans myself and obviously Kara is preparing, we talked a little bit about how to prepare. But is there anything that we need to know? We talked a little bit about the risk earlier but is there anything that we need to know about vaginal birth after two Cesareans that we may not hear about with just VBAC after one?

Dr. Brock: I mean, like you said. The risk is higher. The doctor who might be a little nervous or leery obviously, stress shows that doing a Cesarean section may be higher which I understand. If there are concerns, he may cross-match for blood and have it available in case you need that. That’s how the doctor is not the issue. Like I said, labor in the hospital and not at home because if something happens, “Oh, I’m five minutes away from the hospital,” but that’s not true. You may be five minutes but you’re at least 45 minutes before you can get the baby out. You try to hold your breath for 45 minutes, so that’s why in the hospital. 

But like I said, everything is done before you get pregnant. Try to get in the best shape you can and not gain too much weight and make sure the baby isn’t huge. If someone had a macrosomic infant and is diabetic, the doctor may take that into consideration. 

Meagan: Right. We have a lot of people in our community that don’t have the support in their area and do find themselves having to travel long distances to their provider that is supportive. I think a big worry is uterine rupture. We talk about uterine rupture and it sounds really scary. We talked about getting to that hospital as soon as you can. But for those who are driving or are further away, are there any signs or symptoms that you would say, “Okay, you need to seriously deviate your plan and go to the nearest hospital at this point?”

Dr. Brock: Well, certainly massive bleeding. If you go ahead and have searing pain, that would be from the uterus. There are no absolute signs of anything, but stars up early, that’s why you go in early so these things don’t happen. Thank god the instance of rupture is very small. In a hospital setting, even with a rupture, there’s no guarantee that the baby is going to get in trouble but it’s considered a greater risk. If you’re not in the hospital, it’s a risk to the mother’s health and the baby’s health. But the instance is small. 

But common sense is. If you’ve had four Cesarean sections and now you decide you want a vaginal delivery, you’re putting yourself at greater risk. It’s not worth the risk. Babies don’t do well if mommies aren’t around so you want to make sure you’re doing fine. 

Meagan: Make sure everyone’s good. Yes. Awesome. Kara, do you have any other questions, especially as a patient? I’m sure you guys have this time in the office to ask as well. 

Kara: We have an appointment right after this. No, I just feel really grateful to have found Dr. Brock and I really feel that I wish more doctors were as skilled and as knowledgeable as you are. I am really, really impressed with your experience level and your support of mothers trying to do things the way they want and the way were made to do. I’m just very grateful and thank you for being with us today. I know how busy you are with eight deliveries this week. 

Meagan: Literally, I know. You just had births last night. I’m sure you’ll have births today. It’s always such an honor to have birth professionals on the podcast because these people who are listening to the podcast really are in a very vulnerable state and want to get all of the information. So it’s so fun to have a skilled OBGYN here answering these questions from the community. It really does. It helps people guide and feel better. Honestly, just hearing the support you have, no wonder you’re the VBAC king in LA. 

Dr. Brock: There are a lot of other people who do VBACs. 

Kara: You’re being humble. He’s being humble. 

Meagan: There are. There are a lot of people out there that do VBACs but it does seem to be harder to find people that do VBACs in the manner that you do like, “Let’s monitor mother nature, but let’s let mother nature do its thing.” It doesn’t seem like you have a lot of restrictions. We have a lot of providers out there that do have a lot of restrictions so it’s humbling to hear that you’re like, “Hey, let’s do this. Let’s trust the process. I’m going to be here. I’m going to guide you along the way and I’m going to monitor but I want what’s best for you and I want to listen to what you want to do and I want to support you.” 

Thank you so much for being that person for this community. 

Dr. Brock: Well, the other thing that I was saying is that for someone who is in labor, I do monitor the baby. It’s not intermittent monitoring because that’s how I keep track of the baby. The other thing I do when I do the tracing is that a good baby can look bad on the tracing, but a bad baby cannot look good. So you have to understand that. If a baby is a healthy baby and has some variation but it comes back and it’s back to normal, that’s a healthy baby. But even with the worst tracings, statistics say that 50% of the time, the baby gets in trouble. But just a terrible tracing, follow your doctor’s advice and do what he says. But still, hopefully, results will come back good. 

Meagan: Right. Standard practice all over the world really is continuous monitoring with VBAC because we know that fetal heart dropping and distress are one of the main signs that something, some separation may be happening. If you’re listening, know that it’s pretty standard. That’s pretty standard care all over the world. 

Dr. Brock: It keeps your doctor’s *inaudible*. If you’re not monitored, we don’t know what’s going on. 

Meagan: Right, yes. Okay, well thank you so much for taking the time out of your day and being with us. We really do appreciate it. 

Dr. Brock: All right, have a good day then. 

Kara: Thanks, Meagan. 

Meagan: You too. Bye, you guys. 

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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“Doulas are great. How do I get one?”

‘Hope you’re rich, bye!’

“Wait, now I can’t have one?”

We are so happy to be joined once again by our friend, Kaitlin McGreyes with Be Her Village. Meagan and Kaitlin talk all about the benefits of doulas and what they love most about being doulas themselves. 

Not only that– they also talk about how to actually afford one. Every mama deserves continuous support during her labor and birth. Kaitlin has created the platform to make it a reality. 

Additional Links

Be Her Village Website

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, hello you guys. It is Meagan from The VBAC Link and guess what? We have our friend, Kaitlin from Be Her Village, back. I am so excited to have you, Kaitlin. 

Kaitlin: I am so excited to be here, Meagan. Thank you so much for having me. I love this little friendship that has burst out of our VBAC love and our desire to get everybody their VBAC. 

Meagan: I know. Our passion around birth. It’s just so cool to see how people from different parts of the world can connect so deeply. I just adore you and love you and I do hope that I get to meet you one day soon in person. 

Kaitlin: Oh, for sure. We’re going to make that happen. 

Meagan: Oh my gosh. Last time we shared her VBAC story and this time we are going to be talking about doulas. So if you didn’t know, we are both doulas. Obviously, we are very passionate and heavily involved in the birth world. We are going to talk about, okay great. That’s wonderful. We know about doulas. Now what do we do? 

We are going to talk about that today so if you are wanting to know more about doulas, the stats around doulas, and how to pay for a doula, you want to hold on and listen to this episode. 

Review of the Week

But of course, I have a Review of the Week so we are going to get into that and then we are going to talk all about wonderful doulas. This review is from txliberty92 and it was in 2020 and it says, “From Fear to Confidence.” It says, “When I found out that I was pregnant for the second time, I instantly felt so confused about how to birth this baby. I had heard so much conflicting advice about repeat cesareans and just wanted to hear the facts and hear from people who had been down this road before. I am now 36 weeks into my pregnancy and prepared and totally confident in my upcoming VBAC. I don’t know if I would ever have gotten to this point without this podcast and community.” 

Oh, that makes me so happy. Txliberty92, if you are still listening, because that was in 2020. That was three years ago. If you are still listening, write us at [email protected] and tell us how things went. And hey, we want to share your story. 

Be Her Village

Meagan: Okay. Let’s talk about doulas. First of all, I think it’s fun to talk about why us doulas become a doula because I know that when I was in high school, I knew I loved babies. I always wanted to babysit. I always wanted to be close to a baby, holding a baby, and then through high school, I was like, “I would love to be a labor and delivery nurse,” because hello, they get to be close to babies and hold babies all of the time, right? 

And then I started having babies of my own and learned more. I decided that I did love the idea of becoming a labor and delivery nurse but to be honest, I hate math. That’s literally one of the reasons why I decided not to become a labor and delivery nurse because they have to do so much math. 

Kaitlin: There is so much math in nursing, yes. 

Meagan: So much math and I just hate it so much. For those listening, you guys, I actually had to take Math 1010 three times. 

Kaitlin: Oh my goodness. 

Meagan: That is how much I hate math. I hate it so bad. I suck at it. I hate remembering it and still to this day, I’ve been a doula for over 8 years and I still have a hard time. I have to Google how to calculate mpu’s every single time because I hate math. So that is something that steered me away, but the thought of being able to love and support and educate and hold space for somebody and not do the math–

Kaitlin: Sign me up. 

Meagan: It sounded amazing. It sounded so amazing. So through my first birth, after my undesired, unplanned C-section, I definitely had more of a passion for birth, and then after my repeat and learning more about doulas, I was like, “Yeah. This is it.” I remember the fire lit inside of me that day just like, “This is what I’m going to do. I’m going to love people. I’m going to support people. I’m going to educate people and let them know what their options are.” I have loved it ever since and I am so glad to be here today. 

So where did your fire ignite?

Kaitlin: Oh my goodness. My fire ignited from my VBAC actually. I love that your story was like, “I always knew that I wanted to work with babies and mamas.” I had no idea. I was a special ed teacher in New York City. My husband still works as a special ed teacher in the school where we met when we were 22. That was the path. It was getting out at 3:00, working with kids, and feeling good. It was not being a maternal healthcare advocate at all. It was not doula work. It was not changing the baby industry. It was just not any of that. 

But then I went and I had a baby. My first birth, as you can listen to on the other episode, was on a spectrum from underwhelming on some days. I would reflect that it was underwhelming and other days, it was full-blown traumatic. It really depends on where I am in my head space. 

But it was kind of awful and the C-section wasn’t what was awful about it. It was how people treated me. It was the powerlessness. It was being dictated to and people making decisions around me and not acknowledging me as a human being and as an adult, grown-ass woman who could make decisions about myself and my body. 

Meagan: We’re having another human, right? 

Kaitlin: Right? How dare they. How dare they disempower me so quickly and then less than two years later, I had this incredibly different VBAC experience that was transformative before the baby ever came out of me. It had nothing to do with the vaginal side of it although that was amazing and kickass and I totally recommend it. But it was really about how I went in. I researched. I decided for myself that I wanted a VBAC first off. 

I hired a doula. I hired a VBAC-supportive provider, a doctor actually, and I just walked into that birth powerful and in charge. I ended up having a vaginal birth which was spectacular but that was the fire in me. It was sort of, “Wait a minute. How can I have two completely opposite experiences over the past two years?” So that was where I was just like, “I think the doula was a big part of it,” because I took childbirth education. I hired midwives. I did the things I was supposed to do and the doula, having someone in the moment when you’re in that crucible where you’re just being challenged and tested and you’re in crisis, for many of us, and where you have this deep desire for your baby to be safe and for you to be safe yet you know. 

You know because you’re listening to The VBAC Link. You know that this system is sort of rigged against us. How do you make sense of all that? The answer for me was in my doula. I knew that I needed to become a doula so that I could help more people. I have to be totally transparent. I definitely started out with a little bit of a savior complex. I was like, “If you hire me, I can save you from trauma,” which is not true or healthy for any of us. 

Meagan: It was probably you coping with your trauma. 

Kaitlin: Absolutely. There was this idea that my doula saved me in my birth so I could save somebody else. But it’s true in that sure, we can have an incredible impact but we can’t save anybody. You can’t just hire a doula and like, “Okay, that’s it. It’s done.” You have to hire a doula and work with them and ask questions and still be very much an active participant in your care. The doula is the tool to learn how to advocate. The doula is the tool to set yourself up for success and that was why I got into it because I just thought, “Man, I have had two completely opposite experiences and I want to help more people have the second one, have the empowered one, have the voice, have built the team around myself.” 

So I thought, “I’m going to be a doula.” Little did I know how that would all end up but it’s just amazing. It’s the best thing there is. 

Meagan: Yeah, exactly. I would have never told you when I was becoming a doula, or it was nine years ago in September. Right now when we’re recording, it’s almost June. So almost nine years and I would have never said, “Oh yeah, in nine years, I’m going to have a podcast and be a VBAC advocate and educator and all of these things.” I never would have guessed that, but man. I am so grateful for this journey and where it’s led us. 

You know, we talked about that. Doulas are there to help you. They’re not there to rescue you. I think sometimes even I would say if I would be really honest. I was kind of like that too. I would have a client where they would be going in having these really deep goals and I was like, “I am going to make sure that happens.” I would go in and then sometimes if they didn’t happen or if births went differently or we had unexpected events or something like that, I remember going home and I remember feeling like I failed as a doula. I felt like I failed them. 

Kaitlin: Yeah. Oh, it’s a horrible feeling. 

Meagan: A really bad feeling. For your birth workers listening, it’s important to know that you are there and you love your clients but we can’t save everyone. Just like the clients that are hiring us need to know that we’re not there to save but we’re there to help educate, guide, love, and help you facilitate the things that you need along the way. It’s just an extra crutch. 

Kaitlin: Yeah. I feel like it’s really the work of labor and birth happens in the pregnancy. That’s why you should get your doula as early as you can because it is in your doula’s ability to help understand what your true desires are and help keep you connected to them because one of the things so many of us do and I’m speaking really about myself here too. I’m projecting my own experience. We abandon ourselves. We know what we want. We know that we want XYZ for our birth and then we sacrifice ourselves because as mothers, this is what we do. We sacrifice our time and our energy and our bodies for our babies but that gets used against us sometimes. It’s really great to have somebody dedicated to your team that can sort of continue guiding the entire experience back to you back to those original goals, back to that original desire, and reminding you of what is possible and helping you stick to that. 

Then if you have to shift away from it, they are helping you navigate that shift in a way that feels intentional and purposeful and that you are emotionally able to shift as well so that we avoid that feeling of, “I don’t even know what happened. I felt like I got hit by a bus and now I have a baby and I’m not sure how it happened.” We can’t control a lot of things that happen in birth and doulas can’t control them either which is a journey we go on as professionals. 

But we absolutely can help people navigate their births in a way that feels empowering regardless of the medical factors that end up happening. 

Meagan: Yeah. One of my favorite parts about being a doula is actually helping the partner along the way because I mean, obviously, Mom is the star of the show. She’s having the baby and she’s a very important person. She’s definitely the MVP in that room but guess what? So are these partners. It’s so fun like you said to circle around and help these partners feel more a part of birth as well because they sometimes have that same feeling where all of a sudden they are like, “Oh my gosh. My wife has a baby. What just happened?” 

So it’s so nice to help dads and birth partners feel more involved and more connected and in control in a way of their own birth experience as well because it is their birth experience too. 

Kaitlin: Absolutely. I would argue that doulas are more for the partners in a lot of ways than they are for the birthing person. I personally didn’t hire a doula for my first birth and I regret it. I can say pretty blatantly and bluntly that I regret it because I was afraid that it would take away the intimacy. I was afraid that it would be too many people and that I wouldn’t have this intimate with my partner but what ended up actually happening is that my partner was so panicked by this mess of labor and by his wife being in so much pain. 

He wasn’t of any help to me. I mean, he was as much help as he could have been. I’m not trying to attack my partner but he was really in this place of being a deer in the headlights. I was flipping out. He was a deer in the headlights. Everything was going wrong and he didn’t have the tools. He had never done it before and that’s in a birth that was very stressful. 

Even in a birth where you’re not in a medically-induced place, it’s still really hard to have the entirety of the responsibility of this experience to see your partner who is for the most part– this is a little stereotypical, but it’s true– the women who are giving birth are making the lists and they’re choosing the doctors. They’re setting up their doulas. They’re doing all of the things and they’re making a birth plan. They’re dotting every i and they’re crossing every t and then what happens when they go into active labor? They retreat. Their minds retreat into their bodies and then all of a sudden, they’re not communicating much of anything which can be really disorienting to a partner who feels to them that they need to keep their partner and their baby safe. 

This creates this feeling of alarm and can really not make the whole thing not feel good for everybody. When we have a doula that can come in for the partner and normalize the entire birthing experience whether it’s in the hospital really medicalized or at home during early labor to transfer or have a home birth, it’s so cool to have somebody who has walked this path before to be able to tell your partner, “Hey, this is all fine.” 

To have someone not react when you have somebody vomiting or contracting or shaking or all of these things that happen in the throes of labor, can be so relaxing. What is does is that it helps the partner then join his woman or his birthing person with intention and with this presence without all of the anxiety. It actually creates this beautiful expression of love. 

Not to mention, it’s so cool to have someone show you how to touch your partner. One of them when I was teaching childbirth, I remember he was half joking but he was only half joking. He was like, “I just want you to teach me how far away to stand from her,” because he was just so nervous about the whole thing. It’s like, imagine having someone come in and be like, “Hey, when she does that, just press here,” and it’s like ooh. You get to learn and have a coach that helps you take on that care. It’s the opposite of what so many of us think, myself included, was that a doula would replace my partner or get in the way. Really, what we do is help partners get more hands-on in such a helpful way. 

Meagan: Yeah. Exactly. My husband was really not keen on the idea of hiring a doula. He was like, “I’m not good enough? You’re going to replace me?” That’s where he snapped too. It’s like, “Whoa, whoa, whoa. It’s not like that.” But it wasn’t until we had a doula that he was like, “Whoa. Okay. I see what you do as a profession. I love this and we would never do this again without one.” 

So yeah. Doulas are there for you. They’re there for your birthing partner, but guess what, you guys? They have actual stats on how impactful doulas can be. That is so cool to me to think that there are stats on the profession that I do. It sounds silly. 

Kaitlin: It’s science. It’s science. Passionate science. It’s science. 

Meagan: There are actual statistics that what I do and what I love is helpful. Okay, so let’s talk about them. Doulas can decrease pain medication so epidurals, fentanyl, and stuff like that by 10% which seems little, but if you think about all of the people giving birth. 

Kaitlin: 10% is huge. 

Meagan: 10% is huge if you have 24-hour labor or more. I was 42. Yeah. It’s wonderful. There’s a 38% decrease in the baby’s risk of a low 5-minute APGAR score. 

Kaitlin: And that, I really want to pause on that because that’s a really big deal. The APGAR is your sign of life. That’s literally like do you have muscle tension? Are you pink which means there’s oxygen coursing? Do you have a pulse? It’s literally, is this baby thriving? The APGAR is an enormous measure and what’s wild about this is that doulas are not medical providers. We’re not medical providers. I can understand the epidural being applied. It’s like, “Yeah, we have some tools and tricks up our sleeve to help you manage pain. That makes sense to me.” 

But influencing an APGAR? This means that if you hire a doula, a non-medical provider, whatever magic thing that we’re doing is not really magic. It’s just being present and helping people advocate for themselves, can have health impacts on your baby. That’s wild. Who we’re not touching, who we’re not making medical decisions on. We have no medical training and yet we’re impacting medical outcomes. That’s a big, big, big deal. 

Meagan: It’s pretty stinking huge. In this study, it doesn’t necessarily single out doulas. It’s continuous support which guess what doulas do? Continuous support. 

Kaitlin: Yeah. Well, no other provider is doing that. 

Meagan: No. I mean, they’re in and they’re out. Midwives and OBs, we love them all. 

Kaitlin: Yes, we do. 

Meagan: But they can’t. They can’t. 

Kaitlin: The system is not set up for continuous support. Absolutely. 

Meagan: They can’t. They might be in there for a little bit but then they’re in and they’re out. So a 31% decrease in the risk of being dissatisfied with the birth experience. 

Kaitlin: That’s a big one. That’s a big one. 

Meagan: You guys! 31%. So one of the things that I love about being a doula– I mean, there are a lot of things– but I want someone to walk away from their birth, even if it didn’t happen exactly how they wanted on their birth preference sheet or birth plan, to have a good experience. I want them to look back and say, “You know, I didn’t get this or that or this happened and wasn’t my ideal but overall, that was an amazing experience and I’m happy with my experience and I don’t reference my experience as traumatic,” and just have an overall better view on their birth. 

Kaitlin: That’s the thing though. We all know there are uncontrollables but having respect and feeling in control and feeling like you were part of your birth in a powerful way has ripple effects and implications well beyond that day of your birth. That’s a huge metric and that’s really, really important. 

Meagan: Yeah, huge. Another one, I think, that is really cool is that they have one showing continuous support such as a doula can shorten labor by 41 minutes. 

Kaitlin: Um, yes. They shorten labor. They shorten pushing time and reduce your risk of C-section or surgical birth, forceps, or vacuum, up to 25%. I think there is a saying and I’ll have to find the quote but it’s like, “If doulas were a drug, it would be unethical not to use them. It is clinically proven that continuous support by a non-family member– that’s the doula part, right?

Meagan: Yes. Yeah, I want to talk about that. 

Kaitlin: Yes. Continuous support by a non-family member is wildly impactful not just on your emotional experience but on your pushing time, your laboring time, your surgical birth risk, and your baby’s health. It’s really something that every single person in the United States deserves to have. 

I also want to just put this other steed in here that doulas are not the cause of surgical birth. We are not the cause of longer labors or lower APGARs. We’re not the root cause of these issues but we are one of the solutions that our healthcare system is looking at. 

It’s hard to talk about this because I do want to talk about how doulas are awesome. Everyone should have a doula. 

Meagan: They’re seriously so awesome. 

Kaitlin: But we are very much also a bandaid on a broken system so yes. We’re all currently giving birth in this system so we all should have access to doulas and that’s part of the work that we’re both doing is getting people connected to the doulas in their area and getting people connected to the funding to pay for them because that’s sort of the elephant in the room. It’s like, “Okay. All of these doulas are great and they’re highly impactful.” You listen to a podcast like this and it’s like, “Oh, that’s great. How do I get one?” It’s like, “They cost $2000 out of pocket. Hope you’re rich, bye!” It’s like, “Wait, now I can’t have one?” 

It’s all a really messy stage in the American maternal healthcare system that we’re in right now, but the idea of having a doula or not having a doula when you think about what we all think about as we are preparing for our birth is, “What’s best for my baby?” It’s best for your baby to have a doula-supported birth both for their health and for their parents’ health and their parents’ experience. If anyone’s on the fence about it, I hope that this will spark you into researching and talking and looking into it because there are a lot of misconceptions about doulas. 

They are for everybody even if you are planning a C-section. Even if you’re listening to this podcast because you’re like, “I don’t know. VBAC’s not for me.” Even if you’re listening because you’re a hater. Doulas are for everybody. They’re for every kind of birth. You can plan a C-section. You can plan an epidural. You can plan a home birth. You can plan a birth in the middle of the woods and a doula can be really instrumental in being an advocate for yourself throughout that. 

Meagan: Yes, and I have been to scheduled C-sections. I had two and I wish that I had a doula to be there. So I love that you were talking about, “Okay, wait. We know that doulas are awesome.” Sorry guys, but doulas are awesome. 

Kaitlin: But we are. 

Meagan: Okay, where do we find them? There are websites all over. You can search “Doula Near Me”. The VBAC Link has specific VBAC doulas. You just go to thevbaclink.com and search “Find a Doula”. Type in your zip code and boom.

But yeah, then what? Then what? How do we pay for $2000 doulas? 

Kaitlin: Yes. $2000. I’m in New York. $2000 is kind of run-of-the-mill. Medicaid is covering $1900. They’re paying out for doulas. That’s just the cost of doulas in New York. It really varies according to market but it’s expensive. If it’s an $800 doula, then that means the salaries in the area and the cost of housing and everything else in that area is low. 

I think it’s safe to say that it is a heavy lift for most people to be able to access a doula and not just a doula, but all of the other care that comes with it as well. Postpartum care, tongue tie clips, breastfeeding care, pelvic floor care, maternal mental health. How many insurance companies are covering those things? There’s just an enormous amount of funding that needs to happen in order for us to get the care that we deserve, the baseline of care that is happening in other countries for other mothers. 

One of the things that I love to talk about because it’s sort of my life’s work–

Meagan: Listen how to solve this problem!

Kaitlin: Drumroll, please! It’s really your baby registry. It’s using Be Her Village which is what I created. It’s our platform, our baby registry platform so that you can use this event where all of your loved ones are opening their wallets. They’re going to buy you thousands of dollars of gifts. Literally, the stats are 12 billion dollars divided by almost 4 million babies. It’s a lot of money, a lot of money being spent by communities and well-meaning, well-intentioned, so generous– everyone wants to support a new mother. Everybody does. 

But right now, you can just go to baby stores and get a bunch of baby stuff. I don’t know. We’ve all bought gifts before and I guess the swaddles can help but it’s not the same as knowing that this gift is going to be impactful. One of the best things that we’ve done is we’ve created this platform where you can register for and find the practitioners in your area– the doulas, the lactation consultants, the pelvic floor specialists, the childbirth education, the acupuncturists– everybody who is supporting mothers in their birth and their postpartum time. You can find them and add them directly to your gift registry.

Your friends and family can send you funds, cash, cold-hard cash to pay for them so it’s totally flexible. We’ve had $165,000 funded on our platform so far just from communities who are generously opening up. It is such an amazing tool and funding opportunity that is already happening. We already know about baby showers. They’re happening. We already know how to use a gift registry. What if we use it to pay for doulas? What if we use it to pay for that care? It’s really, really cool so I just highly recommend every single person that’s listening to go to Be Her Village. Click on our shopping guide. Click to get started. If you’re a doula, add your services there. 

We’re reclaiming the baby shower because the baby shower has become this place where we get carloads of boxes where we get all of this stuff. For me, I had to haul it back to my tiny apartment. I’m like, “Where am I going to fit all of this stuff for my baby?” I was living in New York City at the time and we’re really saying, “You know what? Moms need stuff for their babies, sure. We’ll find them and how to pay for them but there’s this real need for care for ourselves.” 

It’s like the conversation we just had. Who doesn’t want a doula after listening to that? Who doesn’t want a doula after knowing the stats of how impactful it can be? What better gift than to say to someone, “Hey, I’m going to help you find that so you can have a better health outcome and so you can have a better experience so your entire transition into motherhood can feel better than it would have otherwise.”

Meagan: Absolutely. I’m going to pull it up. Seriously, it’s so easy. This website is so incredible. You can go and create your registry. You can shop for services. You can give your gifts. Anything, right here. Also, there is virtual. That’s something too. Doulas and birth workers, if you are offering virtual courses, help people find your course so they can get more educated. They can go more prepared. There are tons of virtual services. You can go in. There’s childbirth education. There’s a fourth trimester. There’s restoring your body. There’s heart and mind. 

You guys, this is such an amazing platform. To say I’m obsessed is an understatement. It really is an understatement to say how much I love this platform and how genius you are for creating this space for people. I didn’t hire a doula with my second baby because get this. You’re going to laugh out loud. Everyone’s going to die. I thought that $150 was too much at the time. 

Kaitlin: Oh gosh. 

Meagan: We didn’t have a lot of money. 

Kaitlin: I get it. 

Meagan: Yeah. 

Kaitlin: Meagan, it’s all so backward. We have our babies when we’re making the least amount of money. Then when we have a baby, for many of us, you stop working. At least temporarily, if not for a long time. 

Meagan: You do. Yes. 

Kaitlin: You get squeezed financially and at the earliest time in your career. You’re barely established and who wants to wait to be established? I’m 39 and I don’t even feel established right now. But it shouldn’t be that we have to choose how much care we receive because of our income level or because of the disposable income that we have. It’s not enough. 

My doula cost $1200 and that was nine years ago. It was the same amount as my mortgage. 

Meagan: Right. 

Kaitlin: It was a huge lift for us but luckily, I knew. I was so driven for the VBAC. Actually, my VBAC approach was to do everything the opposite. I didn’t take the childbirth education. I hired an OB instead of a midwife. I hired a doula instead of not. But it’s a big, heavy lift and we have to start thinking about not just, “Can I afford it?” but “I deserve this. How do I do this?” So we have to be more creative as a collective. It’s really cool. 

This baby shower is sort of this untapped area that we’ve just been going to for decades. You go. You buy the stuff at the store. You give it to parents. They return half of it. It’s this thing that we’re doing on repeat and I think it’s time for some serious evaluation about, “What do we actually need? What does a mother actually need?” If you were to make a list, which we do. We have the top ten things you need on your registry and none of them can be found at a store because it’s all about support and care from the community which often looks like professionals as well as friends and loved ones and family members and neighbors. 

Meagan: Absolutely. I am so grateful for what you do. I encourage everyone. If you are looking to hire a doula and you’re just not sure or the funds are hanging over or maybe a postpartum doula. Maybe you’re really needing that support educationally or whatever it may be, this is the place for you to go and check out. You could even hire a birth photographer if you’re wanting to capture your birth. I mean, you guys. They have everything. So definitely, definitely, definitely check them out at behervillage.com. We’re going to make sure to have all of the links in our show notes. Go to Instagram. Follow Be Her Village. 

You’re amazing and I’m so grateful for you. I’m so grateful that your births have taken you on this journey honestly, just like I have with mine. It’s such an honor to be sharing this space and this beautiful community with you. 

Kaitlin: Thank you, Meagan. I feel the exact same way. I’m really, really grateful for you. As much as I hate that we have had these hard birth experiences, it’s all worthwhile because of how we are using it and how we’re using it to help the next person, so thank you for that. 

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.

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

Abby Inman is a pelvic floor therapist, a soon-to-be mother of four, and one of the authors of the book Baby Got VBAC: An Inspiring Collection of Wisdom for Better Births After Cesarean. Located in Milwaukee, Wisconsin, Abby is advocating for hospital policies to make pelvic floor therapy more accessible to all birthing women. 

As a VBAC mom herself, Abby talks with Meagan about why every woman should have a pelvic floor physical therapy consult in the hospital before going home. Abby also tells us some obvious as well as more commonly missed signs indicating that you could benefit from pelvic floor physical therapy. 

Additional Links

Baby Got VBAC: An Inspiring Collection of Wisdom for Better Births After Cesarean

Abby’s Website

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, hello you guys. This is Meagan with The VBAC Link. I apologize that I sound a little hoarse today. I have totally caught a darn bug. I have been trying to get away from it all year not getting sick and apparently, I couldn’t get away with it. So here I am. I sound kind of froggy today but that’s okay. We’re still going to carry on. 

You guys, we have our friend, Abby, with us today and I’m really, really excited because I was just telling her before we started recording, she is just a big ball of everything. She’s got a lot of amazing things to talk about and share so it is such an honor, Abby, to have you on our podcast. 

Abby: I am so excited to be here. 

Meagan: Yes. Oh my gosh. I just want to talk a little bit even before we jump into the review. I don’t want to talk too much about your story because I want to give you all of the time but have you guys heard, Baby Got VBAC? Have you guys heard of that book? If you haven’t, go check our highlights or on our blog because we have it on there and it is such an incredible, uplifting book. 

And guess what, Abby? I don’t know if you know this. I don’t know if you were actually the one that contacted us, but forever ago, someone contacted Julie and me about being in this. We had so much going on. We were in our course and we were like, “We can’t take anything more on,” and we declined the opportunity and now we are kicking ourselves in the pants. We’re like, “Dang it. We should have been in this incredible book.” 

It has so many incredible people and stories and information in it. I mean, it’s amazing, right? Do you want to tell us a little bit about it?

Abby: Yes. Baby Got VBAC. I don’t exactly know what is the subheader. It’s like, “A Collection of Wisdom for Better Birth After Cesarean.” 

Meagan: Yeah. “An Inspiring Collection of Wisdom for Better Birth After a Cesarean.” 

Abby: And it was the brainchild of a VBAC mom herself who is also a writer and an independent publisher, so she just got us all together, found us likely through various social media channels as things are done these days–

Meagan: Yes, yes. 

Abby: And yeah. It’s a combination of VBAC stories from all different kinds of people as well as some awesome chapters done by various birth professionals so some birth educators, some doulas, some chiropractors, PTs–

Meagan: Brittany is in it and we love it. I’ve taken her course. She’s on our podcast. She’s in it. Brittany Sharpe, yeah. 

Abby: Her chapter is awesome. So even though the stories are all VBAC stories, I mean really, a VBAC is the first time going through the whole process and having a successful vaginal birth so I also think it’s a great resource for first-time parents who haven’t necessarily had a Cesarean in their past as well. Of course, it’s awesome for if you’re preparing for a VBAC. 

Meagan: Yeah. I love that you touch on that. We talk about this on the podcast. This is a VBAC-specific podcast. We discuss vaginal birth after Cesarean, but all of us on this podcast– I’m telling you, except for maybe the providers are people who haven’t had a Cesarean, but all of us were in that spot of preparing and had these Cesareans. It is a way to learn how to avoid a Cesarean, your options for birth, your options for location, and all of that. 

So yes, it is VBAC-specific, but just like this book, it is for all parents that are expecting and working and wanting to learn and grow their education. I love this book. It’s amazing and it’s so fun to have you today on the podcast. 

Review of the Week

Meagan: Before we jump in, we have a Review of the Week so I want to hurry and review this and then I will introduce you. 

Abby: Sounds good. 

Meagan: Okay, guys. This actually came in 12 days ago via email and this is from our friend, Jessica. She says, “Hello, VBAC Link. I wanted to write about my appreciation of The VBAC Link Podcast. I had a C-section in September 2020 due to an arrest of descent. It definitely affected my postpartum mental health. When I found out about being pregnant in July 2022, I Googled VBAC resources and found your podcast. I signed up for your emails, read your blogs, your Instagram, Facebook page stories, and listened to your podcast on my morning jogs and walks. I cried. I smiled. I empathized with the moms telling their stories and more importantly, learned so much. I followed many of the tips from you and the moms. 

“On 3/14,” which was not that long ago from the day that I am reading this today, “I was on my morning walk listening to the last VBAC Link episode and switched to my birth music playlist. Five minutes later, I started having contractions. After getting home and calling my doula, my husband took me to the hospital and I was able to achieve my VBAC and had a baby girl. Thank you for setting up this resource. I will continue to listen to the stories even though I don’t plan on having more children. I love the stories, the information, and all of the passion for helping women like me. Thank you, Jess.” 

Oh my gosh. Jessica, congratulations on your VBAC, and a little part of me is so happy that we got to be a part of your birthing day. That is so awesome that you were listening to these amazing stories and went into labor. So congratulations, Jessica, and yes. Just like Jessica, you guys can too. You can VBAC too. 

Just like she said, we have blogs, Instagram, and Facebook. We even have a private Facebook group so if you are looking for a special space that is protected and filled with people just like you wanting to learn more about your options for birth after Cesarean, head over to Facebook and search “The VBAC Link Community,” answer the questions, and then we will get you in so you can start learning. 

Abby Inman, PT, DPT

Meagan: Okay, Ms. Abby. 

Abby: That was awesome. 

Meagan: I know. Wasn’t that so awesome? That was such an awesome review. I got it and I just left it in the inbox unread because I’m like, “That’s going on next week’s podcast.” It was so amazing. I was like, “Oh my gosh.” And we love reviews. We love the reviews so I always encourage people. Maybe you don’t want to drop it on the podcast app. That’s fine. You can send it in an email, but we would always love a great review so that we can read it on the podcast because it makes me smile so much. So much. 

I remember when Julie and I were together, we would get a review and we would just be texting. Our cheeks would hurt. They would hurt because we were like, “This is what we are wanting to do. We are wanting to inspire and motivate people to find their options,” because so many people around the world feel that their options are taken away or that they are robbed of them and that is not how we ever want anyone to feel. I do feel that through this podcast, you get to learn your options and you get to take back that power that maybe once was lost. 

Abby: Mhmm. 

Meagan: So oh my gosh. Well, Abby. You guys, I tell ya. She is just a ball of it all. She is involved in pregnancy and postpartum and pelvic health, writes in a book, and teaches classes. She works in the hospital system. Abby, you’re just amazing. I’m going to turn the time over to you. You’re in Milwaukee, is that right? Wisconsin? 

Abby: I am. 

Meagan: Tell us it all. Share your story. I would love to know more about working in the hospital system and teaching birthing classes and stuff like that as well. You guys, she does this all while having little kiddos and is expecting. So seriously, good on ya girl. You’re killing it. 

Abby: Yeah. I like to describe my life as beautiful chaos. 

Meagan: I love that. Yes! Can I just take that with me and be like, “Yes. Beautiful chaos. That is what I live.” 

Abby: So yeah. I am a physical therapist. I specialize in pelvic health. I’ve been doing that for almost 8 years. Crazy how time goes by. Nobody at the time that I was going to PT school goes into PT school thinking they want to do the pelvic floor. People definitely do because it’s becoming more common which has been such an awesome progression in the 8 years that I’ve been doing this. 

But I was lucky in that I was able to do an internship in pelvic health before I graduated which again at the time was super rare. I’ve been treating, again, in pelvic health my entire career. Really now though, my specialty or even my niche is pregnancy, birth, and postpartum just because that’s the season of life that I’m in and just where my passion is drawn and where there is such a need. 

I could for sure argue that there’s a need for all pelvic health, but this field is growing so there are a lot of other people doing all pelvic health and there are not quite as many people focused pretty fully on pregnancy and postpartum and just that specific time. 

Meagan: Yeah. I was talking to a friend of mine the other day and you know how we have a six-week gap like, “Oh, you have your baby. Okay, see you in six weeks! Hope you’re doing okay.” The two things that I wish that we could fill the gap with are mental health and pelvic PT. 

Abby: Yeah. 

Meagan: Right? There’s such a gap that needs to be filled so it’s so good to hear that there’s a little bit more and that it’s starting to come around where people are focusing a little bit more on pregnancy and postpartum. 

Abby: Yeah. I have a lot of theories about different things related to how we get here but I just think that there is still this saying, “It takes a village,” but a lot of people really don’t have the village–

Meagan: I know. 

Abby: I think that’s what has created the gap. You used to have your other female relatives around who would make you dinner and help you with your baby. Obviously, we just have to live in the reality and that’s why people need help and need services because that’s just not the norm anymore. 

Meagan: It’s not and we’re expected to just bounce back like, “Oh, you had a baby. Okay, great. Keep going as fast as you can.” That’s how it feels. We just had a mom hire us for 80 hours of postpartum and I was like, “Wow. That’s amazing that you are focusing so much on your postpartum.” She’s like, “I want continuous for 80 hours,” and we’re like, “Great,” so we made this work because her mom is from Korea. She was like, “People don’t leave their bedroom. They don’t leave their bedroom. They are with their baby and just like you said cleaning the house and making food,” but here we are. 

So many of our birth stories, our couples, and our parents, literally have to go back 3 weeks later to normal life or work. 

Abby: I know. It’s crazy. That’s not normal. It’s not how it was meant to be. Yeah. I work at a hospital-based clinic part-time and one of my projects is just now really coming to fruition. We’re still in the pilot phase but we’re already seeing really great results and an increase in referrals and again, these are people we would have otherwise not seen. 

The program is for a PT to see moms in the hospital before they go home, not necessarily as a rule, not as, “You can’t go home until you see the PT,” but just as a support service. We started it to be a standard or trigger a referral for anyone who has had a Cesarean and anyone who has had a third or fourth-degree perineal tear. 

I mean, obviously, this is The VBAC Link so we talk a lot about the birth after the Cesarean, but a Cesarean is a major abdominal surgery. Some people, of course, are expecting it and have been through it before and that obviously makes it easier a little bit because you know what is going to happen, but there’s just about no other surgical example that you can compare to the care of a Cesarean. 

It’s possible that you could have an appendectomy and see a PT in the hospital before you go home. Such a benign procedure is often done laparoscopically now. There is just nothing that compares to the gap in care after a Cesarean. It’s literally like, “Oh, we just cut open several layers of your body.” Again, whether you were expecting it or not, you’re also just recovering from being pregnant or if you labored at all and then having this major surgery. Oh, and you’re going to stay here for two days or three days, but now you have to take care of this other human. 

Meagan: Yeah. Yeah. But don’t forget to take care of yourself. 

Abby: But also, here’s no direction about how to do that. 

Meagan: Exactly, yeah. 

Abby: That’s slightly not fair because I don’t mean to imply that postpartum nurses–

Meagan: They send you with nothing. 

Abby: Yeah, that they're not doing their job or taking good care of you. It’s actually that I’m making the argument that it’s why there is room for this kind of program because PTs are movement and rehab and recovery experts. That is what we do. That’s what we are trained in. All PTs graduating now are doctors in physical therapy. I have a doctorate. Just like your dentist is a doctor, I am a doctor. 

Like I said, it’s really an expertise in this area of care and that’s why we’re just the most well-equipped to do that. You don’t have to actually even be a pregnant or postpartum or even really pelvic health trained PT to do this work. You could be a hospital-based acute care or inpatient therapist it’s sometimes called because you really teach people the same sort of things that you would teach your other patients in the hospital like early things about scar tissue healing and scar tissue work. 

Meagan: Scar tissue massage. 

Abby: How to lay flat in bed because guess what? You’re going to have to lay flat in bed when you go home but sometimes they don’t even do that. 

Meagan: And then how to get up. 

Abby: That’s right. For sure how to get up, how to hold your baby when you walk, if you’re having pain, how to go upstairs. Again, if that’s painful, what to do? Just really practical things that people are going to have to do after they are discharged from the hospital and go home. I just think it is invaluable. 

Obviously too then part of our program is to at least get the scheduled for outpatient pelvic PT as well to make that transition really seamless. So yeah, it’s been really cool. So far, it’s going well. 

Meagan: That’s awesome. So awesome. I hope that all around the world, a program like this can be implemented as a standard, just as a standard thing because like you said, it’s invaluable. I also want to say that my nurse and my doc sent me home with a paper that was like, “Keep your wound this. Keep your wound that,” with wound care and instructions like, “Don’t lift more than 10 pounds,” and stuff like that. That is so wonderful but no one told me about the things I was going to feel or even encouraged walking. 

Abby: Or breathing. How to breathe.

Meagan: Or breathing. It wasn’t encouraged. Yeah, get up and go to the bathroom, but it wasn’t like, “Get up and move as much as you can within a certain range and that’s going to help recovery and breathing and scar massage.” Never. Not once in either of my C-sections did anyone ever talk about the adhesions that could happen and the scar mobilization and things like that. That is where it lacks. We just lack so much so I would love to see programs like this happening all over the world. 

So if you are listening and you are in the medical world, this is something that you could try because it is so important. 

Abby: I’ll send you some articles that are being published about it. There is just a handful of PTs who are really pioneering this work and again, trying to get stuff published because obviously, that’s how it works in this medical world, so yeah. Just to have some scientific journal articles. 

Meagan: Yeah. We’ll drop them in the show notes too. Awesome. So yeah. You’ve got the PT. You’re influencing this amazing program. You’ve had a VBAC. In the book, you talk about– and this is not word for word what you are saying– recognizing your birthing plan and then also recognizing your birthing location and making sure that they match because if you are wanting certain things and then you choose– say you want an epidural. You’re not going to have a home birth. You’re not going to have a birth center birth. 

Maybe you’re like, “I absolutely do not want to be induced with Pitocin. I don’t want it to be discussed,” then a hospital birth may not be your best option. I want to also say that sometimes it is possible to avoid that, but it doesn’t always go super easy. It’s often times where you have to fight about it. So yeah. I would love to know if there are any highlights of your birth story or talking about birthing location and how it impacted your– remind me, you were induced with your first for, was it IUGR or was it preeclampsia?

Abby: Yeah, I think it was a pretty common story. I was trained in pregnancy, pelvic floor, and postpartum before the first time I got pregnant. I had taken some coursework about all of this stuff so I don’t want to say that I was cocky at birth, but I felt like I knew more than the average person. 

Meagan: Confident. You were confident. 

Abby: But as we know, birth is a very humbling experience. My first daughter was, I think I went to my 38-week appointment and I had been measuring fine. Her 20-week ultrasound was fine. I don’t think I had another one since then, but it was 38 weeks. My OB did the portable ultrasound to see if she was vertex. I don’t even know. I really should probably ask her. She probably doesn’t even remember at this point because my daughter is about to be five. She saw something that she didn’t like. 

Her suspicion was that maybe the amniotic fluid was low or something. So she wanted me to have a real ultrasound which I ended up doing. All of those things came back fine. The blood flow was fine. My fluid levels were fine, but of course, they measured her as well in the full ultrasound and they said that she is very small and we don’t know why. That was their reason for wanting to induce me. 

Again, being the stubborn person I am, I was scheduled to give a presentation at the Wisconsin State PT conference later that week. I was like, “Well, I’m not staying to be induced because I have a presentation to give in four days so I’ll do that and then we’ll talk. I’m not having a baby before then.” I’m sure my team already didn’t like that so I gave my talk on Friday and then we went for the non-stress test on Saturday afternoon and that’s when they told me, “Yeah. You should stay and be induced.”

I was really not super early or anything.

Meagan: Two weeks?

Abby: Yeah. That was a Saturday, so she would have been 39 weeks on Monday, I think. But really, I mean, my induction story is just that my body was not ready. I mean, I tried to do everything I could to make it slow. It just, like I said, that’s just really what it comes down to. My body really just was not ready. I did not progress. I was doing all of the things that I know how to do and teach people how to do, but at that time, because I hadn’t gone into labor myself, she just was nestled in there. 

I obviously have some qualms about the saying that you hear a lot, “Well, at least you have a healthy baby and at least the mom is healthy.” That should be the low bar. That’s the minimum. That’s not the goal. 

Meagan: I have feelings toward that comment too. I want to be honest. I kind of want to punch people when they say that because I’m like, “Yeah, duh. Duh.” Yeah. 

Abby: Yeah. The birth itself again, was not necessarily traumatic in that I did actually choose. They were like, “Okay. I guess you could keep going. I’ll let you do this for however many more hours, but we’re not getting anywhere.” I was tired and just was like, “Okay. I’m just ready to meet her. Let’s have the Cesarean.”

Meagan: Let’s do this. 

Abby: It wasn’t like she was in distress and they rushed me to the OR, so it was not an emergency in that sense, but again, just like this is going to happen whether it’s right now or in a few hours and then it probably would have been more of an emergency things just because of the timeline of how that goes. 

I would say that my trauma from the birth was more just mental and emotional. Yeah. Really from there, I knew I wanted to basically get pregnant again relatively soon. I knew as we were starting to grow our family, we were going to do that by several children if we could. I knew I was not going to elect to have a repeat Cesarean. 

So basically, my mindset was, “Well, I have to be somewhere where that’s essentially not an option unless it is absolutely necessary.”

Meagan: It’s an emergency, yeah. 

Abby: I made the choice then when I got pregnant again. My two older ones are almost 18 months apart to the day, so also about as close as you’re supposed to have babies after a Cesarean. I chose to have my care with midwives at a birth center in town which is not an option for everyone because sometimes it doesn’t exist. 

Meagan: I know. Yes. We’ve got states right now taking midwives away from the hospital even. 

Abby: Oh, totally. That’s all kinds of crazy. I’ll get on that fight. Actually, so now I’m pregnant again. We are expecting our fourth in July and that’s why I’m still with the midwives at the same birth center and preparing for my third VBAC. Even though I’ve now had two successful vaginal deliveries, I’m always considered a VBAC patient which is just crazy. 

Meagan: We’re always going to be a VBAC, yep.

Abby: I mean, it’s not crazy. Obviously, it’s a definition but it’s crazy that there is risk associated with it. 

Meagan: It’s hard to think that it’s still considered, yes. 

Abby: So that risk, I don’t know. I mean, I’m assuming that this is just the insurance that my midwives use but their insurance company charges them $1500 just for accepting a VBAC client. 

Meagan: Are you serious?

Abby: Right? It’s completely insane. That’s new. That wasn’t true for my last two. It’s new for this one. So that’s crazy. Like I said, it’s a definition but it’s always going to be with me no matter how many children I have. I just think that’s one of the things that’s sort of a part of informed consent, too. You just don’t realize how that’s going to affect you. You know? Anyway, not that again, I would have chosen differently in the moment but things that you don’t think about and don’t realize are going to affect your childbearing experience for then the rest of that time. 

Meagan: Yes. And on the other end, could potentially affect a provider’s ability or choice to accept, right? These midwives could say, “$1500 a person, we’re not going to do this because we don’t want to up our prices,” or whatever. “We can’t take the risk that the insurance is putting on us.” Not that they're scared of the risk of birthing out of the hospital with a VBAC, but that could change. That could impact things so much as well. 

Abby: Very much. 

Meagan: Yeah. 

Abby: Yeah. 

Meagan: Interesting. It makes me sad. 

Abby: Yeah. When my kids are maybe a little older or just after I have this one and can think about things, after that, that’s my next thing. I need to get embroiled in the legal battles of this then I can be like, “This is totally ridiculous.”

Meagan: That is what I want to do. I always say that I have a bucket list of if I have all of the time in the world type thing. I have this bucket list and there are so many things surrounding it. It’s birth. It’s where I’m at in birth. I’m even done having kids, but as a doula and stuff, I’m seeing this. I’m listening to these podcast stories and I’m like, “We need to make a change.” I’d love to start facilitating more change in policies and things like that. One day when I have all of the time in the world, we’ll get there together. 

Abby: We’ll get together again. Mhmm. 

Meagan: Yes. We’ll get together again and start to make some changes. I mean, we are moving in a forward progress. There is change happening. 

Abby: We are. 

Meagan: Okay. I’m going to bounce really quickly back to some PT. I would love to know any tips that you would like to share with your listeners. You mentioned, “Yes. We’re The VBAC Link so we’re talking about birth after Cesarean,” but what kind of PT things can we do prior to? Because I know for me I didn’t even think. It didn’t even cross my mind that I should consider a pelvic floor PT before giving birth and then of course, after having my Cesarean, again, I told you that there was nobody to tell me anything about anything and then here I go, and have another Cesarean and then even with that, nobody. So I had two Cesareans without knowing anything. Any tips for previous and/or after that you can give anybody?

Abby: Yeah, so really in my ideal world, every person sees a PT in her first pregnancy and the reason for that is because your body, of course, just has to make these natural changes in your posture. Your various muscle groups have to change to accommodate the growth of the baby. That changes your center of gravity and center of motion which affects how you move and aspects of movement. Again, like I said before, PTs like me are the experts in movement. 

Again, it’s not to imply that somebody currently is not doing their job, but nobody else is looking at that. So right now, I would say that providers are generally pretty good about offering a PT referral, and again, with things like social media, people are advocating for themselves better as well. But they’re pretty good about putting something in if a patient raises an issue. “Oh, I’m having this back pain” or “I’m having pubic symphysis pain and I’m having hip pain. I’m having bladder leakage,” or whatever. XYZ things.

Again, yes. If you are experiencing some symptom in your pregnancy like that that you think would be muscle or posture related, you should see a PT. But like I said before, I really think that everyone deserves that consultation because again, the natural changes that are happening are natural and we’re not going to stop them, but I can teach you strategies to mitigate the effects of that. How do you consciously move your abdominal muscles and the connection between your diaphragm and your deep abdominal muscles and your pelvic floor and your glutes? How are you sitting at your desk or how are you standing? 

Starting those things when you’re pregnant then carries over to how you move postpartum. Obviously, postpartum is a lot. It’s hard for a lot of reasons, but to also have pain or these other symptoms, any bladder or bowel/pelvic pressure sort of symptoms is just going to make it harder. Again, I really think by learning about these things consciously and applying specific strategies even if you’re the pregnant person who is exercising and running right up until the day she gives birth, that’s obviously wonderful and I support you. 

Maybe it’s just this one-time consultation sometime around, I usually say around the beginning of the third trimester is a good time to do it. You meet the PT. We talk about these strategies and things to implement for the rest of the pregnancy, and then now you’ve met that person and have a relationship with them, so you at least have a resource then postpartum to then be like, “Oh, Abby mentioned this could happen and guess what? It’s happening. Now I know that I’m just going to call her and get on her schedule,” instead of Dr. Google in the middle of the night when you’re nursing and all of this XYZ stuff comes up. 

Meagan: A lot of the time, it says that it’s normal. It’s normal to have these things. It’s like, “Oh, well duh. It’s normal. Yeah. You just had a baby. Yeah, it’s normal.” But it’s like, “No. No, no, no.” Too, I want to mention that sometimes athletes have these tighter pelvic floors and we need to actually learn how to calm and release for effective pushing so that we won’t have more damage. 

So one of the big things that I think is really good, even if it’s just once, is coming in and learning about your pelvic floor. Your actually pelvic floor, not just the pelvic floor in general. Your pelvic floor and learn where you’re at. Do some practice pushes and learn some breathing techniques and learn what’s normal. Learn what’s not so you’re not on Google thinking that your uterus is falling out. Do you know what I mean? It can go that extreme where you’re like, “I’m having this.” 

You Google it and it’s pure panic which is not going to help anything. It’s not going to help recovery. It’s not going to help our mental health. It’s not going to help breastfeeding if you’re breastfeeding because we’re stressed. It’s crazy how there’s a cycle. It’s a domino effect, so yeah. I think it’s so, so, so important as well. I wish I would have known that. I wish I would have known that.

I did that with my son, with my VBAC babe, and yeah. There was a lot to learn. 

Abby: Yeah. You know, I mean while I’m so grateful when I get clients that are done having children and they’re like, “I’m finally prioritizing me. I’ve been having these symptoms since I was pregnant or since the birth of my first,” or whatever. I’m like, “Yes. Good for you. I’m so glad that you’re here.” But it also just breaks my heart because I really think that maybe the symptoms are not entirely preventable. The dysfunction is not entirely preventable, but potentially it could have been less. Or again, now these women have lived “x” number of years– 1, 3, 5, 15, 20 years–

Meagan: I know. 

Abby: Like I said, I really think that early intervention is key. Again, the changes happen in your first pregnancy. Even if you don’t necessarily have symptoms in your first postpartum period. 

Meagan: Yes. Yes. That’s the thing. Is it possible to not have any symptoms but to have some pelvic dysfunction or pelvic issues or scarring? Especially with C-sections, I have a friend who was like, “I have never had a diastasis recti. I’ve never had pelvic floor issues. I’ve never had adhesions. I don’t have adhesions.” She’s had multiple Cesareans and is like, “I do not have adhesions.” I’m like, “Yeah. Yeah, you probably do.” But you know, she says she has no symptoms. 

Then sometimes I wonder, “Do you know what symptoms to look for?”

Abby: Right. Are you just living with things?

Meagan: Yes. Yes. 

Abby: Right. Obviously, yes. That can definitely be true. The symptoms don’t have to be so severe that they are really affecting your day-to-day life or quality of life. Of course, usually, people seek care when they’re so fed up with it. But there can be sneaky symptoms or again, things that people view as not that bad, I would consider as not normal. 

Meagan: It’s just our new normal because we had a baby and we’re being told that. 

Abby: Knowing where every bathroom is in the stores that you go to is actually not normal. That fact that you have a map of where the bathrooms are in your brain– now again, the same argument could be made for people that are potty training their children. But okay, they’re learning for the first time. 

Meagan: Or the second you walk into a store, the first thing you say is, “Where’s the bathroom?”

Abby: Right. “Where’s the bathroom? I’ve got to go to the bathroom.” That’s a symptom. Again, it doesn’t have to be that way. You can change that. This was certainly true for me and I did lots of scar work and stuff, but I basically could not wear normal pants or jeans– definitely not jeans– until I was postpartum with my second, and that had been all stretched out again and everything was slightly less sensitive. That’s a modification that I made and that lots of people make. That becomes your new normal that you sort of forget about, but it’s like, “Oh, well I would just never wear jeans.” Well, that’s not normal. 

Meagan: Why? Is it because you didn’t want to or is it because you didn’t feel like you could or you weren’t comfortable? What types of signs? Just for our listeners because we’re in this spot of, “Do I have anything?”. What kinds of signs or symptoms would be a sure sign? If you are finding the restroom the second you walk into a store, this is a sign. Yes, 100%. Maybe we’ll go from an extreme guarantee that this is a sign to more of the subtle, hidden, could this be a sign? 

Abby: Sure. 

Meagan: Yeah. What symptoms and signs would you say for people listening? 

Abby: So anything obvious would be any sort of daily pain. Just pain every day anywhere. Related to pregnancy and postpartum, hip pain, low back pain, people will say SI pain which is your sacroiliac joint which is the back lower down in your butt, pubic symphysis pain, and tailbone pain. If you feel like you cannot sit on any surface for any given period of time and it’s because your but is hurting, again, not normal. 

Meagan: Yeah, or even pressure. I remember after I had my baby I would be standing up and I would want to sit. This is so weird, I know. But I would want to sit on the corner of something right at the vaginal opening to support it or feel my hand like, “Oh, I just look like a little girl that needs to go pee but I’m just pushing,” because I’d have this pressure after more than 30 minutes or standing after more than 30 minutes. Or sometimes even just going to the restroom, I’d be like, “Oh, I have some pressure down there.” 

Abby: To support it. So that’s a common symptom of the medical diagnosis we call pelvic organ prolapse so if you Google that, it can seem like, “Oh my gosh, things are falling out of me.” But again, that’s not necessarily abnormal especially in postpartum because all of those organs were shifted while you were pregnant so some of it is the settling back into place. Some of it is that your ligaments are still relaxed from again, what your body does in order for us to have babies. 

Some of that for sure continues postpartum especially if a person is breastfeeding, that laxity. But yeah, it’s like learning strategies about how to help that. So certainly, yeah. Pressure, heaviness, any obvious bladder and bowel stuff. If you for sure had to go change your underwear and pants after you sneezed, again, not normal. 

Meagan: Not normal, yes. 

Abby: If you’re a year postpartum or six months, a year, 18 months, 2 years, 5 years, whatever and you are one of those people that’s like, “Oh, I can’t go jump on the trampoline with my kids. I can’t run. I had to stop running.” Again, that’s not normal. We can help you. 

Meagan: Yeah. What about even the inability to hold your core? 

Abby: Uh-huh. 

Meagan: It’s like a big plumb line. It’s all connected. If we had this ability to maybe hold a plank or run or ride a bike and we were able to hold our core in and not feel it release and start taking pressure in our back, but now all of a sudden we’ve had this baby and we’re a year, two years, even three years or more down the line and we’re like, “Jeez.” 

Abby: Why do I still look pregnant? Where are my abs? 

Meagan: Why do I still look pregnant? Where are my abs? Why can’t I hold a plank for 60 seconds anymore when I could hold it for three minutes? Would you say that’s connected to your pelvic floor? I feel like I know the answer. 

Abby: Yes. You mentioned diastasis. It doesn’t matter how you say it. 

Meagan: I know. Everyone says it differently. 

Abby: That’s the condition you’re describing which again, almost everyone has a little bit of that the last several weeks of pregnancy because it’s related to the baby growing. But it’s a pressure management problem and tissue laxity, muscle coordination problem postpartum. 

Meagan: I recently was reviewing my op reports over some things and so talking about Cesarean, we don’t think pelvic floor naturally because we didn’t have a baby come out of our vaginal canal. We don’t think that. We don’t think about abs as much either. I think a lot of the time, even though we were cut down low, I feel like our minds are like, “I wasn’t pushing and using my abs in my Cesarean,” but listen and sorry as a disclaimer, it’s a little blunt. It’s a little aggressive. 

Abby: It’s okay. I mean, all of the pelvic floor therapy is TMI. 

Meagan: Yes. 

Abby: It’s a no-judgment zone and no topics are off-limits. Sometimes you’ve just got to put it out there. 

Meagan: Yes. I don’t want anyone to feel triggered by the words that I’m using because the words that I’m using are directly from my op reports, but this is how they describe my first C-section. It says, “The fascia opened in the middle and extended laterally with mayo scissors. Fascia was separated from the rectus muscles superior and inferior with sharp and blunt dissection. Rectus muscles were entered sharply and opened and then extended bluntly.” 

Abby: Yep. 

Meagan: And then a low incision was made above the bladder. That’s where they go on. But I read I was dissected bluntly with sharp scissors. 

Abby: Yep. 

Meagan: Right? My abdominal muscles were literally stabbed and cut through. As I’ve been reading this, this was my first C-section and she’s 11. 9 years ago tomorrow as of this recording is the anniversary of my second Cesarean, the birthday of my second Cesarean daughter. 11 and 9 years later and I have abdominal issues and I have pelvic floor issues and I’m working on things. I have pain with intercourse sometimes that I would have never related to my pelvic floor, right? And sometimes I read this and I’m like, “Well, no flipping way. No wonder I have a diastasis recti way above my belly button because I was manually cut with sharp scissors.” 

Listeners, I want you to know that if you’ve had a Cesarean and you’re not having any pain, that’s wonderful but that doesn’t mean your body hasn’t received trauma like this. It means it has if you’ve had a Cesarean. You may benefit from pelvic floor PT more than you ever know. And if you haven’t learned about scar mobilization and things like that, it’s time. It’s time to learn about it. So yeah. Any other symptoms? I know we’re cutting short on time, but any other symptoms that you would say to listeners, “If you’re experiencing this, go check out your local PT”?

Abby: Your C-section scar can cause shoulder pain because of that word you used “fascia”. Fascia means connective tissue. It’s basically the thing that connects the whole body. Any good pelvic floor therapist is going to look at your whole body. They’re going to look at you from head to toe. People typically, you mentioned pelvic floor tightness can have dropped. Feet issues, so plantar fascia issues. Your pelvis is in the middle of all of these areas. It’s a highway interchange for things to happen. So again, yeah. You might have a collection of weird symptoms that you maybe didn’t put together as related to pregnancy and birth and postpartum. 

Maybe you’re even seeing another PT and you’ve made some progress, but there’s still whatever sort of issue. You know, it might be worth it just to have a consult and have that area checked out. Or to just be looked at from that perspective. 

Meagan: Absolutely. Such good information. Always, women of strength, remember that you never have to deal. You never have to deal with this. You can take care of yourself and I encourage you to do things for you. Like Abby was saying, she’s like, “Yay! You’re finally coming in. You’re finally taking care of yourself.” But dang it, it’s taken so long. I am guilty of that in so many areas. 

Abby: Yeah. Again, that’s not your fault though. 

Meagan: Nope, nope. 

Abby: Like I said, it’s a problem with our healthcare system. 

Meagan: And not being informed. 

Abby: And not even the individual provider’s fault. That’s why I’m working so diligently and passionately to make it more of a standard because I think that everybody deserves this care. Just because you were pregnant, it doesn’t even matter how your birth went. How it went will mean different things, will do different things, and address different things. Some of it will be similar because the common denominator was that you were pregnant. You grew a baby in your body. 

Meagan: Yep. Your body changed. Your body made amazing changes and did amazing things. It is okay to give back to yourself and thank yourself. Thank your body for doing this amazing thing multiple times for a lot of people. It’s so important. 

Oh my gosh. Well, thank you so much for sharing these tips and a little bit about your story and choosing a birth location and all of the things. 

Abby: I didn’t really even get to my VBAC story but you can read it in the book. Just pick up a copy of the VBAC book. 

Meagan: A copy of Baby Got VBAC right here. You can find it in our show notes today. You can find it on our blog. You can find it on our Instagram highlights. You can Google it. We’ve got it right here. Baby Got VBAC. It’s an amazing one. So thank you so much and good luck for this next amazing journey, your third VBAC. And yes, thank you again. 

Abby: Yeah, thanks so much for having me. I could talk about this all day long. 

Meagan: Right? We could talk for hours and hours about this. We’ll just have to have you on again after you have your VBAC and we’ll just share about each VBAC. 

Abby: Sure. Yeah, that would be great. That would be great. 

Meagan: Okay. 

Closing

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

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“Labor is an event of the mind, the body, and the soul. We have to make sure that we are preparing in each of those elements so that we can then know at the end of the day that we are true to ourselves.”

Sarah, one of the founders of Birth Made Mindful, joins Meagan on the podcast today to talk about how to mindfully approach motherhood in the way that is best for you, your body, your baby, and your family. She also shares her Cesarean and two VBAC stories!

Sarah and her sisters created the Made Mindful platform to help women find their own innate power from within. 

All VBAC Link listeners will receive 30% off any of their courses by using the code “vbaclink” at checkout on www.birthmademindful.com.

Additional Links

Birth Made Mindful Website

Sarah’s YouTube

Sarah’s TikTok

How to VBAC: The Ultimate Prep Course for Parents

Receive 20% off on Needed Products The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hey mommas have you ever looked at the back of your prenatal vitamin and wondered if you are truly getting everything you need? I know I didn't when I was pregnant. Well today I wanted to share with you the #1 prenatal I suggest to all my doula clients, friends, family, and YOU women of strength. It's by a company called Needed. I honestly don't think I was the only one that didn't really understand just how important certain nutrients were for myself or or my growing baby. And that is why i love needed. They have gone above and beyond to create solid products not only that have the key nutrients but also have the optimal amount. Don't be overwhelmed picking a prenatal. Check out all Needes products, including their prenatals, pre/pro biotics, immune support and more at thisisneeded.com enjoy 20% off by using code VBAC20Meagan: Hello, hello Women of Strength. It is Wednesday and we have another great episode for you. Normally we have VBAC stories, but today we are going to be chatting about a lot of topics actually. We have our friend, Sarah. She is actually a VBAC mom and she has been on the podcast before so welcome, Sarah. 

Sarah: Thank you so much for having me today. 

Meagan: Thank you. Thank you. I’m so excited to have this discussion and this episode because it’s something that truly we need to remember. I love sharing all of the VBAC stories of course. That’s what this podcast is about, but it’s also really good to get education and empowerment through other episodes. 

Review of the Week

We are going to get into this episode after I share the Review of the Week. I’m going to tell you a little bit more about our friend, Sarah. 

This review is by spicyhotcurrie. I love that name. That’s fun. It says, “The best education for all pregnant mamas.” I just love that so much because really, I mean, Sarah would you agree? At this podcast, we obviously talk about VBAC stories and how to empower people to make the best choices after Cesareans, but this really could be a podcast for all pregnant moms. Wouldn’t you agree?

Sarah: Absolutely. 

Meagan: Yes. We share so many tips. It’s something that I wish I had when I was pregnant and preparing for my VBAC. Even if I didn’t know if I wanted a VBAC, this would be a great podcast to listen to and see what options were out there and then even what led to Cesareans so I could learn how to avoid them. 

I love that topic. She says, “After one unmedicated hospital birth and one medicated hospital birth, my third birth ended in a physically and emotionally traumatic emergency Cesarean. The VBAC Link Podcast started soon after. I listened to them for over a year before getting pregnant. This podcast has made me laugh and cry and given me so much knowledge I didn’t have even after three births and working in the postpartum unit at the hospital. This podcast has made me so excited for my VBAC in November. Thank you, Julie and Meagan.”

This was back in 2020 so spicyhotcurrie, if you have your story to share, I would love to know. Contact us at [email protected]. If you haven’t left a review yet, we would love your review always anywhere you want to leave a review– Apple Podcasts, Google, or you can email us. Wherever it may be, we would love your review. 

Sarah From Made Mindful

Meagan: Okay, Sarah. Welcome. 

Sarah: I’m just giddy to talk to you about birth today. 

Meagan: I am giddy to have you here to talk about birth. I don’t want to share your story. I want to let you share your story, but I do want to tell everybody who you are. You are an amazing person, an amazing individual, and you’re a mom of course. Of course, you’re a mama of three now. 

Sarah: Three boys. 

Meagan: Yes, a boy mama. You’re a birth coach, an educational coach, a doula as well which you guys, I’m just going to point out that Utah is amazing. I’m just saying that if you’re in Utah and you’re listening, you’re spoiled. We’ve got some good doulas here. Let’s see what else. You’re the founder of Made Mindful, right?

Sarah: That’s right. 

Meagan: Made Mindful. Okay. Tell us more. Tell us more about that. 

Sarah: Made Mindful came out of all of our experiences, me and my two sisters, with the different births that we have experienced together. 

Meagan: It’s Carly–

Sarah: Carly and Christina. 

Meagan: Christina, yes. Carly and Christina. 

Sarah: That’s right. 

Meagan: I love that you’re all sisters. That’s so cool.

Sarah: We have our website, Birth Made Mindful. We want to encourage women and families to empower themselves with education, positivity, and most importantly, just believe that they have the strength within themselves to create the birth of their dreams. 

Meagan: Absolutely. I love that. It’s so hard sometimes because it’s so overwhelming. There’s so much going on and we’re getting so many opinions coming from all of the other places to know and you hear things like, “I wanted to do that but my body couldn’t and this but I couldn’t, and this but I couldn’t,” so then we start doubting ourselves like, “Can I? Can I do that? Is that possible?” Don’t you feel like that is happening all over the place?

 

Sarah: It is. It’s just an overwhelming amount of information that we have to sort through. I think that also adds confusion. When we can look inside ourselves, we can find out really what matters most important to our families and to us as mothers and blossoming mothers if we are first-timers. Knowing what our options are, knowing some of the medical events that could take place with birth, and then being able to be in tune with ourselves and our bodies to know how to proceed. 

Meagan: Absolutely. You have experienced very different experiences. Do you want to share just a little bit more about your experiences and what truly led you here?

Sarah: I would love to. My first son was five years ago, his birth. My water broke prematurely. I wasn’t in labor. After about 40 hours at the hospital, we had a Cesarean section. It wasn’t an emergency at that time, but he was sunny-side up so I just wasn’t having meaningful dilation. His Cesarean was necessary, but after that experience, I started looking back and just thinking, “I want to have a vaginal birth for my next birth.” I just didn’t want to be in pain and have the recovery and some of the problems that stem from abdominal surgery right after birth. 

So I prepared a lot. I listened to your podcast. I just researched as much as I could when I was pregnant with my second son. It was right around COVID. His due date was March 20th, 2020 so about three days before his due date, my obstetrician let me know that she could no longer support me in a vaginal delivery. 

Meagan: Did she tell you why?

Sarah: I share that entire story in Episode 132 so if you haven’t had a chance to listen, it was just a remarkable story. I think it was mainly because of COVID. The hospital had updated their policies that all of the women in the queue for delivery that week and that month would either need to have an early induction or a repeat C-section and that they weren’t going to be able to support VBACs. But because I armed myself with knowledge, I had gotten myself a doula, I just felt like that wasn’t the route I wanted to go. I wanted to allow my body at least the chance for my first VBAC. 

I know that a lot of women even after having multiple Cesareans will attempt a VBAC but your chances of getting support in the medical system are a lot stronger the first time. So I knew that this was my window. I was actually able to find a midwife who took me on. This is just a couple of days before he is born. I ended up having a beautiful, redemptive VBAC at a birthing center. It wasn’t short labor. He was actually also in a sunny-side-up position so it was about 30 hours. 

My wonderful, supportive midwife confirmed, “If you would have been in a hospital, they would have done another C-section in the amount of time it took you to dilate again with being sunny-side up and all of those twists and turns of our labor.” But we did have a VBAC and it was amazing. The feelings, the emotions, all of the energy that I felt, I literally wasn’t tired for three days after his birth because all of those chemicals were appropriately working within my body. I was able to breastfeed and latch in a much easier way with that child so I knew that I wanted to start sharing my story and offer encouragement to other women. 

So in between his birth and then the birth of my next son which was about two years later is when my sisters and I put our knowledge together and created digital courses. We created affirmation cards and just decided that we were going to try to start sharing our message with all of our sisters and our community so that they could have great experiences in their birth. 

Meagan: Yeah. 

Sarah: For my third son, we actually delivered with that same midwife but I opted for a home birth. The reason why I wanted to have him at home was mainly because of tracking contractions. There’s always that question, “When do I go to the hospital? Am I too early? Am I too late?” If you show up and you’re only 3 or 4 centimeters dilated, are you then a burden on your medical staff? And they’re starting the clock if you’re in the hospital. 

So I thought, “I wonder if I was just at home if my body would relax enough that there wouldn’t be any halting from my body.” I just said, “It doesn’t matter how long it takes. I’m prepared to labor as long as this baby needs.” I also had made peace with the fact that if we needed to transfer to a hospital, I would not feel like a failure. I would approach that with the understanding that I was going to the hospital and utilizing the tools and the help that I might need if we did need a transfer because a lot of people are afraid of what a home birth means if there’s a transfer. Most of the time, it’s not an emergency if there’s a transfer that’s needed. 

Meagan: Yeah. Really, most of the time it’s due to a hangup and there are resources at a hospital that aren’t at home anymore. We’ve exhausted our resources. Maybe there is a little bit of Pitocin that is needed. I say needed, but it is something that could help and they’ve exhausted breast stimulation with the breast pump or maybe it’s been a really, really long labor and we’re just tired, and that epidural is something that really can help to actually have that final outcome that we were looking for. It’s just going to be in a different place. 

But it’s rarely an emergency and it’s okay. It is okay to transfer. It’s okay to make that choice. No failing or giving up. They don’t go together. There’s no failing. 

Sarah: Exactly. 

Meagan: Just because there’s a change of plans doesn’t mean there is failure involved. 

Sarah: Yeah. That terminology is so tricky when people consider a transfer from your home as a failure but most women just choose to transfer to the hospital before they plan to push their baby out. So his birth was remarkable. It was a few days after his due date again. I had started feeling a little bit anxious about when he would come. I decided that I needed to release all of that. I went swimming and I just told him, “I know that you’re safe, but I also want you to come as soon as you’re ready.” My labor started that night. 

I could sense that the contractions were ramping up, but I wanted to rest as much as possible. I didn’t want to have the mindset that I needed to walk around or be upright because with my prior births, it had taken me a full day and I didn’t want to feel exhausted myself. So at about 1:00 in the morning, I went into the guest room so I wasn’t waking up my husband and I just tried to sleep in between my contractions and it was successful. I was able to listen to some meditations and to find that quiet comfort within my bed. 

With sunrise, the contractions started ramping up and after about one hour of steady contractions, I thought, “It’s time to wake up my husband. It’s time to let him know that things might be started.” 

So after observing me for a few minutes, he decided that we should call the midwife right there. I definitely didn’t think that I was ready because I had really only been in what I would consider active labor for an hour, but when our midwife came to my home, I was 8 centimeters dilated and they were ready to fill up the birth pool and have me hope right in. It was just peaceful and quiet. My midwife and her team almost seemed like they were just working in synchrony in the background. 

There wasn’t any coaching. There wasn’t any interruption to what I was experiencing and having my husband and I there. We did send our toddlers off to Grandma’s house so that we could just have the house to ourselves. But it was amazing. I got in the birth tub and my water broke probably 20 minutes after that. And then after about 20 minutes of pushing, I was able to deliver him and just have that same concoction of hormones that just make you feel so elated, so happy, so grateful for your baby being born that immediately, any of those feelings of pain that come with pushing have gone and just being able to snuggle him there in my own home and be tucked in our own bed just minutes after. I felt like a home birth really was the birth of my dreams. I felt like a queen and it is what made me want to help encourage women to create the environment that they want so that they know that they are the leader of their birth. Yes. Oh, I love it. I love it. I love it.

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Meagan: I really do love it. I really, really do. It’s just so amazing. And it connects with me so well because of the same thing. After my second Cesarean, I learned more about doulas. The doula work just called to me. I was like, “This is what I want to do. I want to help people know that they can have different experiences.” 

One of the hardest things during our pregnancy journey is the preparation and knowing what preparation to do. There are so many things out there. You’ve prepared differently each time especially because you are preparing for different scenarios with different locations and stuff but are there any tips that you would have for birth prep in general and self-empowerment? How do you truly believe in your ability to do what you want to do and then create the environment to do that?

Sarah: With my first son, I prepared with HypnoBirthing. I wanted to be able to find that meditative state so that I could move forward with an unmedicated birth but one of the disservices that the course instructor did for me was she said, “We’re not going to study Cesareans because you’re not going to have a C-section. We don’t need to start focusing on that because it won’t be an option.” 

So looking back, I would advise women to actually get as educated as they can with the medical system and know about inductions and know about options for inducing labor both natural and medical options regarding induction. But I also think one element that is most missing in the system is for our doctors or our providers to help us know that we have the power within us. We’re not taught about the physiological process of birth so we don’t understand that there are hormones within us and messages that our baby will signal to our body that it’s time to start the process. Right? 

Knowing that our bodies are made to go through this and that everything is intended to stretch, I think that we can eliminate a lot of the fear that we have if we only believe that we will be successful with an epidural or with vacuum assistance. Just knowing that our bodies are made to birth our babies whatever size they come, whatever date they choose to arrive, that our bodies have the answers within them. 

I also think it’s important to realize that the perception of pain is also internal. One thing that I have been learning a lot about is that our body only feels pain because of the messages that our brain then starts to comprehend. So if we begin to feel a contraction and our brain’s message is, “This is wrong. This is bad. This has to stop immediately,” all of a sudden, we create an environment of tension and stress within us. This is the opposite feeling that we need in order for our baby to continue to dilate and for the baby to be born. 

So what I try to instruct women and families to focus on is that the contraction is the method by which the baby is going to continue to descend and it’s the correct feeling that we should be having at the time. Now, I’m not saying it’s easy. I’m not saying it’s absolutely pain-free, but understanding that the waves are the only way for our uterus to contract and expel the baby then will give us power inside. 

We also have different pain-blocking receptors within our body. So as our contractions rise with each stage of labor as they start to get more intense through transition and then as we start to feel that natural urge to push, we have also been experiencing the counteracting force within ourselves of being able to block that pain. Then when our baby is born, having the skin-to-skin time completely erases all of those feelings that we had. 

So knowing that our bodies are perfectly designed to accommodate everything that we will experience gives us so much confidence that we can then proceed and we are able to labor as long as it takes. We are able to continue to breathe. One thing I like to think about as I’m experiencing a contraction, and one of the reasons I think that my labor was so much faster, was because every time I had a contraction, I would try to breathe as if I was allowing his head to push into my toes. I wasn’t pushing, right? You’re not supposed to push until you feel the urge to push, but I was allowing myself to think open thoughts so that my body could open and be in that state for cervical change but I was also trying to focus on the down and out of the baby being born.  

When we have a contraction and we’re not grounded or we’re not prepared for those feelings or those really strong sensations, it’s a lot harder for our bodies to then continue to progress in a way that is unhindered and allows us to feel safe and secure and that everything is a correct sensation. 

In both of my vaginal deliveries, I actually did not feel like transition was a stage of torment or suffering for myself. I know a lot of women say that they can start to feel when they are in transition. For me, that always came in the pushing element. When I felt that pressure, that’s when I decided, “I really need to get grounded here because this is happening.” So for my third birth, I knew that the more that I can focus and feel what was happening inside of me and utilize those feelings to help push the baby, the sooner I can come through this situation. Right? 

Sometimes people talk about a hard scenario and they say, “The only way out is through.” 

That’s another thing for labor where you have to go through all of those feelings. 

Meagan: Yeah and those feelings can be really intimidating, right? Really intimidating so through our prep, prepare for those feelings. Prepare for the way to change up your breath because there are those moments sometimes where it’s like, “I don’t know if I can do this,” and our shoulders raise and our faces tense. If we can breathe through that, breath is so incredibly powerful. It’s so powerful. But if we can breathe through that, it can really, truly help. Just our breath alone and then like you were saying, how our mind relates to pain if we can change our mindset– this is totally not birth related but I am really big into cold water therapy like Wim Hof and all of the things. 

My husband and I converted our deep freezer into a cold plunge in our backyard and I will tell you, when I am in that, it’s freezing. At 40 degrees, it’s really cold, but when my mind connects to, “It is cold. It is cold. It is cold,” my whole body just trembles and I’m freezing. I’m telling myself, “It’s so freezing.” I’m trying to work through it, but I can’t. I’m just shaking. Then when I breathe and I’m like, “Okay. Calm down. You’re okay. You’re right here. You’re strong,” and I start coming out of that space of fear and exactly what’s happening if that makes sense– I’m telling myself that I am freezing. I am cold. I mean, I am cold but I’m also okay and I’m also going to get through this. It’s crazy. 

I just did it with some friends and they witnessed it. They were like, “Wow. That’s crazy.” I audibly have to say it out loud. I can’t even just do it internally. They are like, “Wow. That is really cool.” It’s the same with labor and with birth and all of these things. 

Sarah: Knowing that you are exactly where you need to be is what then will give your body confidence to do what it needs to do. I think that’s why birth affirmations can be so positive because as we speak out loud, our brain believes what we say. So if you are in labor and you are saying, “I can’t. I’m in pain. Make it stop,” all of a sudden your entire body starts to feel that tension and starts to feel that panic. But if we can use affirmations to say, “I am safe. I am secure. I am strong,” saying these things will then solidify to our bodies that that is how we feel. 

Meagan: Absolutely. Absolutely. I want to talk about changing plans and things like that. If we have a birth that is going another way which is maybe undesired, maybe a Cesarean or a repeat Cesarean. Maybe we’re at home and we are transferring to the hospital or you wanted to go unmedicated and you’re getting an epidural, I wanted to talk about the word failure and how impactful that word can be and how we have to offer ourselves grace. Do you have anything to say about that? 

Sarah: Absolutely. I think the first thing to do is to understand that when you share a birth story that didn’t have the outcome of your desire, a lot of people will say, “At least there’s a healthy baby. At least there’s a healthy mom.” While those things are most important and unfortunately, the opposite can happen at birth. It’s devastating. We also have to know that our mindset can control how we feel about an experience. So just as I shared that I had made peace knowing that a transfer to the hospital would not equal that I’m a failure, knowing that you have done everything that is within your power to achieve your main goal will help you then to feel like you’ve had the most beautiful birth. 

Sometimes I think that it’s more about just knowing that you’re respected and knowing that your wishes were granted during birth, that you had a birth partner or a support team that listened to you, and that made you feel like the goddess that you are in birth. 

Meagan: And heard. 

Sarah: And heard. Sometimes what we want is we want that epidural or we want that induction and we have reasons within ourselves knowing why we want the birth that we want. When we can create an environment within ourselves that then fosters that, that’s when our birth feels like it’s unstoppable. That’s when we know that we have achieved everything that we set out to do. 

I think one important way to prepare in that regard is to do what I call a fear release. When we’re thinking about all of the options that can go wrong, we tend to stop that thought immediately because we don’t want to think about a worst-case scenario. We don’t want to fill our minds or our bodies with that negativity but if we can approach it before it happens and we can actually say, “What is my plan? If my water breaks before my labor has started, what is my plan? If dilation isn’t happening at a good rate, what are my options? Can I get a Foley bulb? Is Cervadil an option while I am laboring?” we can actually walk down the path of each of our fears and we will start to see that we have the same amount of knowledge essentially that our providers have in what paths would be available. 

For me, I was writing everything down and every single thing that I would feel prior to birth. If I was feeling frustrated, if I was feeling scared, if I was feeling nervous about adding another child, “How am I going to take care of all of their needs?” all of those things are real and can feel overwhelming. If we don’t have the support externally, then we have to find where we stand within ourselves. 

Labor is an event of the mind, the body, and the soul. We have to make sure that we are preparing in each of those elements so that we can then know at the end of the day that we are true to ourselves and that we have listened to the promptings that come and that we follow what makes us feel like we are driving the car that will get us to the destination of our baby’s birth. 

Meagan: Yes. So in saying that, we have to act on the promptings that we feel and sometimes it may be something different than what’s being suggested. For a long time in birth, I didn’t realize that I could say no or could say, “I would like to do this,” or “Talk to me about this,” and have that discussion and that active conversation about what I was feeling. With my second C-section, I didn’t want to go down to the OR. I didn’t want to have a repeat Cesarean and I didn’t feel like I could say much more than, “Okay, let’s go.” 

So I want to talk about that. We have these feelings and then how do we act on them? Obviously finding that supportive provider and having that supportive team, but then how do we find the courage within ourselves to say, “Hold on. I hear you. I hear what you’re saying, but I would like to talk about this,” or “My heart is telling me this. Can we talk about that?”

Sarah: I think the first step that we take is knowing our rights. Just like you said, if we have a provider that is suggesting an intervention. Maybe it’s a position that doesn’t feel comfortable to our bodies. We have to know that we are allowed to say no and that when informed consent is a part of our birth plan, we can always ask them what the options are. 

So if someone comes in and says, “Your labor hasn’t progressed for 4 hours. You don’t have anymore dilation. It’s time for Pitocin,” we can say, “What are my options? What might happen if I do not choose to have Pitocin at this time? Is it something that we can look into 2 hours from now?” Because I have had a hospital birth that ended in a C-section and then my other two births outside of a hospital, I recognize that it’s not always as easy as we might think if our providers are–

Meagan: Pushing back. 

Sarah: If they’re pushing back and if they have a protocol that they have to follow based upon their hospital. Those are put in place to protect them as providers with liability and also to protect mothers and babies, right? No doctor would want to take a risk for a mother and a baby but when we feel like the request that we have should be honored and that we can ask those questions to then receive a response that we are able to then come together and work as a team. Knowing that everybody who is there really does want the best for you and your baby, knowing that you might offend someone by letting them know that, “Hey, I don’t want this to happen at this time,” but that you have the right to do that and that if needed, you can actually switch providers. For me, that was very scary. 

Meagan: A couple of days before. 

Sarah: It was a stressful event to have to be finding someone. I went to a few other obstetricians and they said, “You’re far too late. You’re too far along in this pregnancy to be coming to me.” That’s when I decided that even if having a VBAC outside of the hospital presented an added element of risk because I might have to transfer to a hospital if something went awry, I knew that was the route that I needed to take in order to achieve what I felt like was my right to attempt a VBAC. 

I love the work that you’re doing because so many women, as they are deciding if they should have a C-section or if they can try for a VBAC, find that there are roadblocks that are in our way. I don’t want to say all of the time, but a lot of the time, our providers want the very best for us, but some of their suggestions might not be what helps us achieve a VBAC. 

One example I can think of is an early induction. Right? We know that the highest chance for a VBAC is for spontaneous, vaginal delivery to occur and yet we are also under pressure for our babies to be delivered by 40 weeks. 

Meagan: Or 39 even sometimes. 

Sarah: Or 39. And just as a woman’s menstrual cycle is not always a 5-day event or our cycles aren’t always the same amount of days– 

Meagan: 14 days apart, yeah. 

Sarah: Exactly, that maybe you knew exactly the date you conceived or you had IVF so you knew exactly when your egg was implanted, it’s very hard to know if that 40-week date is accurate. Both of my VBAC babies were born at 40 weeks and 3 days. To me, that’s interesting because I think, “Maybe my body is regulated enough that that is just when my babies are developed.” You know? So knowing that if a provider is telling us, “You have to have your baby by 40 weeks,” we can say, “What are my options if I choose? Can I take a non-stress test after the 40-week mark to find out how my amniotic fluid is doing and to make sure my baby is healthy and strong?” 

Meagan: Yeah. 

Sarah: And if you do find that there are complications, then there is no regret when you have the induction at that time. 

Meagan: Right. Yep. 

Sarah: Or when you seek medical assistance or when you elect to have that repeat Cesarean because you knew that your wishes were honored and that you were able to be number one. 

Meagan: An active participant of your birth. Being an active participant in your birth is so important. Like she said, if you choose an elective Cesarean, that’s okay because you were a part of that decision making or if you choose to be induced or if you choose to keep going or whatever it may be, being an active participant in your birth can truly impact the way you reflect in your postpartum experience.

Last but not least, I would love to talk about the postpartum too. I think we would both agree that a lot of the times– I don’t want to say this with everybody preparing to give birth, but I feel like it’s very much so in the VBAC world, we are so focused on how to get a VBAC, a vaginal birth after a Cesarean, and how to have this end result that we forget about what comes after the birth whether it’s a vaginal birth or Cesarean. We are so focused on how to get this birth and this outcome that we forget what happens in that last period. 

Sarah: Exactly because our bodies know how to birth a baby without the knowledge that we possess. Even after we gain all of this knowledge, it really is our body’s job and our baby’s job to be born. But the postpartum period then falls all the way back on the families. So if you’re not prepared, if you don’t understand what will be happening physically within your body and how long it takes to heal, you could find yourself underwater at that time. Your baby requires food every few hours so if you’re attempting breastfeeding and you’re having struggles with breastfeeding, all of a sudden it feels like the postpartum period is harder than the birth for a lot of women. 

We have a separate course for the postpartum period. We call it “The Fourth Trimester”. In it, we dive deep into sleep both for parents and for infants. We talk about breastfeeding or feeding your baby if you elect formula. We go into postpartum depression and anxiety and really just try to help women understand that the time to prepare for the postpartum period is during pregnancy. It’s not just the 38th week of pregnancy because your baby might come at that time. I remember with my first son, my hospital bag wasn’t even packed when my water broke because it was in that 38th week and I thought I still had a few more to go. Everybody said that first-time moms always go overdue. 

So even knowing that the La Leche League offers free consults over the phone at any time of the night or day, knowing that alone is just a resource that we can use. I have to tell you for my third birth, I thought, “Okay. We will just have this set. Everything is going to go swimmingly,” and my little baby boy just was not latching correctly which causes so much pain as you’re trying to nurse but it also caused one of my breasts to be engorged in a way that he wasn’t extracting the milk but I was still experiencing those letdowns. 

So after a few days of just struggling– and I had met with the hospital lactation consultant– and feeling like, “I don’t have the resources I need,” I met with women from the La Leche League multiple times and finally, one of the pieces of advice that she gave us was the turning for my son. She mentioned, “When you sit down to feed your baby, you’re not going to think of it as a feeding session. You are going to try latching.” She actually gave me a number. She said, “I want you to try 20 times to latch.” 

I thought, “That is way more than I have been trying.” I usually start to feel defeated after the 5th or 6th time of trying to get this all to work. Then she said, “Your baby might be angry. Your baby might be hungry, so feed them an ounce of milk from the bottle or spoon feed however you want to feed them, and then try again 20 times on the other side.” I cannot tell you what a difference this made knowing that I was going to sit down and try 40 times to latch my baby. 

After the 8th attempt, he latched and we never had problems again. All that it took was for me to change my mindset as far as what I expected. Right? So even though I was an experienced mom, I had breastfed before, my little baby is just learning this for the first time. He’s awfully small. He has the reflexes to suck, but he needs to be trained just as much as I do. We had to come together and work through that. I don’t think that I could have made it happen without the support of the La Leche League. 

A lot of the time I think, “There are always excuses,” when we’re in the postpartum period when we’re tired or we don’t have a store open when we need something and Walmart is closed at 11:00 and all of a sudden, you’re having a fight with your partner in the middle of the night because you’re not prepared so knowing just the amount of supplies that you’re going to need and how long you’re going to bleed after birth, all of these little details can be really overwhelming. 

Thank heavens that we have more people talking about it. We have companies that are responding to these needs. I think that we have more individuals offering support at this time where they say, “Oh, I”m just going to buy you that gift basket that has all of the support that you’ll need.” Having a friend that can bring over their old nursing bras that they’re not using anymore so that you’re just ready to go with the supplies that you need, can make your postpartum period feel like you are off to a great start. 

Meagan: Absolutely. There was something you had mentioned too, and this goes for birth, where you were like, “I never had problems before. I nursed my other babies just fine and this baby’s brand new and a new experience.” That goes with all things in life and with birth and postpartum. Just because we birthed this way or this is how our birth went or this is how or breastfeeding journey or this is how my postpartum went, doesn’t always mean that we shouldn’t prepare for the next baby and the next birth and the next postpartum. It doesn’t always go exactly the same. 

Then also, remember these babies. Yes. Is it instinctual? Yes. They know where to get milk but again, their mouths are different. Everything is different so it can change so having patience and getting to that spot where you get to your nursing station, you take a deep breath in, you are taking a deep breath out, and you try 40 times. You are trying and not letting number three get so infuriating because your baby is going to feel that too. Your baby is going to feel that stress. 

It’s the same thing in birth where if we have someone bring in some stressful feelings, we’re going to all react to that. Our bodies react so remember to find your breath, find what you need to do, and have the patience to walk through that.

Sarah: The reason we named our company Birth Made Mindful was because the word mindful in and of itself just means that you are taking in everything around you and you are allowing yourself to feel without judgment what is happening. It’s the hardest thing whether you are in birth or whether you are having a challenging experience as a mother, just know that you have enough time to pause, you have enough time to think, and to really find out what answer feels right to you. 

What is your heart telling you? What is your mind telling you? Can those two things come together in a way that then you can make a decision that will empower you? I’ve been writing the book for our company, “Birth Made Mindful”, and it has just been an amazing process of going even a level deeper than just a digital course to explain to women that they have the strength within and that each of us is powerful. We are champions. 

I love the phrase “birth warrior” but I don’t want anybody to feel like they have to have their sword and their shield as they go into birth. We want it to be more of a collective feeling where all of us are working together so that we can have an experience that will then launch us into motherhood or maybe it’s our second child so launching us into having multiple children in a way that will really give us vibrancy. It gives us energy. It gives us meaning in motherhood and the support that we know that we can do it. 

It really does come from having an understanding of where we are at inside and allowing anything that doesn’t feel congruent, that we can work through those things and we can then find out where our true passions lie and make sure that we honor ourselves and honor our desires. 

Meagan: Our intuition. Oh, well tell everybody where they can find more about your courses and your blogs and hopefully soon, your book. 

Sarah: Yes! We are at birthmademindful.com and most of our social media handles are at Made Mindful. That way we can cover Motherhood Made Mindful as well as we continue to grow our course offerings and continue to try to help our community find joy in birth and motherhood. That is our mission to have every family feel like they are armed with knowledge and that they have all of the support that they need to take on the most important event of their lives. 

Meagan: Absolutely. Thank you so much for sharing a little bit more about your other birth story and sharing these tips with the listeners. It really is so important to prepare our mind, our body, and our soul for all of the experiences. Obviously, we know that things happen sometimes and there are going to be unexpected things that come but even through preparing and being in that space and taking that time to say, “Wait, what is happening?” just processing it in the moment and having the question be asked can help you as well for after. 

I love that you talked about doing the fear release. We talk about doing the fear release too. Sometimes we don’t realize that we have traumas because we don’t look at it as a super traumatic experience but then as we walk through our birth and things, we realize, “Oh, that might be a traumatic thing I need to process. That’s a fear,” or “Maybe it’s not traumatic but it’s a fear of mine. It’s enough to hang me up.” So it’s important to walk through these situations as well. 

I think it’s awesome that you offer the two courses. Postpartum. Obviously, I love VBAC and I love the prep but there’s so much to postpartum that is just forgotten about so I think it’s really important that we talk more about that so thank you so much. 

Sarah: Absolutely. We want your listeners to get a discount when they come and buy your courses. So they enter VBACLINK into any of our courses, then they’ll get 30% off of both of those courses if they want to come to check it out. 

Meagan: Wow. That is amazing. 

Sarah: We just hope to continue to provide education, knowledge, and support to families. Like I said, birth is a transformative event. It’s the day that your baby is born but it’s also the day that a mother is born. In this day and age, we need all of the help that we can get. 

Meagan: Absolutely. Thank you so much for taking the time to be with us today. 

Sarah: Thank you so much for having me. 

Closing

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

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A few months ago we posted a video clip from Kaitlyn’s birth taken by Danielle Wilstead at Wild Oak Birth Photography and it went viral! We have Kaitlyn and Danielle with us on the podcast today sharing the backstory behind her inspiring video. 

In the video, a nurse is asking questions incessantly and Kaitlyn is advocating for herself while literally pushing out her baby! 

Kaitlyn shares the power of trusting that your body will tell you what it needs and listening to it when it does so. 

Additional Links

Kaitlyn’s Photography Website

Danielle’s Photography Website

Emma’s Birth Story

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, hello everybody. Guys, this is Meagan with The VBAC Link and we have such a fun episode for you today. It’s actually not a VBAC mom. I’m just going to put that flag right out there right now. She is a mama. I’m sure you will recall if you are following us on social media that went viral after her birth photographer posted a very incredible little snippet of a story of her birth. 

We posted it back in February and we will probably post it today. If you have not seen it, definitely go today to go watch this video. Her birth photographer, Danielle at Wild Oak, posted this video and it immediately gave me chills. Immediately. I want to say that she is not a VBAC mom but the episode today is going to be sharing her story and then also sharing more about how to really truly advocate for yourself and even make decisions that might be hard or sound weird to someone else. 

This mama has a history where she actually birthed out of the hospital and then with this baby, she birthed in the hospital. A lot of people would be like, “What? Why would you go back?” so we are going to talk a little bit about that. I want to welcome Kaitlyn and Danielle to the episode today. Ladies, thank you. 

Danielle: Thank you for having us.

Kaitlyn: Mhmm, thank you. Emma and I are here together. Hello. 

Review of the Week

Meagan: I love when babies are on the episode. I love it, love it, love it. Okay, so before we get into the story, I do want to turn the time over to Danielle because she is so gracious and going to read a Review of the Week. 

Danielle: Yes, okay. So this review came in from Apple Podcasts and this is from kim_md44 and they titled this, “When a Podcast Gives You a Transformative Experience.” The review says, “It’s hard for me to put into words how much this podcast has meant to me the last four months. I discovered this podcast during my second pregnancy when I was prepping for a TOLAC and wanted so desperately for a VBAC. Like many other listeners, my first birth was traumatic and ended in a C-section. One of the biggest hurdles I had to overcome was the mental gymnastics of getting over that trauma and truly believing my body was capable of birthing a baby vaginally. 

“This podcast did wonders in that journey. Hearing so many other women sharing experiences similar to mine not only helped me feel so validated, but it gave me so much hope for the future. This podcast gave me a community, my people. It gave me resources to help me advocate for myself and well, it paid off. I got my VBAC. On October 5, 2021, I had a beautiful, healing birth experience where I was able to birth my daughter vaginally. I did it.

“So to the provider who told me that my pelvis was too small to birth my baby, who told me that this baby would have to be significantly smaller than my first to even think about attempting a VBAC, my second-born was a whopping pound heavier than my first and I pushed her out of my vagina. I did it.”

So powerful. 

Meagan: That just gave me the chills. 

Danielle: Yes. All of the chills. All of the chills. 

Meagan: Yes. Such an empowering message and review. Thank you so much for that review. Just like she did, you can too. You can too. It’s hard to sometimes imagine it being possible, but it is possible. So thank you so much for that review. 

Kaitlyn’s Stories

Meagan: Okay, beautiful ladies. I have been looking forward to this. I texted Danielle. Obviously, it was going viral within seconds but I actually saw it from someone else’s page. Of course, I recognize Wild Oak Birth so I was like, “Oh my gosh, this is from Danielle,” so I went over to your page and watched it 50 other times. I was trying to reshare this because this is such an empowering video. This is so amazing and then I had to text you. I texted you and I was like, “Holy cow,” and then I was just thinking about it and I was like, “Hey, this is such a great message that we can share with our listeners,” because as TOLAC mamas, as VBAC mamas, it can be really hard to be in a situation where you have people constantly saying, “Well, you could do this but you don’t want to,” or “You don’t want to do this,” very similar to Kaitlyn’s, “Well, you don’t want to birth like this.” 

Well, why don’t I want to birth like this? We’re being told how and what to do. It’s very hard, very hard in the medical system to advocate for ourselves and say, “No, actually I don’t really want to do this.” Anyway, so I want to turn the time over to Kaitlyn and Danielle if you have anything to say. But really, if you want to share this story because I know that we’ve only seen this tiny bit of this story so can you tell us a little bit about your journey and how it came about? I know that Danielle posted that you did choose to birth in the hospital after out of the hospital so maybe talk about the decision to do that because decisions in this VBAC world and in birth in general can really be hard to make but they can truly impact the way our birth has the outcome. So I would love to turn the time over to you. 

Kaitlyn: Thank you. Yeah, it was wild seeing that little two-minute snippet of a very precipitous birth– I will not lie. That was precipitous. 

Danielle: Very fast. 

Kaitlyn: Very intense, but just that last little bit go everywhere around the world honestly. I’ve had a lot of beautiful, beautiful messages from people reaching out just sharing that they were terrified about birth and now they feel a little bit of hope and a little bit of peace. That’s, I think, I hope that your listeners will be able to get out of listening and hearing this story and my experiences and my feelings because it’s that hope that everybody needs. 

Yes. You can make good decisions. Yes, they are hard and yes, things can be beautiful regardless of what happens. So yeah. It was a very big experience. 

This is my third. Emma is our third and my first was a hospital induction. Like many, it was more on the traumatic side. I had an OB who was not super supportive. They were like, “Why would you not have an epidural? That’s dumb.” So not a good fit. 

With my second, I had a birth center down the street from us in Colorado. That was a water birth and so healing. The midwives gave me over and over and over again the opportunity to decide for myself like, “Okay, here’s this option. What do you want to do? Here’s what we understand. What do you want to do? Do you want to do your GBS swab?” “Yes, I do. Thank you.” They were providing that kind of care which I loved and as a birth worker myself, I love. Families deserve that kind of shared decision-making all over the board. 

We moved again and got pregnant. This was the one that we weren’t expecting. We have three December babies now, three December girls so March is very fertile apparently. That was exciting but I wasn’t ready to be pregnant yet. The only person I knew I wanted to be on my birth team was Danielle. I was like, “Danielle, I’m pregnant. I’m due a few days before Christmas. Please come.” She was like, “Okay, I’ll think about it.”

Danielle: I remember it being so close to Christmas. It is a hard decision but I’m like, “This is Kaitlyn. It’s Kaitlyn. I have to be there. I’m going to make it work.” 

Kaitlyn: I was so grateful for that because honestly, I don’t know who else would have come flying. But then it was like, “Okay, great. I have Danielle. Who else?” 

So yeah. For me, again that shared decision-making is really important to me but I felt really torn between my second and my third. I think I just got a little bit clearer on, these are the exact risks in the hospital and out of the hospital. They are pretty matched. Like, oh okay. There’s no set risk like, “This midwife will have this much risk.” I attended some births where some midwives out of the hospital didn’t transfer fast enough. That was partly the family’s preference as well, but just like, “Oh, this is what I’m comfortable with and it’s not quite this.” 

I interviewed a bunch of midwives and actually switched care temporarily and it just didn’t feel right. It didn’t sit right to be out of the hospital. I was like, “Okay, we’re going to have a home birth.” My oldest was stoked. It was like, “Great. We’re going to have the birth tub and I’ll be there for you.” It was super sweet but it didn’t feel right. I remember working with my therapist and writing a pros and cons list for both in and out of the hospital then being like, “Okay, how do I feel about this? How do I feel about this?”

I was able to think through and process, “Okay. This is my bucket of fears and the pros in a hospital birth with this midwife, and here’s my bucket of fears and my bucket of pros in this home birth midwife group,” that I was looking at. I just felt, “Okay. Nope. I’m going to pick the hospital bucket.” That felt a little wild to me. I definitely got in my head a lot about, “Okay. I’m a birth worker and who’s going to judge me for doing this? Will people think that I’m making the right decision?” 

Meagan: Which can I just add that it makes my heart hurt a little bit that anybody let alone a birth worker has to– not doesn’t have to but it happens because I did the same thing when I was preparing for my VBAC after two Cesarean birth. It was like, “Oh, who’s going to think this? What are people going to say about my decision to do this?” to the point where I didn’t even feel like I could share it. I didn’t feel like I could tell anybody. I had just a select few people who knew my plan but I was scared to share it. 

It’s hard because the biggest thing that matters is that it felt right for you. That’s what matters. 

Kaitlyn: Yeah. That was interesting and good for me. I have a fantastic therapist so we talked about this at length like, “Okay. Why do you feel that this is important?” You are right. And just trying to pull that back and pull back that power of decision-making and coming back to myself.

Meagan: Yeah. Good for you. Good for you. 

Kaitlyn: That was big and lots of work and lots of talking with my husband as well like, “This is how I feel. This group of people says that this is the right decision and this group of people says that that’s dumb and stupid and you should go with this decision. I can’t please both groups so I feel so torn.” But yeah. I think that it felt good and I knew that my hospital midwife was going to support me. I had literally brought– so the next thing I did was that I went through and my therapist was like, “Okay, let’s acknowledge all of the trauma points from your first birth in the hospital and why this feels so scary because we can work on this. We can make this feel less scary.” That was really helpful because I literally made a list that I sent to Danielle.

I was like, “These are points that are trauma points. This is how I can address those per se.” I brought that list to my midwife and was like, “Okay, let me tell you that these were the moments from my first in-hospital birth that was traumatic for me that I don’t want to happen again. These are the points that I would appreciate and why these points in my birth plan are meaningful to me.” That was an awesome realization. I felt so much better like, “Okay. I know my provider is on my side. I’m not hiding anything from her. She’s not hiding anything from me. I trust her and I trust her to take care of me if whatever happens.” That was the foundation that I needed. I needed it to be there. 

Meagan: I’m sure it solidified, “Okay. Yep. Definitely right. This is definitely right.” 

Kaitlyn: Yeah. 

Meagan: Which is such a great feeling to have. 

Kaitlyn: Mhmm, it is. I remember at my 40-week appointment, me getting all nervous over here because my last 40-week appointment with an in-hospital person was like, “All right. Let’s schedule your induction.” She was like, “No, we’re not going to talk about it. We’ll talk about it when we need to. Everything is going to be just fine, Kaitlyn. Trust.” She told me about a client of hers that had birthed beautifully next to the bed. She was like, “That was such a beautiful birth.” It restored my hope in birth. 

Meagan: It’s like she was projecting your fate. 

Kaitlyn: Yeah, that was kind of funny. Yeah. I walked out of that appointment being like, “Okay. I trust. I trust. I trust. This is going to be okay. I trust myself. This is the right decision. Let’s move.” So the day after my due date, we went in. I just wanted some data. I was like, “Okay. Let’s check. Let’s see where we are at.” I was 3 centimeters. I was like, “Okay, that’s good. Whatever.” Danielle and my team were like, “Woo! 3 centimeters!” I was like, “Sure, thanks.” 

But then I decided to do a stretch and sweep. You just have to be where it’s like, “Okay, that’s right. This is mindfulness. That’s how I’m paying attention to sensations. This is what pushing feels like. It’s pressure on the vaginal wall.” Yeah. The rest of the day, I got some cramps and bloody show out of that. It was midnight. I think I texted everybody. I was like, “All right. These are solid contractions. They’re punchy. I don’t feel like I need support yet, but FYI, things are starting to move.” 

My husband woke up. I made myself some eggs. Great. It’s my birth tradition that I have eggs in my early labor mostly because in my first birth, I was like, “I want eggs,” and they were like, “Sorry. You can’t have them.” 

Meagan: Hey, listen. Eggs are good protein and fat. That’s power food right there but I love it. 

Kaitlyn: That’s what I was craving. 

Meagan: It’s all in spite of you telling me that I cannot have these. I will eat these with every baby.

Kaitlyn: I will eat my eggs and I will enjoy them. Yes, and I do. So yeah. I woke up and I made myself eggs. I walked around the house. My husband woke up and was like, “Oh, are we moving? Okay. Let’s do this.” Then we were like, “Okay, this is early birth where you pack yourselves and finish wrapping presents.” And then all my birth team was like, “Yeah, these were consistent minute long, 3-5 minutes together contractions. We’re coming.” 

I was like, “Okay, that sounds good but I don’t feel like I need support yet so no rush.” Then Danielle started driving and then I texted her and was like, “Nope, never mind. They stopped.” So Danielle turned around and they just stopped so I went to bed at about 3:00 AM and yeah. I’m not sure why it stopped but it did so I got more sleep. I woke up the next morning and there was nothing happening. I was like, “Oh, okay. I still don’t feel l like I’m going to be pregnant much longer so let’s move.” 

I scheduled an induction massage with one of our fantastic people up here. He is awesome. I sent my girlies off to play with grandma and got some alone time with my husband, some cervix ripening. So yeah. I remember getting to my prenatal massage at 12:30 PM. I got there, walked up the stairs, and felt, “Ooh. That is a solid contraction wave. Maybe we’re not going to make it to sushi,” because that was our plan. We were going to get a massage and go to sushi. We never made it to sushi. 

Danielle: Nope. 

Kaitlyn: I remember walking in and Eva asking, “Okay, are you having any contractions?” I was like, “I think a few, yeah.” By the end of that massage, 80-90 minutes later, I remember I was in full-blown active labor at that point. I remember thinking and realizing, “Oh.” Eva’s a birth doula as well so she was like, “Do you want some counterpressure?” I remember her counterpressure feeling fantastic and that’s when I knew, “Oh, this is active labor.” 

I finished my massage. It took me forever to get dressed again. I texted the birth team super trembling. That’s another cue for me like, “Oh, my body is changing things kind of fast.” I was like, “Okay, it’s time. Come. I want support now.” 

That was at 2:00 when we left the massage. I got home at about 2:30. I remember on the way home being like, “Okay. We are going to go home. I’m going to get some calories. My birth team is going to get there. We’re going to stay home for a few hours and I’m going to know when I need to go. I’m going to trust myself. My body will tell me when it’s time. I know where to go. It’s going to take a little bit. We’re going to get settled at the hospital and we’re going to have a baby in a few hours. It’s going to be fine.”

That’s not quite what happened. We got home. I gobbled a little tiny bit of food because at that point I don’t feel like eating very much. Danielle got there first then my doula, Carly. I just remember everybody being there and realizing everyone was there and just being like, “Okay, whew. I’m all good.” It felt bigger than the last time. “This is already hard.” That’s what I remember telling Carly. I was like, “This is already hard.” She was like, “It’s supposed to be.” “Yes, you’re right but it’s hard.”

Meagan: But it’s hard. 

Kaitlyn: Yeah. Then I remember my oldest came in. My middle child was taking a nap. She pretty much napped throughout my whole birth but my oldest got to come in and be with us while we were home. That was so sweet and filled that bucket for me of, “I’m not having a home birth. I don’t get to be with her throughout my whole labor,” but she got to be there for at least a little bit which was a little sweet. 

Meagan: Special, yeah. 

Kaitlyn: Yeah, sweet moment. She was super, super sweet. 

Danielle: She was. 

Kaitlyn: “Come in, Mom. Hold out your hand and sit here.” Then she started offering me books because that is her favorite thing. Then she told us, “Mom, that was too loud. Don’t wake up Sophie.” 

Meagan: That’s hilarious. 

Kaitlyn: That was so funny. Then I felt it. My body told me, “Shift. It’s time to go. I don’t want to be in the car for any more of this. Let’s move.” It took me 10 minutes to get out the door, but I’m pretty sure Danielle followed us on our tail the whole way to the hospital. 

Danielle: I sure did. 

Kaitlyn: I put my AirPods in with my mindfulness track and I fell asleep between contractions in the car on the way to the hospital. 

Danielle: Yeah. 

Kaitlyn: I remember sitting there and waking up, “Wait a second. How in the heck did I fall asleep?”

Danielle: Yeah, well behind you driving, all I could see is her head tilting back like this and I’m panicking inside. You know, that backward arch is very common when baby is coming out. You are going back. Baby starts coming. 

Kaitlyn: Danielle was freaking out thinking I had a baby. 

Danielle: Is she having a baby in that car?! Pull over! Then she stood up again. I’m like, “Okay. What was that?” 

Kaitlyn: It was me falling asleep. 

Meagan: Were you in the back seat? 

Danielle: No, I was in my car behind her. 

Meagan: No, her. Was Kaitlyn in the back seat? 

Danielle: Oh no, she was in the front seat. 

Kaitlyn: I was in the front seat. 

Meagan: So you could see this. 

Danielle: Yes. Yep. Yeah. Yeah. 

Meagan: Oh my gosh. 

Kaitlyn: That was incredible. She was like, “That’s a sign that you were coping excellently.” I was like, “Oh, thank you. Thank you.” Which I never imagined because that car ride was the most dreaded part of my labor. I hated being in the car for that five minutes down the road to the birth center.” So I was like, “Okay.” I remember getting in the car being like, “Nope. I’m going to make this. It’s going to be totally fine. We’re going to be fine.” I remember my body slowing down a little bit. Contractions were not so close together in the car. There were probably four in that 20-minute car ride instead of six or seven which was really good. 

People will be like, “You almost had a car baby,” but I didn’t. My body knew where I was and I think that’s a pretty incredible part of births for me is that my body will slow down and pick up depending on what I need. 

Meagan: Obviously. Yeah. 

Kaitlyn: They will slow down. An hour and a half before Sophie was born, I slept for a half hour. 

Meagan: Oh my gosh. It was starting and then it was like your body needed a break and went to sleep for the night. 

Kaitlyn: Yep. Take a break. Kick back up. 

Meagan: We’ve got to trust our bodies. 

Kaitlyn: Yeah. That was really cool. I was mind-blown that it happened. But yeah. I got to the hospital, pulled in the parking lot, stepped out of the car, and things picked right back up. I was like, “Okay, we’re moving.” I booked it to the front door. Nobody was in the lobby. We sat there for a contraction and I was like, “Nope. Let’s go.” We went to the elevator and went upstairs to L&D. We didn’t see anybody until we busted into L&D. I let myself be loud. I was like, “All right. Things are intense. I’m going to be as loud as I want to because I do not want to go to triage right now. I want to go to a room and I want to be done.”

Meagan: Yeah. I need a room!

Kaitlyn: Yeah. I remember Danielle. I don’t think it was you. Maybe it was Carly. Maybe it was you. 

Danielle: Carly was behind me. 

Kaitlyn: We have a mom. Here. She’s in labor. They were like, “Oh yeah, come in.” I was like, “Thank you.” 

Danielle: Mhmm. 

Kaitlyn: Glide down the hallway. Glide down the hallway. They brought a wheelchair. I was like, “No. I’m not sitting down. That’s not happening.” 

Danielle: At this point, you were probably already 10 centimeters. 

Kaitlyn: Um, no. I was probably in transition. I was transitioning. 

Danielle: You think so?

Kaitlyn: Mhmm, yeah because we got to our room and they were right on top of each other. That’s when I was like, “Okay. We’re at transition. Let’s get Heather here now, please,” but I couldn’t say that because I was answering all of the questions. I was amazed at how much mental capacity I felt like I had at that point. I’m not sure if that’s because things had just moved so fast or what, but I felt like I could answer all of their questions. “No, I don’t want a gown. Yes, I want this. No, I don’t want that. No, thank you. Yes, please.” I was like, “Nope, that’s going to be hard to get on the bed. Sorry.”

Meagan: I remember you saying on the video, “Yeah, I know but it’s not going to happen.”

Kaitlyn: Yes. I was on the other side of the bed first. I tossed off all of my clothes in those little tiny in-between moments between those on top of each other transition contractions. I tossed off my shoes. I tossed off my dress and then moved to the other side of the bed so that he could have a base reading of the heart rate. 

I remember my doula asking me– I remember seeing Danielle out of the corner of my eye setting up my tripod and being like, “Okay, Danielle’s good. I can have a baby now. I just need to document it.” 

Danielle: I’m good to go now. 

Kaitlyn: I remember hearing my doula start to fill up the tub because she knew that I liked water and water was helpful. I listened to that and was like, “Mmm, I don’t think I’m going to get there.” I remember her asking me, “Kaitlyn, do you feel pushy right now?” I was like, “No, not right now.” Then my water broke literally five seconds later all over my husband’s shoes. I was like, “Ha ha, now I feel pushy. Psyche!” 

Yeah. So then my nurse was like, “I really want to check you. I really want to check you.” I was like, “I’ll check myself.” 

Meagan: She was adamant. 

Kaitlyn: So I checked and I was like, “Yep. Her head is at a finger’s width from my perineum.” She looked at me and then moved to the other side, “What did you say?” I think she was just a little bit in disbelief of, “Wait, are you having a baby? Am I going to be okay?” I could feel her anxiety mount beside me but didn’t feel like there was any room for that. I was stoked. 

Meagan: I can’t imagine how you felt because I was feeling it watching it and I’m sure many other people were how she was like, “Well, I’d hate to have you just be 4 centimeters and have your midwife come.” She was feeling anxious. 

Kaitlyn: I clearly say, “That’s not happening too. No, I’m not 4 centimeters. That’s not happening.” I’m literally complete and going to push out a baby any minute here. 

Meagan: Yes. We could feel the angst and I’m sure you could feel it with her next to you, touching you, saying, “Get help in here!” Having those things being said, you were able to just really stay in this space even though all of these other things were happening. 

Kaitlyn: Mhmm, yeah. I think that was also interesting for me as a people pleaser. 

Meagan: Okay, so you’re a people pleaser person. How do you feel like you were able to disconnect that, “I normally would say to do whatever and follow your direction?” 

Kaitlyn: That’s an excellent question. 

Meagan: Yeah. I don’t want to make it sound like, “Go against your medical provider!”

Kaitlyn: I mean, I didn’t anticipate that from myself. I did not expect myself to be able to hold boundaries for myself because that’s not something that I’m a super expert in.

Meagan: Intuitively, it came out.

Kaitlyn: It’s something I struggle with. My therapist was like, “Don’t expect too much of yourself in labor. You’re literally pushing out a baby. Rely on your team.” That’s why I had my team there was to back me up and talk for me when I didn’t feel like talking but somehow, there was just– I don’t know if it was because I had thought things through and knew, “I know where you’re coming from.” These nurses are there to manage risk and they are trained. Who knows how many things they hear all day long from an OB or some provider who ranted on a nurse for not checking their client before they got there?

 

Meagan: Right, before they arrived so they’re feeling angst. 

Kaitlyn: How many stories have they heard? So I think I came in with that perspective. These nurses are trying to help. They’re trying to do their best. They have a very risk-averse perspective. That’s their job. It’s to manage all of that. Great. I don’t have to worry about it then. They’re going to be there doing whatever. So I could hear her fear and I feel like, I don’t know if it was my subconscious or what, but somehow it was like, “Okay, she’s scared. I’m not. I’m going to push out a baby. She’s coming. I’m stoked because I’m almost done and I know I can feel that she’s here. I’ve done this before.” 

It was really helpful because I had done that before. It felt really familiar. I was back in familiar territory. I had done work to know and trust myself a little better to say, “Okay. I know how to make good decisions. I can decide things and now understand what my body is saying about myself. I’m feeling scared. I’m feeling anxious,” and at that moment, it was, “I’m going to have a baby. She is coming and I am excited because she is almost here. It doesn’t matter what this person over here is feeling. That’s not my job to regulate her emotions. She can do that. She’s an adult. My job is to just be here and push out a baby.” 

That’s what I did. I had that pause, that conversation happened all in that pause between, “Okay, I’m complete and pushing,” which maybe happened for a minute. 

Danielle: Yeah. 

Kaitlyn: So yeah. It was like, “No, you’re not going to check me because I’m going to push out a baby right now. There’s no space.” My doula was like, “Okay, where do you want to push?” I was like, “I’m not moving. Right here apparently.” Yeah. It was big. That was the beautiful, beautiful part of this birth was feeling my instincts take over. It was like, “Hey, this is intense, but my body knows exactly what to do,” and feeling her head come down and push on my perineum, and my hands were right there. Then her head was out. I don’t even remember everybody being like, “Oh, there’s a head.” None of that had any space in my ears. 

And there were all the other sensations happening. I pushed her out. I remember looking down. I felt like I didn’t see anything until I looked down. I was like, “Oh, there’s a cord around her neck. I’m going to pull it around her neck and I’m going to pull her up.” I had walked through that step by step with my midwife more to get a feel of, “How are you going to support me because I want to catch my baby?” So my brain knew what was happening. And she was fine. All is well. We’re done. 

Then yeah. Then there was space for joy. I remember laughing. That was amazing. That joy and laughter and then the nurse was like, “Let’s sit you down.” I’m like, “Sure. We can sit down now. Now I can do this. I can’t move when I have a head at the top of my vaginal canal but I can move now.” We sat down and I just remember looking up at my team and we all just laughed at each other like, “What just happened?” I cried and I laughed and I cried and I laughed. That was amazing. 

Then I think as soon as all of the checks happened, I could feel my nurse beside me calm down. Her adrenaline spiked and made its course. I feel like she came back to herself and was like, “Well, that was crazy. Let me go get you checked in now.” It was so funny. So that was kind of cool too being like, “Okay, look. Everybody has big feels and if you’re not used to this then that’s fine.”

Meagan: Yeah. You know, I love that you said that about your nurse. You could feel her anxiety. You could feel the tension but at the same time, you weren’t going to allow that tension to enter your space when it was so easily able to do. It’s so easy to let the tension that is happening in the room enter the body. We know how it can impact our birth and our modes of delivery. 

Kaitlyn: Absolutely. 

Meagan: I love that you said, “You’re the adult. I know you’re an adult. I know you’re here. I know your intentions. I know you’re here because you care and you want all things to be well, but I’m not letting you project that. I’m putting my wall here. You can be next to me but your space isn’t coming into my space. We can be in the same space with different emotions.”

Kaitlyn: Your emotions are yours. Mine are mine. 

Meagan: That’s going to be a big takeaway, in my opinion, for this episode so listeners, it’s going to be hard. That’s a hard thing to do. It’s really hard. 

Kaitlyn: It doesn’t always happen and it’s okay if it comes in a little bit. 

Meagan: Exactly. 

Kaitlyn: That’s where your team comes in. That’s why I was depending on my doula or was going to depend on my doula but somehow didn’t need her to do that and build that wall for me but to be that reminder of, “Hey, where do you want to birth? Where do you feel like pushing? Are you pushing? Let’s stay present with yourself. What are you feeling right now?” and letting yourself feel those emotions because it doesn’t have to be joyful right away. That’s not a requirement for a good birth. That’s something that I also worked on. It was like, “Okay, what’s a beautiful birth? It does not have to be this painless, joyful thing,” even though Emma’s kind of was. It was intense but it was joyful. 

Meagan: It looked intense. 

Kaitlyn: And intense. It hurt and it was hard and felt manageable all at the same time. So yeah. 

Meagan: So incredible. 

Kaitlyn: That was amazing. And yeah. So happy. My midwife got there seven minutes after Emma was born to help with the placenta. The hospitalist walked in three minutes before that like, “Heather is right behind me on the road. I promise that she’s coming.” 

Meagan: You’re like, “It’s all right. I’m holding my baby. I’m good. I’m good.” Oh, man. 

Kaitlyn: She delivered the placenta and laughed with us. She was like, “Oh yep, she wasn’t waiting for anybody. That’s totally fine.” You didn’t miss out on me here. You did fine. I’m not worried. Yeah then everybody left us alone for the most part. That was amazing. 

Danielle: Yeah, I mean you did so many things postpartum that I don’t think many people ever do. You can share more about what you did but the staff really did give you so much space and that was really awesome on my end to see. It was almost like you were at home but at a hospital sort of just hanging out. Your girlies came in and even while your girlies were there, you and Carly were looking at the placenta. There was so much that I don’t typically see in a hospital setting and it was really, really cool to see. The energy was just so calm. Overall, so calm, just so happy. Everyone was elated like, “Wow.” Just kind of in complete shock but in the best way. 

Meagan: Yeah. I’m sure there was an overwhelming amount of joy and again, shock like, “What just happened? But whoa. Wasn’t that amazing?” I’m sure. One of the questions we get often actually was kind of what Danielle talked about. They say, “I want to have a VBAC and I really want the out-of-hospital experience, but I don’t feel like I can go out of the hospital. I don’t feel comfortable or my insurance, or whatnot. Do I really need to?”

Kaitlyn: Generally for a VBAC, yeah. 

Meagan: Absolutely. So what tips would you give for that postpartum and how to create that good postpartum? You intuitively just were here. You were confident in your body’s ability which I think is one of the biggest things. You were confident. You’re a people pleaser you say, but because you were so confident, I think it made it easier. I don’t know you very well, but I think it could have made it easier to not please people because you knew. You knew things were going to be okay. You knew you were here. You were confident in your spot. Sometimes that’s hard and we don’t have confidence. That’s okay too and that’s again why we have our team. 

So we’ve got our team building confidence, education– these are my takeaways from this episode. Having those conversations with the providers before. You had some really good provider conversations that helped you know what to expect and know that she was truly on your team too. So yeah. Any other tips that you would suggest?

Kaitlyn: Yeah. I mean, I went through all of those postpartum details with my midwife like, “Okay. I want to birth the placenta attached to my baby. I don’t want to cut the cord for a while. I want that to be calm and unrushed. I don’t want to worry about it right away. I’m in no rush for you cut that link quite yet.” 

Meagan: Which in the hospital doesn’t happen a ton. Usually, they cut the cord as soon as they deliver the baby. 

Kaitlyn: My provider had never done that before. My provider had never delivered the placenta attached to baby. 

Meagan: Oh, see? Yeah because that’s not very common. 

Kaitlyn: She was like, “I’ve never done that before. Can I clamp it first?” I was like, “No, let’s just let it be.” She was like, “Oh, okay. If that’s what you want then that’s fine.” She knew that was important to me and was one of the things on my backup plan if a Cesarean was ever going to be in the cards that if nothing is emergent, let’s keep the placenta attached. That would be really meaningful to me. She knew that and I knew that she would advocate for that for me. 

Meagan: And that is okay to not have it be attached.

Kaitlyn: It ended up having the placenta attached for two hours. She left it in the bucket next to me. I was like, “Yeah, it can right here. It’s fine.”  Then they were like, “Okay, call the nurse when you’re ready to cut the cord and do the newborn exam.” I was like, “Great. We’ll let you know. Thanks.” So we called them about two hours later like, “Okay. I’m ready. I’m ready for my placenta prints.” I also do a print with paper and blood and do a tree of life. It’s kind of hard to describe in the audio but my doula and I nerded out over my placenta and did that while my husband was with my girly doing all of the newborn exam stuff. That was so fun. 

Meagan: Awesome. 

Kaitlyn: Yeah. I had my mom bring my older girlies in and they were so, so cute. “We are so excited to be here with you.” They wanted to hold her so we got that family time together too. I had to really convince them to leave before bedtime. That was hard. 

Meagan: I’m sure. 

Kaitlyn: And then yeah, I took a bath postpartum before we moved to the postpartum rooms and that was awesome. Danielle and my doula and I just sat there in the bathroom processing what had happened. 

Meagan: Yeah. 

Kaitlyn: Okay, what just happened? Did that happen? Did this happen? When did this happen? Did that really happen? And just being together. I loved how unrushed that felt and that nobody was in a hurry. Everybody was chill. They’d check on things and make sure all was well, but they filled that role and then I had my emotional support team to be with me. So sorry, I don’t know if that was too much but that was all amazing. Yeah. It was that kind of experience that I loved from my out-of-hospital birth was the team filled up the tub for me and asked if I wanted to take a bath. I was like, “Yes. That would feel glorious.” So I stuck that in my birth plan. I would love to take a bath postpartum.

Meagan: I’ll never forget the first shower after I had my baby. It really was so wonderful. It just makes you feel fresh and clean and new. You know? 

Kaitlyn: Mhmm. 

Meagan: It’s a lot. Your body just went through something pretty intense so I’m sure that felt lovely and probably helped the cramps. 

Kaitlyn: Yes. Postpartum cramps are more annoying than the labor ones in my opinion especially because they get more intense after each child. That was also my birth plan. And then postpartum, give me IBUprofen as fast as possible because those stink and I want to enjoy myself. Then it took them an hour and a half to get me admitted so that didn’t happen but that’s okay. 

Meagan: Darnit. 

Kaitlyn: It’s fine. 

Meagan: Well, thank you so much. So much. There are so many nuggets within this episode and listeners, I know it’s not a VBAC story but wow. Wow. How amazing can it be? It can be so amazing. We know that it isn’t always like this. We know that this is not every birth story out there and it is a little bit more rare but it doesn’t have to be either. It doesn’t have to be. We can create those teams. We can talk with our providers and have a solid plan. We can trust our body, believe in our body, and believe in our ability. We can advocate for ourselves. We can block out the stresses of others and not let them into our space. There are so many things here that we can do. 

A big takeaway too is that even if it doesn’t end in the actual result that you’re wanting, maybe the VBAC isn’t the result. But even if that isn’t, if you are an active participant of your birth and you are truly going through this and it’s not just letting people make you get on the bed, make you get a cervical exam when your baby’s pretty much coming out and doing all of these things, you will feel more empowered about the decision and hopefully will be more included in the decision made in the end. 

Kaitlyn: Mhmm, yeah. And if that’s something you value, being in control and in charge of your body and decision-making in your birth process, then yeah. That’s possible however it goes.

Meagan: It’s possible. Yes. Also just remember there’s no wrong way to birth, guys. You don’t have to show up last minute and have a baby. You don’t have to. You can go in and be induced and you can have an epidural and you can still have these beautiful experiences. Truly, you really can but yeah. I feel like there are some golden nuggets within this episode and I just want to thank you guys both again for being here, taking the time, and sharing this remarkable video. It really inspired the world obviously. Obviously, it’s inspired the world and we’re excited to share this episode with our followers. 

Kaitlyn: Thank you. 

Meagan: Thank you. 

Danielle: Yes, thank you so much for having us. This has been amazing. 

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 we are joined by a truly amazing woman of strength, Morgan. She recently retired after 25 years of active duty service in the Coast Guard and is a mama to two boys and one girl, each with their own very unique birth stories. 

Morgan’s first baby was born vaginally. Her second was a lifesaving crash Cesarean. Her third was a surprise HBAC born en caul! The high of this empowering birth carried her through a difficult postbirth hospital experience in which she almost lost her uterus. 

Meagan and Morgan share facts and insight regarding the amniotic fluid index. Morgan also gives tips on how to have necessary conversations with your provider to advocate for the birth experience you deserve.

Additional Links

Bridget’s Website (Morgan’s Doula)

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, hello. Happy Wednesday, women of strength. We are bringing another story to you. You are listening to The VBAC Link and we have our friend, Morgan, here today sharing her stories. I’m really excited because just before we started recording, we talked about how Morgan said that she is a numbers girl. She’s like, “I love numbers.” It’s something that I love too but never have ever retained as well as Julie did. I’d be like, “Okay, I’m trying to remember. Is it this or that?” and she’d be like, “It’s this.” 

I remember names and stuff like that and she remembers numbers. That has been something that I have really missed without Julie being here so I’m excited to talk about numbers with you today, Morgan. We’re going to talk specifically maybe about amniotic fluid and percentages and things like that. But yeah. I’m excited to get into some numbers. If you’re looking for some numbers on the chances of VBAC, we’re going to talk about amniotic fluid. What really is a scary number and when do we really need to induce a labor? Stay tuned. 

Review of the Week

Of course, we have a Review of the Week so before I turn the time over to Morgan, we will read Britjl14. That is their review today. The subject is “Tears of Joy.” It says, “I literally got teary-eyed when I saw that your podcast was coming back. You gave me the courage to have my VBAC after two Cesarean baby, 9 pounds, 15 ounces, in late August. Such an uplifting and informative podcast. I tell everyone who mentions wanting a VBAC to look this up. So excited for more to come.” 

I love that. You guys, when we decided to bring the podcast back, it was so exciting for us too. So, so exciting. It was so fun to get all of the emails and the messages on Instagram saying, “Ahh! We’ve been waiting!” because we took a 10-month break. A 10-month break. That’s what we needed to do for our personal lives but we are so happy. I am so happy to be back. I definitely miss Julie every time that I’m recording, but I’m really so happy to be back and so honored to be a part of all of these beautiful stories because really, I wish I had this when I was preparing for my VBAC. I really do. 

I go back. This probably sounds silly because I’m recording the stories and I’m hearing the stories but then every week, I go in and I listen to the stories because I am learning things after recording and hearing them the first time, a second time. I’m learning things about births and certain procedures so it’s always a learning experience even for me who “specializes in VBAC” so it’s really, really fun. 

So yeah. Thank you so much for your review. Remember, if you have not had a chance to leave us a review, we love them. We always, always read them and add them to our queue to read them on a podcast. 

Morgan’s Stories

Meagan: Okay, Morgan. Hello. 

Morgan: Hi, hi. Thanks for having me. 

Meagan: Hi. Thanks for being here. Thanks so much for being here all the way from Alaska. 

Morgan: Yes, yes. Juneau. 

Meagan: Awesome. So awesome. Well, I’d love to turn the time over to you to share your story. I guess it was actually your second birth story technically?

Morgan: My third. My third, yeah. My second was a C-section.

Meagan: Yeah, sorry. That’s what I am talking about, your C-section. Your second birth story, I also want to talk about because it was a very valid Cesarean. 

Morgan: It was. Yeah. 

Meagan: I want to talk about that too because we can come across as so negative with Cesarean because it’s a VBAC podcast and we’re sharing a Cesarean story that led to a VBAC but a lot of the times, the Cesareans were negative or unneeded or undesired or unplanned, so sometimes it can come across that we are talking badly about Cesareans but I want to point out today with Morgan’s story especially that it was very, very needed. We are so grateful for Cesareans too. Even though we are a pro-VBAC podcast, we are not anti-doc and anti-Cesarean. That is for sure. I will let you share your story but I just want to talk about that because sometimes I think it can be like, “Wow. This podcast hates Cesareans,” and that’s not the case. That’s not the case at all. 

Morgan: Yeah, so I have three kids now and my first was a vaginal birth. It was mostly pretty well sought out and went through as expected. I was 41+5 and everything went pretty well. I did have some retained placenta at the end so I had to go back in for a D&C at six weeks postpartum because we hadn’t caught that before. 

My second pregnancy was a really good pregnancy. I was healthy. I was working. Everything was going as expected except my son, Cooper, was transverse. He would not budge. I tried so many things to have him budge. I was doing Spinning Babies. I went to the chiropractor. I could not find an acupuncturist where I was that I trusted and was ready to go to, but we tried so many things to get him to turn and it wouldn’t work. 

Toward the end, my doctor and I discussed doing a version. To me, we had discussed the risks of it were having a C-section at the end, but that’s what we were going in and trying to avoid anyways so the risks weren’t bothering me at that point so we did end up trying a version. It worked. It was very exciting, but then he turned back. I was like, “Oh no!” It was devastating. It was so devastating. 

Meagan: Oh, that would be hard. 

Morgan: That was one version and he turned back. So the doctor had said, “Man.” She was right with me on my birth plan too. She was there. She was ready to go. She said, “Well, let’s try another one.” I was like, “Okay. Let’s do it.” I went through it. I got through the first one. It was uncomfortable but we did it. So the second one, we tried another one, and sure enough, he turned. We were like, “Yes! We’ve just got to keep him there.” I was standing up all day. I wasn’t going to move. He was going to stay in. 

He turned back. I felt him turn back. I was like, “Ugh.” A second successful version that then turned back. After that, we were coming up on our due date and I was just so adamant about wanting a vaginal birth at that point that I said, “You know what? Why don’t we try a third version and we’ll just induce right after that? Maybe I won’t get my unmedicated birth but I’ll still have a vaginal delivery,” which for me was important because I wanted to be able to breastfeed without any concerns. 

So we tried. We tried a third version. It was on my due date. We were in the hospital. We were ready to induce afterward. My doula was on call. We were going to call her in after I started laboring. In the middle of the version, we lost his heartbeat. She had me connected with an ultrasound the whole time. She’s doing the version and there’s a nurse that’s doing the ultrasound and all of a sudden, we had no heartbeat. 

She said, “Maybe it’s just where we are. Let’s move a little bit and see.” I turned and I moved. We tried to find the heartbeat again and we couldn’t find it. She said, “Just give me a second.” She walked out of the room. I was all the way in the back of the labor and delivery unit at that point. She walked out of the room so calmly. She went into the hallway and yelled, “We need help in here!!!”

Meagan: Whoa. 

Morgan: I was like, “Whoa.” I was not expecting that. What went from calm right in front of me went to a massive emergency in a hallway. All of the nurses descended and the bed got moving. We went into the operating room and it took 20 minutes because I didn’t have an IV or anything connected to me at the time. So 20 minutes later–

Meagan: So you were under general anesthesia? They didn’t put you under general?

Morgan: They did not. No, I saw it. I saw the whole thing. I mean, they had the cover up but there are so many reflective units and metal everywhere that I could actually see what was happening which was fine. I don’t mind that. 

But yeah. They pulled him out 20 minutes later. He was not breathing. No breathing, no heartbeat, or anything. They had to do CPR. 

Meagan: Scary. 

Morgan: They got him back. The nurses got him back which is just amazing. He was rushed to a NICU at another hospital, the highest level NICU. I think it’s a 4. 

Meagan: Yeah, mhmm. 

Morgan: Yeah, so he went to a children’s hospital where there was a massive NICU. He’s good. Friday is his birthday and he’ll be 8. He’s just an amazing little kid.

Meagan: So amazing. 

Morgan: So I’m very, very grateful for that C-section.

Meagan: How was that for you? How was recovery for you? 

Morgan: Recovery was fine. There were no unexpected occurrences. We knew it was going to take a little longer. I knew not to work. The thing that was hard was, well first, breastfeeding because I had so much IV fluid in me. 

Meagan: I was going to ask. 

Morgan: Yeah. I got really nervous because I was pumping. He was at a different hospital. After two or three days, I saw my levels go down drastically and I was like, “What is this?” What happened was that the IV fluids had left my system so it was just my natural breastfeeding amount. I was not expecting that drastic change. But once we figured out what that was, that was good. 

The second thing that was hard was his being in a NICU. Once I was discharged from the hospital, my husband was driving back and forth from the home to the hospital. Luckily we were close enough, but I could only sit. I couldn’t lay in that NICU. I couldn’t lie so there was a little bit of pain there. Once we were ready to get him breastfeeding, we didn’t have a room for us. He was still in the NICU so I was sleeping outside in the guest area, like the waiting room along with other families that were going through things like their kids in cancer and stuff and there was nowhere for the parents to stay so we were all making tents in the waiting room. So that was a little hard for that recovery. 

Meagan: That is hard. That is really hard. 

Morgan: Yeah. That part was stressful but once we were all home, it was good. It was good. 

Meagan: How long was he in the NICU?

Morgan: He was there for 11 days. They were worried about brain damage so it was a hypothermic treatment that they put him on. 

Meagan: Did they put him in a cooler?

Morgan: Yep, mhmm. 

Meagan: Yeah. Well, so grateful that all is well. There must have been something. It’s so hard because my baby kept going breech. My midwife would flip him and then boom, back breech. Flip him, and then boom. Back breech. It was the same thing. I’d feel him and I’m like, “What the heck?” She finally was like, “We have to trust him. There’s a reason. We don’t know why. We don’t understand it, but we have to trust him.” It’s so hard. It’s so hard. 

Morgan: Yep, yep. 

Meagan: Because I was like, “If I have to have a third Cesarean because he’s breech, I will be so mad.” But yeah. That’s so hard. 

Morgan: Right. That’s so true. I think Cooper was telling us, “I’m not supposed to be here if I go this way. Things are going to go bad,” and sure enough, they did. He tried twice but then yeah. 

Meagan: The third time was too stressful for him. 

Morgan: It was too stressful. I think possibly that maybe that umbilical cord got bent in a way that no airflow could go through or something. We don’t know. But yeah, thank goodness for that C-section because it brought him back to us. 

Meagan: Absolutely. Yeah. So then baby number three? 

Morgan: Yep, baby number three. That was five years later. We’ve had a lot of difficulties with some miscarriages. I didn’t mention before that I’m Active Duty Coast Guard. I also am on the ships all of the time so you have to plan pregnancies around shipboard life. 

Meagan: Oh my gosh. 

Morgan: Yeah. There are big time periods between my kids. But baby number three was five years later. I wanted a VBAC from the start. I wanted an unmedicated VBAC. I knew I could do it. After my first pregnancy where I was so close to being unmedicated and my second pregnancy being a C-section, I knew that VBACs were available. I knew that I could do it. I was so adamant about going down that route. 

With the Coast Guard, you don’t really get to choose. With any military, you don’t really get to choose your provider. Most of the time, we are in a military treatment facility. I was very, very grateful to not be there. I had some negative experiences in both the local MTFs. This was in Washington, D.C. so getting to be with a civilian provider was just amazing to me. I was very happy. We were with the INOVA hospital system at that time. 

The provider I went to for the first appointment was at 10 weeks. We had a great heartbeat. Everything was going well. I was like, “I’m going to have a VBAC with this child.” He said, “Okay. I am good to go on that.” It was exactly what we were expecting. I would never have expected him to say otherwise at that point. I’m like, “Vaginal birth is clearly the way to go without any sort of condition saying otherwise.”

The pregnancy progressed. I guess I should mention that I was 40 at this time. With my second child, Cooper, I was 35 or 36 when I had him so I was in that high-risk stage just for age at that point. So of course, I’m there now at 40 and everything was fine. The pregnancy progressed. Everything was going well. At some point midway through, we were looking at what position the baby was in and she was breech. I was not happy about that and he was like, “It’s okay. It’s okay.” Knowing what happened with Cooper, I was not so thrilled. 

Meagan: You’re like, “I have some trauma on that.”

Morgan: I did, yes. At this point, I didn’t go for a chiropractor but I did learn that there was a wonderful acupuncturist in the area that had wonderful success with turning babies so I went to him. It was a 3-hour session and I actually felt her move in the session. It was just amazing. I couldn’t believe it. It was so cool. I’m like, “I feel her moving.” So she did. She turned a whole 180 at that point. 

He left us with homework. He called it, “Hot hot sticks” where you burn this incense over your pinky toe. 

Meagan: Bladder 6, yeah. 

Morgan: My husband would do it and the acupuncturist said, “You don’t take it away when she says, ‘Hot’, you take it away when she’s like, ‘Hot, hot, hot, hot!’” so that’s why she called it hot hot sticks. 

Meagan: Hey, I have actually seen that work though. The baby flips with those things. It’s called Bladder 6. It’s really cool. 

Morgan: We did that. He’s like, “You have to do this every day.” We continued to do it. It was great. I mean, I speak wonders about his service in the D.C. area. So that worked. We go back to the doctor and around 30 weeks, he started saying, “Okay, we need to schedule your C-section.” I was like, “Why? No. We don’t need to schedule a C-section.” He goes, “Well, you had one so we just need to schedule it.” I said, “I’m doing a VBAC. We talked about this.”

Meagan: Yeah, remember at 10 weeks?

Morgan: Right, right. He said, “Well, just in case.” I was like, “Why can’t we just induce? There are many steps between vaginal delivery and a C-section.” 

Meagan: Yes. 

Morgan: And scheduling a C-section I should say, right? So he taught me then, “We don’t induce with VBACs. There’s no Pitocin.” Later on in the story, I found out that that’s not exactly accurate. Some doctors will do it but he wouldn’t. That appointment was leading us down the road of research and starting for me to learn more about how to advocate and how ACOG and obstetricians and gynecologists work in their network and what their risk levels are and how important being able to talk to them in their language was. 

Meagan: Yeah.

Morgan: He said, “We’re going to schedule a C-section for 37 weeks.” 

Meagan: Whoa. 37 weeks?

Morgan: I was floored. Yes. I was like, “This isn’t even a full-term baby. No. No, no, no.” He goes, “Well, this is when they do it. It’s just easier. If you want a VBAC, as long as you go into labor before the C-section then we’re good.”

Meagan: 37 weeks?! How rare is it that people go into labor? I mean, it happens. We know this but it’s not very common that the body just spontaneously goes into labor before 37 weeks and then we have a baby going into labor at 37 weeks and we’re concerned because before 37 weeks, we’re not full-term. Interesting.

Morgan: Exactly. I was like, “No. No, no, no.” I was so upset after that appointment. I was like, “First off, my body would never go into labor before that.” I mean, sure. I’m speaking in exacts. 

Meagan: Didn’t you say that your first one was 41+5?

Morgan: Right, 41+5 for my first. With my second, I had no contractions. I mean, he was transverse, but I had no contractions before 40 weeks so I was like, “There’s no way my kids are coming early. That’s just proven to be wrong for my body so far.”

Meagan: Oh my gosh. 

Morgan: I left that appointment and I was really frustrated with it. I started doing work. I started doing research on where are the risks, what are the risks, and getting myself familiar with it. I started being in that defensive zone where I was having to prove myself. I found your website. I found your blog. I started listening to every single episode. I mean, it just gave me so much knowledge on where to look and what to look out for and the bait-and-switch that you were calling it. I was like, “This is me! This is what’s happening.” So I did. I researched and defenses were up at that point which is unfortunate because you don’t want to be in a defensive situation. 

Meagan: It is unfortunate, exactly. It’s so hard because again, we’ve talked about this on the podcast. We don’t want to have to walk in with our arms up and be ready to punch. It’s not what we should be doing. We just want it to be a nice, cohesive relationship where the provider is listening and we are listening to the provider because it’s also important for us to listen to the provider. They did go to medical school for a reason but at the same time, we also have to know that sometimes what those providers are saying is maybe skewed based on their own experience or maybe whatever. I don’t know. We’ve had providers tell people that they have a 30% chance of rupturing after one Cesarean. We have to still be aware that there is more information but we should never feel like we always have to have our wall up and our fists ready. It shouldn’t be like that and it’s unfortunate that sometimes it is. 

Morgan: Right, right. So after that appointment, I had already known I wanted a doula, but I was adamant about getting a doula with this one as well. I found one and she was amazing. She had been a doula for a VBAC before so she had also pointed me toward research and was ready to help me. She really was. She was awesome through this whole event and the whole birth. 

Time continued to progress. I remember going and taking my older kids to Chuck E. Cheese one day. They were off doing their thing with all of the arcade games and I’m on my phone. I’m listening to a podcast. I’m scrolling through ACOG research and I’m like, “I don’t want just the bulletin. I want the research behind it.” I’m doing all of this on my phone trying to find it all and I found it. I found what I was looking for. It was not just the risk of a VBAC and the risk of a second C-section. It was, “What happens when a person has already had a vaginal birth?” It’s a conditional probability, right? I’m a numbers person. I had already had a vaginal birth. Then it looks up, “What are those risks for a person to have a VBAC and a person to have a C-section?” When a person had already had a vaginal birth, the risks for a uterine rupture and the risk for mortality were actually so far below what the normal risk levels were. They were actually below your first birth. So if you’re a first-time mom and you’re having a first-time vaginal birth and you still have the mortality risk and you still have the uterine risk, my risk was lower than that because I already had a successful vaginal birth. 

Those were the risk levels he was working on. I was using his research and I was like, “No, no, no. You can’t tell me my risk levels are extraordinarily high when your own research that you are following tells me that I’m actually safer. I’m in a less risky stance now than when I had my first child.” I was even more adamant at that point to go towards a VBAC. I told him, “I will not have a C-section at 37 weeks.” I think it was your podcast that helped me advocate for myself in terms of standing up to a doctor. I have advocated in many other situations like law enforcement, school, or whatever but doctors were a whole new ballgame for me. To be able to say, “This is my right and this is my voice and I get to make this decision,” was a little intimidating before. 

Meagan: Oh absolutely. 

Morgan: I learned how to do it. So over the course of 3 or 4 weekly appointments at that point, I had rescheduled and rescheduled and rescheduled until finally, I got him to 41 weeks for a C-section. That was with the threat of going to another provider who I did go see on my own who was willing to induce with a mild amount of Pitocin, was willing to wait until 41+4 for a C-section, and was just on board with the concept. 

I had gone to see them and the unfortunate part was that they were not in the network so while I could pay a little bit of that bill, I couldn’t pay the what-if part of it. Like what if things go bad and I have to be in the hospital? All of that wouldn’t have been covered. 

Meagan: Which is so hard. 

Morgan: That would have been tens of thousands. 

Meagan: That’s so hard when we are restricted by insurance. 

Morgan: Yes and I was. Tricare is very restrictive. You don’t get to go choose another doctor just because you don’t like this one on Tricare Prime. You are stuck and I was. I went back to him and said, “I don’t want to be here right now but I can’t be anywhere else. I can walk into an emergency room and have a birth that way.” I was totally fine with doing that so I told him, “This is where I am. I am not happy with your care for me right now. I don’t think that you’re listening to me. I’ve seen another provider that tells me that this is possible and I also know that there is a wonderfully VBAC-friendly hospital in Washington D.C. I will easily drive past yours to go to that emergency room if I need to,” because that’s where I was bound within our insurance needs. 

He listened. He listened then and he said, “Okay.” So that’s where 41 weeks came. He did, though, say, “I’m not going to give you Pitocin.” I did learn that was his decision. He felt that–

Meagan: You have to respect that is his opinion. Yeah. 

Morgan: Right. He gets to determine what is safe in his mind and he thought a C-section was safe. He did not think that Pitocin was safe. I was like, “Fine. That’s fine.” So we waited. We waited until 41 weeks for a C-section. Through that time period, I continued with the monitoring appointments that they want high-risk women to do. So two times weekly, I was going to the hospital. Not his appointment area, but the hospital where they had a clinic. 

Meagan: The non-stress tests and stuff?

Morgan: Yes. All the non-stress tests. It was the non-stress tests where you have 20 minutes of checking the heartbeat and then always an ultrasound as well where they were checking the amniotic fluid levels. After all of these things got done, it took about an hour and I would meet with the doctor who would go over the information with me. That was one-on-one time. I think there were three or four doctors there doing all of the work. 

I ended up getting to see this one doctor pretty regularly. She was great at answering my questions so I asked her all of the time, “Where are your numbers for amniotic fluid? You are telling me I have an amniotic fluid level. In my world of work with the Coast Guard, then that means there is a risk level if it goes too high or too low so I want to know where your levels are. If you’re giving me a number on amniotic fluid, what’s the high level and what’s the low level?”

They told me. They said that the low level was 5.5. I have no idea what the measures of unit are but I know 5.5. I kept going and kept going. Everything was always perfect. 

On Friday around 40 weeks, she was starting to get worried about a VBAC. This is again a different doctor. At that point, I had already gotten my membranes stripped once. I was dilated to 1 and I was still up a little higher. So there was no movement. There were no contractions, nothing but everything was still fine. All of the levels were still fine. On that Friday, my amniotic fluid was a 9 so it had dropped, I think, by 2. It was 11 that week and by Friday it was a 9. 

I had been busy but it was still above the 5.5. Everything was fine. She said, “We should admit you.” I said, “What are you going to do if you admit me?” They couldn’t answer me.

Meagan: Because they’re not willing to give you Pitocin so they’re not willing to induce your labor. So what is admitting going to do I guess other than signing up for the Cesarean at that point?

Morgan: Right, right. So I was like, “Are you just going to let me sit in a room for days on end until I go into labor naturally?” 

Meagan: Yeah. 

Morgan: Is there a time limit for that? She couldn’t answer those questions. So I said, “You know, I’m okay. I’m going to go home.” So we went. We agreed that I would come back on Monday. I would do a lot of drinking water and Gatorade and I would come back in on Monday and see if that changed my amniotic fluid level. 

So I did. I came back in first thing on Monday and again, everything was fine in terms of how they had prescribed the numbers to me ahead of time. So fetal kick counts, fine. Baby’s heartbeat, fine. The non-stress test and everything there was fine. The amniotic fluid level was at a 7. It had gone back down a little bit further but it was still above the 5.5. 

At this point, she called in the on-call doctor for my provider’s group which was another female and we said, “Let’s just do another check right here to see if I’m dilated any further.” I was okay with that. So she did. I hadn’t dilated any further but the baby had dropped some at that point. I was happy with that because the baby needs to drop first before you start dilating. That helps it. 

Meagan: Yep. 

Morgan: But they didn’t see that as anything. They were only looking at dilation. I said, “I’m good. I don’t feel like I need to be here. Everything is fine.” They said, “Well, you haven’t started dilating further.” I’m like, “Well, it’s not like you dilate 10 centimeters over the course of 10 weeks. That’s not how it works.”

Meagan: Nope. Nope. Dilating needs some contractions a lot of the time too. 

Morgan: Right, right. We’re having this weird conversation where they’re telling me that I’m in trouble and I’m just not seeing it. There’s no urgency in their voice. There’s no actual concern in any of the testing that was happening and again, I’m asking again, “Well, what are you going to do if you admit me today?” They again can’t tell me an answer. So I said, “I’m going to go make a call.”

I called my doula and we had a long conversation. At that point, we really thought, “If I had to go back again on Tuesday or Wednesday, it was just going to get worse with them urging me and urging me and how much stress did I want to add on for them to do that?” We were getting close to that 41-week C-section date at that point. So even doing all of the things, right? All of the induction things that you do. You’re pumping and you’re doing the red raspberry leaf tea–

Meagan: Walking, yes. 

Morgan: All of the walking, everything. Nothing had changed, right? I went back to the doctor and I said, “I’m not going to be admitted today. I am going to go home.”

We went home and we went to our last resort of induction which was taking the Cytotec, that weird horrible tasting stuff. 

Meagan: Castor oil?

Morgan: Castor oil. Taking castor oil. Cytotec is that horrible drug that induces miscarriage. It was castor oil. So I did two tablespoons of castor oil in a milkshake. It was Ben and Jerry’s peanut butter. I wanted a really strong, intense taste to get rid of the castor oil taste. I told my doctor ahead of time that I was probably going to do that. I wasn’t trying to hide it. 

Meagan: Yeah, you weren’t sneaking around. 

Morgan: I did it. That was what I had for dinner that night at 6:30 and at 10:30, I had to go to the bathroom. At 11:30, contractions started. We were home and the kids– both boys were in bed at that point. We were just in labor. I went to the bathroom a few times. At some point, I said, “I really want to be in the bath,” so I went to the bath. I had a nice warm bath and I stayed in the bathtub probably for 45 minutes or so. 

Then I said, “I need to go to the bathroom again,” and that was when it probably felt like starting to push at that point but we weren’t sure if it was still the remnants of castor oil or if it was literally pushing. Our doula had said, “You’ll probably feel the castor oil effects for that first hour of labor.” We were still in that first hour so I was like, “Okay. Okay.” But Dave, bless him. He saw a change in me that I didn’t see. He saw me get into a more determined working mode in my face. 

He called my doula and he called my sister. He got everybody in motion. My sister was going to come to watch the boys so that we could get to the hospital when the contractions were around five minutes. My first vaginal birth was 14 hours so that’s what I was expecting. I thought it would be somewhere around 12 hours or so for this one. By the time my doula got there 30 minutes later, I was crawling on the floor. She said, “Let’s just see how you’re doing.” I must have looked like the devil because I said, “We’re going to the hospital,” while I’m crawling. 

Then I had a contraction while she was right there and she was like, “Whoa. You’re pushing, Morgan.”

Meagan: Whoa.

Morgan: “We need to go to the hospital. You’re right.” I was like, “Okay, okay. Let’s go.” That was one contraction. In between that next contraction, we got dressed. That contraction happened and then the next one. These are about two to three minutes apart at this point. 

Meagan: Really close, yeah. 

Morgan: I’m crawling to the end of my bedroom. I had another contraction at the top of the stairs. After that one was done, I walked down my flight of stairs and I got to the front door. I had another contraction and by then, my doula Bridget said, “You’re not going to make it to the hospital. We have to have this baby here.” “Okay.”

Meagan: Oh my gosh. 

Morgan: Yeah. Dave calls 9-1-1. Fairfax County has an amazing fire system set up so we were expecting them within seconds. They did. They probably got there five minutes later from our call. 

Meagan: Wow. that’s fantastic. 

Morgan: They’re really fast but I had already had the baby by then. 

Meagan: Oh no way!

Morgan: Yeah. He was out looking for them to show up and I had the baby one contraction later. 

Meagan: Oh my gosh. 

Morgan: Kori comes out. 

Meagan: So he missed the birth. 

Morgan: He did. He was outside getting the ambulance and firetruck to come. So Bridget was in there and she’s like, “Morgan, you’re baby’s coming. Catch your baby.” I was like, “Oh.” So I reached down and I was on my hands and knees. I reached down and caught her. She was still fully inside the amniotic sac. 

Meagan: She was born en caul?

Morgan: Yeah.

Meagan: Oh, so cool!

Morgan: Yeah. There was no water rupturing or anything so she was fully inside her sac. Bridget had said, that’s the doula. She said, “She’s inside your amniotic sac. You need to open that up.” So I remember opening it up and having the water come out around her and fall to the floor. We had gotten some towels down. Then she screams and I just bring her up onto my chest and hold her. She’s bright and pink and everything is fine. I felt wonderful. 

Meagan: I bet. 

Morgan: It was such a great experience. There was no scariness to it. I wasn’t worried about being at home. I felt really in control of the entire process. I knew what was happening. I knew my body was working the way it was supposed to work so I wasn’t worried about the pain. There was a lot of pain but it wasn’t like pain. It wasn’t like someone was pinching me. It was intentional work. It really honed me in on what was happening and it was just amazing. I loved every minute of it. 

I’m holding her on my chest and two minutes later, nine big firemen come running over. I’m naked. I’m naked. I’m breastfeeding because I had taken off my bra at that point. I’m breastfeeding. I’m just sitting there against the coat closet. 

Meagan: And your husband was probably like, “Uhhh.” 

Morgan: Dave is right there. He’s right next to me at that point. It has to be nine or so. It was definitely a full firetruck and an ambulance and it was all men. They all walk in and I was mortified. I was like, “Oh my god.” Everything about my toned, intact, powerful, and in-control birth just went out the window. 

They got me a blanket so I covered up and they were ready to cut the cord. I said, “Let’s just hold. Let’s just hold off for a minute,” and they did. They let me hold off on cutting the cord. 

Meagan: Beautiful. 

Morgan: We let all of the blood drain out. I breastfed. I made sure we got that in and then eventually again, Bridget was so good because she kept a really good awareness of everything that was happening in the situation. She said, “You know, you haven’t delivered the placenta yet so we need to go to the hospital.” I was like, “Oh, right.” 

In the big transition, I had lost my big, powerful, intact mode of doing what I knew I needed to do and I switched to covering up my body and all of that. I wasn’t in the zone.

Meagan: Yeah, which is kind of telling if you think about it. When you’re vulnerable like that, you’re like, “I forget that I have this other part of birth that I need to take care of,” because you’re just so protective of yourself. 

Morgan: Right. Right, yep. So we walked out to the ambulance and I did. I walked out to the ambulance holding her and we got there. We had a 20-minute ride. At some point in that ride, I thought I needed to get the placenta out but I couldn’t. I was by myself. I didn’t know these people. I felt too vulnerable to be able to do it there. 

Meagan: You didn’t feel safe, yeah. 

Morgan: We get to the hospital and the ER decides that they don’t need me. I’m not an emergency at this point so they take me up to labor and delivery. The doctor that I had seen earlier, the day before because it was a 24-hour shift, she’s the one that was still on call. She said, “Okay, well we have to get the placenta out.” She was doing this in a very rushed, not pleasant way. She was upset with me because I didn’t listen to her earlier and now I’m coming in on an ambulance. I could tell that she was mad. 

She said, “We can do this here or we can do it in surgery.” I said, “Well, let’s do it here. I don’t need to go into surgery if I don’t need to. You can give me an IV, put a little Pitocin in me and let’s go. I know that’s how you do that to get the placenta out.” At this point, there’s no issue with uterine rupture because the baby is already out so Pitocin should be fine. But that is not what happened. 

I said, “Yeah, we’ll do it here.” The next thing you know, she sticks her entire hand all the way into my uterus. I am in so much pain and she rips out the placenta and with it, she ripped open my uterus. 

Meagan: *Gasps*

Morgan: I screamed. It hurt so much. I handed Kori, who is my little girl, over to Dave at that point. Bridget was just floored. She tells me this afterward because I passed out. 

Meagan: I’m sure you were in shock. 

Morgan: I must have been. She went over and went out of the room and yelled to get help even though the doctor was in there. There was another doctor that was nearby. It was the anesthesiologist who came in. She said, “No, no, no. We’re not doing this here. We’re going into surgery.” My doula took a picture of my blood pressure or my heart, whatever it is. The blood pressure monitor at the time. I was at 50/20. 

Meagan: I’m sure your heart rate was through the roof. 

Morgan: Yeah. It must have been. 

Meagan: You were in shock. 

Morgan: It was bad. They took me back to surgery and I did come back when I was in surgery. I remember feeling pain like they were moving my legs all around. I was telling them, “You’re hurting me. You’re hurting me. Get me under. You’re hurting me.” I had five D&Cs at this point in my life so I knew what they were supposed to feel like which is easy. They’re not supposed to hurt at all. I was supposed to be under and I wasn’t. I was telling them, “You’re hurting me.” 

I remember that it was either the anesthesiologist or the nurse. I couldn’t see who was next to me, but they were saying, “She’s not under. Stop. She’s not under.” So finally, I did get under and I had to have a big blood transfusion because of all of the blood loss that I had. 

Meagan: Blood loss because of your uterus, yeah. 

Morgan: They stitched me up–

Meagan: Stitched your uterus?

Morgan: Yep. Whatever they had to do. I don’t even know what they did but I still have my uterus. It’s still in there. 

Meagan: Which is great. 

Morgan: Yes. Yeah. They fixed whatever they needed to fix. That same doctor fixed whatever they needed to fix. I went to recovery. I woke up maybe four or five hours later and it was my doctor that was on call by then. He had said, “You’re lucky you still have your uterus.” I was like, “Well, I shouldn’t have been in that situation to begin with.” I definitely shouldn’t have had a hand go into me the way that it did. 

18 hours later, I walked out of that hospital. I went home. I was discharged. I felt fine. The blood transfusion worked wonders. 

Meagan: Yeah. I’m sure it made you feel better. 

Morgan: Yeah, and now two years later, I’m allowed to donate blood too so I do regularly because of that. I did before but now I totally recognize that need and do it. But I look back at my birth story and I think about the home birth. I don’t really think about what happened at the hospital too much but I do think about how amazing that home birth was and how wonderful it was to have the people near me that were fully a team. 

Everyone that was there was there for me and it was an amazing team. It was just an amazing birth. I loved it. I knew I could do that. I knew I could do an unmedicated, vaginal birth and I did. Man, it was awesome. 

Meagan: An unmediated, vaginal birth en caul too!

Morgan: Yeah, yeah. 

Meagan: Oh man. That is so amazing. What you said, you hold onto the home birth. You hold onto that experience. I think sometimes we have to hold onto those experiences. I had kind of a really wonky experience. I don’t know if I’ve talked much about it. I need to do an episode and talk about my postpartum but after I had my son, my VBAC, my body went into some weird shock too and I kept passing out actually. We don’t really know to this day. I didn’t bleed externally or internally. We don’t really know what happened and it’s been really frustrating to me to know that and it’s there. It’s in my mind just like this hospital experience. 

Obviously, this insane uterine/placenta issue that shouldn’t have happened like you said is in your mind but then you’re holding on to this over there and that’s what I do. I hold onto my VBAC because I do still wonder what happened or whatever. You’re like, “Yeah, it shouldn’t have happened in the first place, but I’m holding onto this HBAC technically.” It was an unplanned HBAC. That is sometimes where we have to go. We just have to hold onto the good. We have to hold onto the good because there is so much good that outweighs potentially the bad. 

Morgan: Right, right. 

Meagan: Yeah. Yeah. Congratulations. Congratulations. 

Morgan: Thank you. 

Meagan: I’m sorry that your husband missed it. 

Morgan: I know. He did. He walked in right afterward and then my sister came right after the firemen to watch the kids. I mean, it all worked out. It was great. Even the boys got to see her before we went to the hospital. My older son, Zach, was just wonderful. He came over and just connected with her right away. Cooper who was five at the time was like, “Oh, firetrucks!” 

Meagan: Firetrucks! That’s cool!

Morgan: He’s like, “Awesome! Firetrucks. Can I go back to bed?” I was like, “Yep.” It was neat. It was perfect. It was the perfect home birth even as unexpected as it was. It was wonderful. 

Meagan: Yeah. Yeah. Oh, well congratulations. Congratulations. 

Morgan: Thank you. 

Meagan: Yeah. Let’s talk a little bit about AFI which is the amniotic fluid because you were getting into this space of, “Oh, they’re getting concerned. Oh, let’s admit you. You’re at a 9.” I think you were at a 7 maybe when they were like, “Oh, let’s admit you.” 

Morgan: They started at 9 on the first day. It was like, “You’re at 9. Let’s admit you.” 

Meagan: Yeah. Yeah, okay. 

Morgan: I said, “No.”

Meagan: I’m glad my memory is not too far off. 

Morgan: You’ve got it. 

Meagan: But yes. Let’s talk about that because something that can happen and it doesn’t always happen but it can happen when we’re doing non-stress tests or things like this very commonly in the end is that they’re paying attention to this AFI. Sometimes that is one of the factors that pushes people to being induced. Not push reluctantly, but it’s the ticket for induction for a lot of providers so let’s talk about it. You love numbers and you talk about 5.5. A lot of providers will even say 5-25. 25 is high so after 25, we’re looking at high fluid which is also another concern for providers if we have too much fluid. 

But after 24 weeks of pregnancy, it’s most common for them to measure an AFI. They usually don’t pay attention to it before 24 weeks but they sometimes do after. It is normal for it to be anywhere from 5-25. The question is, okay. Say you’re at 6. Say you’re at 7. What do we do? Do we have to induce? No, we don’t. You are proof of that. We do not have to induce. What can we do to help with amniotic fluid? Are there other ways?

You mentioned drinking Gatorade and water. Definitely increasing your fluid can make a huge difference. We’ve had a client go in and she was actually at 6, just above 5. She was like, “I just want to go home tonight. I’ll come back tomorrow. Obviously, I’ll come back in if baby’s not very active or anything like that.” She went home and she drank magnesium, like Mag-calm, and a lot of fluids. She went back in and it had gone up. It was just above 7 so not a ton, but it had gone up. They were like, “Oh, okay.” She was like, “I feel good about this.” 

She kept doing that. She kept going in for non-stress tests and fluid checks. Fortunately, it continued to stay just fine. Then sometimes it doesn’t and we don’t know exactly why, but hydration is super helpful for upping amniotic fluid levels. Salt can help us retain that a little bit. But yeah. And then getting actual IV fluids. Did they ever offer for you to get IV fluids or anything like that?

Morgan: No. Wouldn’t that have been helpful? Huh. Yeah, they didn’t. I didn’t even think about it. You’re right. That would have been really helpful. 

Meagan: Yeah, so sometimes when we’re ingesting through our mouth, we don’t retain the fluid as much but sometimes via IV, we can and it can be really helpful if we’re dehydrated. I’ve been dehydrated before and I’m drinking, I’m drinking, and I’m drinking but it’s not seeming to help then I’ve gotten into Instacare and gotten an IV and it was boom. Night and day, it felt so much better. That can really improve by getting an IV fluid. So you can be like, “Hey, I want to get an IV fluid. I want to get some fluids.” 

Sometimes, low amniotic fluid can be caused by underlying conditions like high blood pressure or maybe if they’re a diabetic patient. I actually don’t know exactly if gestational diabetes can affect it but I would assume probably. Treating these and checking in with blood sugars and making sure our blood pressure is good can also help our fluid levels and our hydration just by checking in and making sure there aren’t any preexisting things. 

Then if we have moms that are dropping dramatically by 5 points or whatever, that could be something where we just do bed rest. We just chill. Just don’t do anything to exert our body. And then of course except for eating and going to the bathroom, showering, and taking care of ourselves, we aren’t out and about going to Chuck E. Cheese but that doesn’t mean going to Chuck E. Cheese lowers your amniotic fluid, I’m just saying we are literally doing nothing. That can sometimes help increase amniotic fluid as well and of course, stay hydrated. 

Then diet. Diet. Getting more lean protein and whole grains and really fresh fruits and vegetables can also– there’s not a ton of really heavy evidence within this but there is some evidence that shows it can impact your amniotic fluids which is kind of crazy. You’re like, “Oh, food.” But hydration and stuff come through food and it gives back to our body. So anyway, there are others out there and everything but those are some tips on how to raise amniotic fluid and help. 

Like you said, you felt very comfortable, very comfortable where you were at. 

Morgan: I did. 

Meagan: Yes. That’s still another leading factor. We always have to check in with our gut. Always, always, always. Morgan says, “Okay. I’m feeling good about this. I’ve done the research. I know the numbers. I’m a numbers gal. I feel good. I feel good about this.” Look what happens, right? But it is hard. I would love to know any opinion that you have or anything that you would like to share because it is really hard. You spoke about it earlier. Having that conversation and where your research started and learning how to advocate for yourself which you did very much so. 

I mean, it would have been very easy for you to schedule a Cesarean at 37 weeks or it would have been really easy for you to schedule a Cesarean at 39 or 40. But any tips that you have for our listeners to really, truly advocate for themselves? Again, we talked about how we don’t want to go in with our punching gloves. We don’t want to be punching and be combative back and forth but we want to have that really healthy relationship saying, “This is what your practice of obstetricians and gynecologists says. Let’s talk about this. Let’s have this conversation.”

Morgan: Yeah. It was a hard conversation. I would say it was not one that ended in one appointment. That actually made it hard too because you’ve got a 30-minute appointment and you have to stop this conversation and start it a week or two weeks later. But every time, I really thought ahead of time. It was not a spur-of-the-moment discussion point for me. It was one that was planned. I wrote down exactly what I wanted to discuss beforehand so that we could really have that conversation and we could get through it in the amount of time that he had available. 

I do want to still be respectful and respect his schedule. I want to respect the other women that are there that need care as well. I also wanted to hear from him on why he wouldn’t do Pitocin, why he was worried about wanting to be so far in front of 40 weeks, or not wanting to go past 41 weeks. I got the answers to those things. Some of them I agreed with and some of them I didn’t, but really these decisions on pushing the C-section date back to 41 weeks, he ended up being okay with after all of the discussion and me saying, “Look, I don’t care about scheduling. I don’t care if it’s first thing in the morning. You’re assuming that I want to get in on the schedule at 8:00 AM but I don’t. I don’t care about that. If it has to be 3:00 in the afternoon, whatever. I want it to be at 41 weeks. That’s more important to me than an 8:00 AM scheduling of stuff.” 

I did go to the other doctor and get a second opinion but I had to pay that $300 for that appointment. 

Meagan: To do that, yeah. 

Morgan: Right, right. 

Meagan: I love that you mention how it’s so easy on both parties, on the birthing parents' side and the provider’s side to just assume, “You don’t want to fast all day because when you have a scheduled Cesarean, you have to fast so you want an 8:00 AM Cesarean, don’t you?” But it’s so important to say what you mean and where you’re at so there is no assuming. They know. They know where you’re at. 

Morgan: Right. Right. 

Meagan: I mean the same thing with providers. I encourage them to not just assume that the patient wants something but also talk about where they’re at. Like you said, you could have that conversation and be like, “I can see that. I can see that 100%. This is where I’m at,” and then you guys can have that meeting ground. 

It’s so important. It’s really hard, you guys. It’s really, really hard when you are in that space because we don’t want to go against a medical provider. We don’t want to fight. We don’t want to say, “You’re wrong.” That’s just not the position we ever want to be in but if there’s something that’s deeply in your gut and you’re like, “No. This is not what I’ve found out,” or “No. This is not what I’m okay with,” then have that conversation. I encourage you to have that conversation because that is going to better your relationship with your provider. 

Morgan: Yeah, absolutely. 

Meagan: Well, thank you so much. 

Morgan: Thank you. 

Meagan: Thank you so much for being here with us and sharing your beautiful story. I’m sorry that happened at the hospital but I’m so glad that you were able to leave pretty quickly and get back to your family at home. 

Morgan: Yeah, me too. I did not like that. But when I look at everything that happened, it was a wonderful story. I got my baby girl. Our family is complete and I’m just in awe of what a woman’s body can do. 

Meagan: Yeah. Absolutely. We are true women of strength. 

Morgan: Absolutely. 

Meagan: No matter how we birth, we are women of strength. I full-on believe that. Thank you so much and have a wonderful day. 

Morgan: Thank you. You too. 

Closing

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

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When the empowering VBAC experience she envisioned took a hostile and combative turn, Carlise knew she needed to change birth locations immediately. Though signing an AMA was not something she thought she would ever have to do, Carlise found the strength to fight for the birth she deserved. Her thorough research and supportive husband and doula gave her the confidence to not tolerate a doctor’s inappropriate behavior.

Meagan shares the pros and cons regarding AMA forms to help you feel educated if you find yourself in a situation similar to Carlise. While it was extremely difficult, leaving that first hospital during labor was ultimately what allowed Carlise to have her beautiful, unmedicated VBAC!

Additional Links

Carlise’s Instagram

AMA Article

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello, hello. You are listening to The VBAC Link and we have another story for you today. We have our friend Carlise and she is from all over the place but she is in Texas currently. This is where you had your VBAC. In Texas?

Carlise: Yeah, so both of my pregnancies have been here in El Paso, Texas. 

Meagan: Perfect. She had a VBAC in Texas and she had a wild journey kind of similar to a month or two ago, I want to say maybe it was Morgan where she had to sign an AMA and leave while in active labor. We are going to talk a little bit about AMAs today as well in addition to her VBAC because it’s something that we don’t talk about a ton. If you don’t know what AMA is, it’s against medical advice. That is a form that we would have to sign to pretty much say that we are leaving against medical advice but sometimes we are put in situations– and I’ll share a story that I’ve been to as a doula– where we feel that we have to sign these AMAs. 

Review of the Week

In this situation, you signed the AMA and went on to another hospital and had a VBAC and a different experience. So we’ll talk a little bit about AMAs but first, we have a Review of the Week as always. Just a reminder, if you haven’t left a review, we would love your review. You can leave it on Apple Podcasts or on Google. You can just search for The VBAC Link on Google. You can email us at [email protected] or wherever you listen to your podcasts. We love your reviews. 

This is from runnervt. It says, “This podcast helped me get my VBAC.” It says, “I started listening to The VBAC Link to process my Cesarean due to breech presentation. It helped so much to hear women put into words all that I had thought and felt. Then I listened to it in preparation for my VBAC. Today, 8/7/22 and there were times I thought that my VBAC was slipping away but I was able to be prepared and get a little lucky and pushed out my 9-pound baby in 48 minutes with no tearing!” It says, “Thank you so much. Talk about the feeling of being superhuman. Thank you so much, Julie and Meagan.”

I love that, superhuman. You are all superhumans. Birth is just so wild. Wouldn’t you agree, Carlise? It is such a crazy experience but it is so amazing. It is so beautiful. It is crazy to think about how different births can be. 

Carlise: 100%. It’s crazy. 

Meagan: Between one baby to another or say you have five babies and you’re like, “Yeah, this has been the same.” I have a friend who has had her 5th baby. She was like, “Okay. I have had easy peasy births” and all of these things, and her 5th baby was a Cesarean. She was like, “That came out of left field.” It was a whole crazy thing. She was really sick and baby was really tangled in her cord. But yeah. It’s wild. It’s wild to think just how the unexpected can happen so I think it’s so important to listen to stories just like the one that we are going to be sharing today and all of the stories on the podcast so you can get a better grasp and understanding of childbirth, how it looks, the interventions, and all of the things that can happen in childbirth. 

Sometimes it’s really hard to listen to those Cesarean stories for sure because you’re not wanting another Cesarean or if you’re a first-time mom listening to the podcast which we do have first-time parents listening to the podcast, it’s hard to want to listen to those because it’s not what you’re preparing for or it’s not what you think would ever happen but like 90% of us on this podcast, we didn’t think a Cesarean would happen either so it’s so, so, so important for us to learn all of the ways birth can come at us. 

We are going to get to your story but I would love to know if you have anything that you would like to add in the beginning of advice to the parents listening. 

Carlise: I think just doing as much research as you can possibly do and know that you may have some pushback in getting your VBAC or the birth that you want in general. But be confident in that research and also share that with your spouse or your support. Let them know, “Hey, this can happen or these are choices that we might have to make,” so that everybody’s educated and everybody goes in the room knowing what can happen because anything can prep for all of it but you’ve got it and it’ll be fine. 

Meagan: Yeah. Yep. I love it.

Carlise’s Stories

Meagan: Okay. Well, we are going to get into this story but first, I just want to quickly introduce you a little bit more. We talked about how you are in Texas but you are from a small town in Missouri where you met your husband right after high school which is so awesome. You have been married for six years. You’ve lived in Alabama, Germany, and now Texas. You are a stay-at-home-mama providing stability for your girls. You have the two girls. What are their ages?

Carlise: My oldest daughter is two and we just had Amelia last month so they are almost exactly two years apart. 

Meagan: Two years apart. That is so awesome. Your husband is an Active Duty Pilot?

Carlise: Yes. He flies Apaches.

Meagan: Yes. That’s so awesome. That’s really, really cool. I am so grateful to you for being with us today and I would love to turn the time over to you to share your VBAC story. 

Carlise: All right. My first pregnancy was super uncomplicated. There weren’t any issues throughout the entire time. We actually got pregnant in Germany and then when we were PCSing or moving back to the States, I was 17 weeks. We didn’t have any issues. Then we got to about 34 weeks and baby was breech. They were like, “No, no. It’s good. It’s good. Baby can flip, whatever.” 

I’m over here planning my vaginal birth, no problem. I have all this research done and then 35 weeks, still breech. 36 weeks, yep. Still breech. They gave me all of the things. ECV, moxibustion, Spinning Babies, and chiropractic care, but it was right in the middle of COVID so I couldn’t do chiropractic care. I couldn’t do acupuncture. I tried all of the things but she just wanted to be like a little taco. She was my little frank breech baby. 

We scheduled a C-section for 40 weeks. She wanted to come at 38+4 so we had gone in because I had a very, very slow leak. It was slow enough to where I was like, “Okay. Is this my water? Is it not my water?” Yeah. Sure enough. 

So when we got in, we had to wait a few hours because I had eaten that morning. We had a pretty uncomplicated C-section. The spinal took multiple different tries so that was horrible. The drain was at my collarbone so I didn’t get skin-to-skin after. All of the medication just made me super foggy and I straight up don’t remember the first two hours of my daughter’s life. I don’t remember latching her for the first time. It’s still really rough because that’s not the experience I wanted at all. 

Meagan: Right. 

Carlise: So when I got pregnant again 14 months later, honestly I walked into it a little naive because when I had done my research for my first pregnancy, I knew I wanted that vaginal birth. I had seen information on VBAC a lot actually when I was doing some of my research. I just kept seeing that it was a good thing. It was recommended by ACOG or whatever so I just thought that that was normal. 

Meagan: You didn’t even question it. You’re like, “Okay, great.”

Carlise: I didn’t even think about it. When I was trying to make my appointment on post because we have Tricare Prime and you have to be seen on post. They were like, “Yeah, no. We can’t get you in until you’re 17 weeks pregnant.” I was like, “No. That’s not going to work.” They pushed me into the network off post and that’s actually kind of what I wanted but little did I know, the military hospital is the most VBAC friendly. I didn’t know that at the time. 

I had chosen an OB that everybody was like, “He’s great. He’s so good.” I was like, “Awesome.” At my first appointment with him, he sounded so supportive. He was like, “Yeah. You sound like a really good candidate.” He looked at my OP report. I was feeling really good about it. 

Then every consecutive appointment with him, I think I had three legit appointments, he just kept saying, “C-section this. C-section that. Whenever you want to schedule a C-section–” and I’m like, “Yeah. I have a sneaking suspicion that this is going to be a bait and switch here.” 

Meagan: Which is a terrible feeling. It’s not a fun feeling when you’re like, “Why is everything switching?” 

Carlise: Especially when he sounded so supportive, it was so disappointing, and then having to switch at 20 weeks, you’re like, “Okay, great.” Then, the anatomy scan that he did was literally less than five minutes. We both know that is not an anatomy scan. He pointed out major features. He didn’t look at the spine. He didn’t look at the heart. He didn’t look at any of these things. I was just feeling so uncomfortable with my care so I was like, “Yeah, no. I think I’m going to be done.”

I was interviewing doulas and my doula had asked where this doctor delivered. I told her. The two hospitals that he delivers at have the highest rate of C-sections in the area as well as really, really bad reputations for episiotomies. Hearing her stories from being a doula at those hospitals was not great. I was like, “Okay, yeah. No, I’m going to switch now.” 

I talked to her about where she recommended and she’s like, “Honestly, on post. If you can get back on post, that’s going to be the most recommended but if you can’t,” which I wasn’t able to, the university hospital was going to be the second best place to get the VBAC. I switched my care. My pregnancy was super uncomplicated again. At the university, I never saw the same doctor which I really didn’t want but I was just like, “Whatever. I’m going to do this whether or not I have a supportive provider, so it’s good. You’re just here to give me prenatal care.” 

They were definitely more tolerant than fully supportive. They kept saying at every single appointment, “You’re going to get an epidural, right? You’re going to get an epidural.” I was like, “No.” They’re like, “Okay, well it’s just in case.” I hear that a lot.  But no, I’m planning on going unmedicated. They just kind of left it. 

Then we got to about 38 weeks and my doula had called me. She’s like, “Hey, I just had a horrible experience at UMC. The nurses were really pushing back at everything that this first-time mom had wanted.” They didn’t treat her well and it just sounded super, super iffy. She’s like, “We can obviously still go. I just want you to be prepared that it might be something that we could encounter.” The whole time, I was like, “I just want to go to the military hospital.” I had my daughter there. I was really comfortable with the staff. I really liked their care. So I was like, “You know what? We’re just going to go to the military hospital in labor.” She was like, “Okay, cool. Sounds good.” 

So that’s what we ended up trying. One day before 40 weeks, I went into labor super early in the morning. It was 1:30 in the morning. They were very odd contractions. It was like a rollercoaster for 24 hours. They started at ten minutes apart and then six but they would bounce around. They weren’t consistent at all. That just happened forever. I was just like, “I just want to be done.”

Meagan: You’re like, “I’m tired.” 

Carlise: I was so tired. I was trying all of the things like the Miles circuit and curb walking, playing with my daughter, and trying to rest. Nothing was working. My doula was like, “Do you think it’s a mental block? Do you think there’s something?” I was like, “No, I feel good. The TENS unit is amazing.” I baked a cake while I was in labor. I was just like, “I don’t understand.” She’s like, “You’ve got this. It’s fine. It’s going to progress. Just try to rest as much as you can.” 

Then it was at 40 weeks at 1:30 in the morning that we started progressing a lot quicker. I was at 6 centimeters and I was like, “Yeah, I’m going to call the doula.” My husband ended up calling and while he was on the phone with her, they were just getting really, really intense. He was like, “Yeah. I think we’re ready for you to come.” 

She started making her way. It was about a 45-minute drive. At about halfway for her, she calls and she’s like, “You know, Carli sounded like she was ready to go. Is she progressing?” Doug was like, “Yeah. It’s getting serious.” 

She’s like, “Okay. Let’s just meet at the military hospital. Let’s meet there. I’ll meet you at the parking lot.” We go ahead and make our way over there. It’s about a 15-minute drive so it’s not too bad. 

She gets there at the exact same time that we do. The doula had also let the hospital know that we were on our way. They were already expecting us. When we got to the L&D, the nurses took me back. They did all of the normal blood pressure. They hooked me up to the monitors. They asked me why I had decided to go to the military hospital in labor. I gave them my whole explanation and they were like, “Yeah. Okay, sounds good.” They were super nice and very supportive. I had also taken all of my labs with me, the GBS strep results, and all of the things as well as printed out my post-OP report for them to have as quick and easy access. 

Meagan: Which as a side note is always good to have even if you’re not planning on going to another hospital because you never know if a precipitous labor happens or anything but it’s really nice and usually providers enjoy having that. It brings comfort. 

Carlise: Yes so that’s why we brought it. They also had seen that I had been in triage two weeks before because my daughter wasn’t moving as much. I decided to go there so that way they could check the baby and also have me in the system already. I had talked to a doctor as well about coming there in labor. They asked me all of the things like if I knew the risks and benefits of VBAC, just took some medical history, and were very supportive. They were like, “Yeah, absolutely. We don’t mind you coming here in labor at all.” 

I felt so confident. I felt so confident going in. The nurses had been like, “Okay, cool. Sounds good. Are you wanting an epidural? Are you wanting an IV?” I was like, “No. I don’t want an epidural. I just want a heplock. I’ve been able to keep down fluids and everything so I’m not having any issues with that. I just want a heplock.” They were like, “Cool.” So very supportive and nice nurses.

They were like, “Okay. We’re going to get your support.” They went and got my doula and my husband and then they did a cervical check. At this point, my contractions were three minutes apart and very consistent. When they checked me, I was at 4 centimeters, 90% effaced, and -1 station. Baby was still up there a little bit. They also noticed some decels on the monitor. I was on my back and I was so incredibly uncomfortable. My daughter did not want me on my back. Every time I was on my back, it was awful. 

We had asked the nurses if that was a possibility and they were like, “Yes, but you bought your ticket for admission because of those decels.” We’re like, “Okay, no problem.” We were expecting to get admitted anyways. So then the nurses were like, “Okay, we’re going to get the doctor but I want you to know that he’s very military.” My husband, my doula, and I are looking at each other and we’re like, “Hmm. That’s a weird way to describe a doctor. Okay.”

We were just expecting very blunt and very upfront. While we were waiting, I was just so uncomfortable so I got up beside the bed by the nurses’ station and was just rocking. I was having a really hard time with my contractions at this point. My doula came up behind me and gave me hip compressions. 

Then the doctor comes in. He doesn’t introduce himself. He’s not like, “Hi, how are you guys doing?” Literally nothing. He goes over to the doula and just goes, “And who are you?” The doula introduces herself and he’s just going on and on about how she’s in the way. He’s yelling at her like, “You’re in my way. You can’t be in my way. You can’t be in front of medical equipment.” She’s just helping me with a contraction so he’s not even recognizing or caring at all that I’m having contractions and that I’m in pain and she’s trying to help me. He’s just more concerned that she’s in the way. 

So then she moves beside the bed and he looks at her and goes, “After the exam, we’re going to have a chat.” We’re like, “What is with this dude? Why is he being so aggressive?” So then the first thing that he says to me again just in a very disrespectful tone is, “Why are you here?” I’m like, “What a weird question to ask someone in labor.” I was like, “I’m in labor.” He goes, “No. Why are you at this facility when none of your prenatal care has been here at all?” 

The nurse was trying to tell him because again, I’m having contractions pretty often but no. He wanted all of the answers from me. He was just being so aggressive and I told him the whole explanation that I had already told the nurses. I also mentioned, “You’re being really, really combative. You’re making me uncomfortable.” He’s like, “You know, I’m not trying to. That’s not my intention, but you need to understand the position that you’re putting me and this hospital in by changing your care at 40 weeks.” 

I was like, “Okay. I’m sorry, but I’m already here.” He just goes on for 30 minutes about how we’re putting him in a precarious position and we need to understand this. We need to understand that. We don’t have your records. I was like, “Dude, I brought you all of my labs. I brought you my post-op. What else do you want? What else do you need?” 

Again, he just keeps going on and on. Eventually, my husband was just like, “Okay, man. What do you need from us? Do I need to go to the other hospital and get your records? Can you request the records or can we just move on because we are getting nowhere?” The doctor was just like, “You need to understand.” I was just like, “Dude, we get it. We understand.” 

After that, he was like, “Okay, well I need to see if you are intact” which is a very weird way to say that he needs to check my waters. For some reason, I just had the fog. I knew that it was a swab. My doula was like, “It’s okay. It’s just a swab. They’re just going to swab you to see if your water broke. It’s not a big deal.” The nurses are like, “We’re pretty sure that her water hasn’t broken yet.” He’s like, “No. I need to check myself.” 

So they’re prepping the swab and then my doula hears him ask the nurse for lubricant. I could have sworn that he said something about a speculum but I’m not sure about that. My doula was like, “Hey, Carli. Do you consent to a cervical exam?” I was like, “Wait, no. No, no. I do not consent. I just had one not even ten minutes ago. So, no.” 

So then the doctor starts yelling at the doula again and saying, “Stop. You don’t give medical advice.” Then I’m having a contraction and he’s accusing her of making medical decisions, of moving me before the doctor came in the room, but he didn’t like that I was beside the bed standing up. He thought that she did that. So then after the contraction, I was like, “Dude, no. She’s only acting on my behalf when I have asked her to do something. You really need to back off. No. I do not consent to a cervical exam.” 

So then he explains why he wants to do a medical exam. 

Meagan: Again, you had just had one not long ago. 

Carlise: Right, exactly. 

Meagan: A little backstory, guys. I was reading this story on social media and I remember when I was reading this, I was like, “Why? Why? Why?” Every time, in my head, I’m like, “Why do we need to do this? Why do we need to do this? They just did this.” I was putting myself in your situation. 

Carlise: It was so aggravating. The fact that he was prepping the cervical check without talking to me first. The doula had to mention it. You’re like, “Okay, that’s a super big red flag. Thank you for letting me know,” because if she wasn’t there, my husband would have no idea. So he explains why he wants to do a cervical check again and I’m like, “No. I don’t want a cervical check.” 

So then he goes and sits down, stops prepping any exam at all, and he’s like, “I’m a really good doctor but I need to be able to do my job.” I’m like, “Dude. I already said that you could do the swab to check my water. I’m not refusing your care. I just don’t want a cervical exam.” 

He’s like, “No. You’re refusing my care. I have to do both in order to–”

Meagan: Make an assessment. 

Carlise: Make a decision. I was like, “Okay. I’m really uncomfortable with your insistence here. I want a new doctor. You’re not listening to me. You don’t seem to care that I’m having contractions every three minutes. I want a new doctor.” He goes, “There isn’t one.” I’m like, “What?” He’s like, “Yeah. I’m it.” So then the doula was like, “Okay. There has to be somebody on call. Can you go ahead and call them in?” So then he says, “Stop” again to her and says, “I do not engage with you.” 

I was like, “Okay. I’m going to repeat the question. Can you call the person who’s on call please?” He was like, “No, there isn’t anybody on call. It’s just me. The next provider doesn’t get in until 8:00 AM.” At this point, it’s around 4:00ish. I was like, “Okay. Can I just labor with the nurses? Because you’re not touching me.” 

Meagan: And the nurses were being so great. 

Carlise: They kept trying to interject and answer questions for me but he wanted the answers from me. At that point, I was like, “Okay, dude. Just get out. Everybody needs to leave. I need to talk to my doula and my husband.” 

They go ahead and leave. I’m like, “Okay. I don’t know what to do.” I’m freaking out. My doula was like, “It’s okay. You’re fine. We can stay here and deal with this dude. We can go ahead and just leave and go home. Your contractions are probably going to slow down since we’re dealing with this or we can go straight to the other hospital.” I was like, “Okay. Let’s definitely just leave. I’m done.” 

We told him that we were leaving and he just seemed shocked. 

Meagan: I’m sure. 

Carlise: Just completely shocked. I was just like, “No. We’re leaving.” So then they were like, “You have to sign out AMA then.” I was like, “Cool. I’ll go ahead and do that. You’re not touching me.” We went ahead and signed the paper. As we were walking out, I’m having to stop every minute. The doula is like, “Okay. Yeah. We’ve got to go straight to the hospital.” 

We ended up, and in mind fog, I was like, “I forgot my birth plan so we’re going to run home real fast. I’m going to get my birth plan.” That turned into an F-1 pitstop because I’m over here with really, really low sounding and having a rough time. Doug, my husband, is also freaking out. He’s like, “We’re going to have a car baby.” 

Meagan: Oh yeah, I’m sure. 

Carlise: He’s just panicking. So he’s speeding on the way to the other hospital. We get there and I had never gone through that entrance before. I had always gone in a different one on the back because my prenatal care was with Texas Tech and UMC, they’re right next to each other. So I always went into a different entrance. 

So the entrance that we went into, I had no idea where to go. I’m over here. I swear I’m about to push and we don’t know where to go. This super nice lady who was coming into work was like, “Do you guys need a wheelchair?” Doug was going to say no! I’m like, “Yes. Yes, I do.” 

So she gets a wheelchair. She brings us up to triage. As soon as we get up there and there was a trash can right next to the elevator. I’m just throwing up right next to the elevator. They’re trying to get Doug to fill out paperwork and have me sign things. I’m just kind of dying. Then I needed to go to the bathroom. I didn’t need to push. I just needed to go to the bathroom. 

I go in there and my water breaks. My plug comes out. So then I’m just gripping the walls. I’m just blinded here by my contractions. So they get me into a triage bed and they’re like, “Oh yeah. Yep. Mhmm. She is ready to go. She is fully dilated. Baby is definitely ready.” The doula is over here like, “Okay, yeah. We need to switch her bed too.” So they switched me into a labor and delivery room. She’s calling all of the shots here because the lights were so bright. I’m over here like, “Oh man.” So she’s like, “Okay, those lights need to be dimmed. We need to take this gown off of her.” 

She was taking off my TENS unit. They’re trying to put on monitors and I’m promptly trying to take them off so just being very unhelpful which I did not care about. So then they were trying to get the monitor on to check the baby. I was on my hands and knees which they did not want me on. I did not care. The doula is trying to help so she had reclined the bed so that I could lean over it so that way they could get the monitors on. That actually ended up working super, super well. 

Then I was feeling the need to push. Then I was just really self-conscious because I was feeling like I needed to poop. I was just like, “Oh no. This is horrible.” She’s like, “No, that’s normal. It’s fine.” I was like, “No, I actually think I need to go.” So she’s like, “It’s fine. They’re going to catch it. Don’t even worry about it. Just focus on the baby right now. You’re okay.” She snapped me out of it. I was like, “Okay, we’ve got this.”

I was pushing and they were like, “No, no, no, no. The doctor’s not in. Don’t push. Don’t push yet.” I was like, “I’m not not pushing so y’all need to figure it out.” So then the doula’s over here like, “She’s crowning. Baby’s crowning right now.” Then they’re just rushing in and I could feel the ring of fire. I was like, “Okay. I need to pause for just a minute,” because I could feel if I kept going that I was going to tear up. I honestly loved that I could feel that versus having an epidural and not being able to feel that. 

Within another couple of pushes, baby was out and I didn’t have any tearing. I didn’t have any issues at all whatsoever. I did not get the Pitocin for the delivery of the placenta and I didn’t have the IV. I didn’t have anything, just honestly the most natural birth except for the hospital situation. 

Meagan: Yeah, yeah. But no interventions other than maybe a cervical exam here and there. 

Carlise: Exactly. It went super well honestly overall and I was so proud of myself because I was just like, “I did that and I was able to advocate for myself.” My doula was amazing. My husband was very supportive even though he was freaking out. 

Meagan: Oh I’m sure. Yeah. 

Carlise: He told his dad. He’s like, “It was super, super intense. The last couple of pushes, she sounded like a banshee and then baby was out.” I was like, “Wow, babe. Thank you. Thanks. That’s super sweet of you.” The nurses afterward kept coming in and they were like, “Okay, we need to drain your IV and we need to check your stitches.” I’m over here like, “No guys, I don’t have any of that.” They’re like, “Wow, okay. You’re the easy patient.” 

That birth, I was able to feel her before she came out. That was amazing. She got right on my chest. Delivering the placenta was super easy. I love that I can remember it and I’m proud of myself. The first thing that I said after birth was very colorful which definitely included, “F that doctor” which we then had to be like, “No, no. Not you, ma’am. Sorry.”

Meagan: Yeah, yeah. I can relate to that one because that’s what I said. I said, “Screw you,” and then I named the doctor. Take that. 

Carlise: Mhmm. I was just amazed and then everybody that I tell when I’m like, “Yeah. I left the hospital at one-minute contractions,” and they’re like, “Oh, no.” I was like, “Yeah, no. I would rather have had a car baby legitimately–”

Meagan: –than to go there. 

Carlise: Absolutely not. I was so disappointed and the fact is that’s what we encountered. We put in all of the complaints that we could possibly put in and I’m still waiting on the head of OB to contact me but the doula had a really, really good meeting actually with the head of OB, a lot of the staff, the provost marshall apparently was in there as well. 

Meagan: Wow. How did she connect? How did she go about doing that? 

Carlise: Apparently, with doulas, there is a different system for them. I’m not entirely sure but there are different routes that they can go because they are professional birth workers. She had contacted the head of OB and then the head of OB was like, “Okay, this is really serious.” So I think they just coordinated together. The end of that resulted in a giant meeting with all of the OBs to basically educate them on what to do when a doula comes in. 

Meagan: Oh wow!

Carlise: And that doctor that we encountered has to go to those meetings. My doula’s teaching it. It’s a class. I was like, “Yeah man. You’re going to deal with that.” 

Meagan: That’s actually really cool to help that space be a little bit more collaborative because I feel like we are a little spoiled here in Utah. People are like, “How do the doctors treat you and handle things when you are in there?” Usually nine times out of ten, it’s very friendly and it’s not hostile like that but if it were, I think that we would probably want to be doing something like that as well and say, “Hey, we are all here for this patient. We are all one team here. We’re not here to be combative and create trauma emotionally.” That’s really cool. That’s really awesome. Good for your doula. 

Carlise: Yeah. I was so proud of her, especially being yelled at by a doctor. 

Meagan: Yeah. Yeah. 

Carlise: She’s trying to advocate for me as much as she can but she also doesn’t want security called on her so she was having to find a balance between that. 

Meagan: And she doesn’t want to make it any worse for you. 

Carlise: Exactly. That was super, super odd. The fact that I meant to mention it in my story, but he had been quizzing me over VBAC facts, then he was telling me that I was wrong. I was just like, “What?” and just freaking out. She just helped me so much. I’m a huge advocate for doulas and having one and I 100% recommend anybody to have one for sure. My husband would have had just no idea exactly how to advocate for me in the way that my doula had. It was great. 

Meagan: Yeah. Yeah. I feel like there are so many benefits of doulas but just like we were saying, she helped him too. She helped him through this process I’m sure to feel more comfortable and at ease with the things that were taking place. Even that alone whether you had a lot of help with counterpressure and stuff like that but being able to have a sounding board and someone there that you feel is on your team and it’s not you two against one person. I’m sure that brought so much comfort to him. 

Carlise: 100%. The fact that the doula had also done some childbirth education with him so that he knew how baby comes out and the different stages as well. 

Meagan: Yes and then when you have a provider questioning the facts around VBAC and you’re saying this and then they’re saying no or they’re shutting you down or they’re giving you false percentages which I know is a thing, that can be really, really scary if a partner is not educated or doesn’t know ahead of time. So that’s another really great pro of doulas is that they usually meet with you before, counsel, and go over all of those stats. 

I remember the feeling. I literally was on the treadmill walking, trying to pass the time because I hate the treadmill, reading your story and I’m like, “Oh my gosh. This is just so intense. It’s so intense.” 

Carlise: It was nuts. When I was trying to prep my husband for the VBAC, I’m pretty sure he just got really annoyed by me listening to this podcast all of the time. I’d be like, “Babe, you should have heard this from this mom.” He’s just like, “Ugh, I can’t wait until you’ve had the baby because I’m so done hearing about all of these VBACs all of the time and all of these stories.” But then honestly, it prepared him. I was like, “Babe, this can happen,” so when we were facing this doctor, he wasn’t second-guessing me at all. 

When I told the doctor the different things that I knew about VBAC because he wanted to make sure that I knew, Doug was like, “No. She definitely knows the stuff. She could spout this off normally.” He was confident. That made me more confident and with my doula being there, it helped a lot. 

Meagan: That makes me smile. I love it. Now you can be like, “Yeah, now I’m one of those people on the podcast.” 

Carlise: Mhmm, yeah. He was like, “I get to hear this story for the 35th time.” 

Meagan: I love it. 

Carlise: I was like, “Last time, babe. Last time.” 

Meagan: Last time. Maybe, maybe not. You’ll be sharing it for years. You’ll be sharing it for years. 

Carlise: Exactly. 

Meagan: Well I want to talk a little bit about the AMA, the Against Medical Advice form. It is one that like I said, maybe I’m crazy. It might have been a year ago actually that we talked about. It’s not one that happens often or that people maybe even know exists. I just want to give a little side note. It’s not something I suggest always doing like, “I’m just going to sign this AMA.” Against Medical Advice forms are taken pretty seriously but when you are in a combative, hostile environment, an AMA may be something that can get you out of that experience. 

I, as a doula, was at a birth where a mom chose to sign an AMA. From a doula’s standpoint, it was really interesting. I was like, “I would have totally done that too as a mom.” We were very much in labor. It was very clear that we were in labor but the toco, the monitor, wasn’t picking up the contractions. 

This doctor comes in very rudely and says, “You’re not even contracting. I don’t even understand why you’re here.” She looks at me and her husband. She’s like, “I’m contracting, right?” We’re like, “Yeah, you’re contracting. You’re doing really great.” They’re like, “We’re probably just going to send you home anyways so we can just sit here and wait,” and just was very rude, questioning her, and pretty much saying that she was not even in labor and that she was over the top. 

Carlise: Oh, lovely. 

Meagan: This one doctor that came in was like, “You are just highly sensitive and being overdramatic. Maybe you should learn how to cope better because you’re not even contracting yet,” and just talking down and being very rude. She’s vomiting. She’s shaking. She is clearly laboring. They leave and she turns to us and says, “What other hospital takes my insurance?” As a doula, I wasn’t expecting that but at the same time, I should have expected that because of how rude they were to her. I said, “Well, this hospital and this hospital.” She rips out her IV because they had given her an IV for fluids for vomiting. She ripped it off, was holding her arm, and was like, “Let’s go!”

Carlise: That’s intense. 

Meagan: I was like, “What?!” She was literally holding her arm and she was like, “I am done.” Her husband was like, “Me too.” They were getting her dressed and as a doula, I’m like, “Okay. I go where you go.” 

Carlise: Man, all right. We’re doing this now. Okay. 

Meagan: She’s walking out and they’re like, “What are you doing? What are you doing?” They’re freaking out and she’s like, “I’m leaving. I am going somewhere else to have my baby. You said that you were going to send me home anyways so I am going home.” They were like, “We’ll have to have you sign an AMA.” She was like, “Where do I sign?” They were like, “Oh, but your insurance won’t cover this.” 

Carlise: Mhmm, yeah. Okay. 

Meagan: She was like, “I don’t care. I’m signing this AMA.” We went. We were 6.5-7 centimeters when we got to the hospital and had a baby a couple of hours later. Dad caught the baby. It was a beautiful, beautiful experience. 

So AMA, what does that mean? It’s really leaving the hospital without the physician’s advice before they decide to discharge you. It says right here in a NCBI which we will make sure that this is in the show notes today if you want to read a little bit more. But it says, “Leaving a hospital against a physician’s advice may expose the patient to risk of an inadequately treated medical problem and result in the need for readmission.” 

That is important to remember, that we as parents know that. We are signing this form and we are saying, “We assume the risk of us leaving because we are leaving against your advice,” but I also think it’s important for us to know and follow our mom's gut to be like, “I’m just going to have this baby and do this.”

Carlise: 100%. 

Meagan: You have to think about it. If you are in an AMA situation, you want to really think about it. You want to weigh out the pros and cons and you want to be educated. If you’re listening to this podcast, you’re definitely starting your education because as you mentioned, you learn along all of these stories. But it’s a big thing. The article says, “The problem with AMA discharge is the prevalence of risk and costs. It can formulate recommendations of managing and preventing them on the basis of available evidence.” That’s so hard because they can say, “Well, this happened because you left,” or even the cost of insurance. 

They can say, “Oh, well we won’t do this because you left against our advice.” So it’s important to definitely learn more about an AMA and why you would sign an AMA but know that an AMA exists because if you are in a hostile environment, it’s probably not a healthy one. 

Carlise: Right and that was my thing too. I didn’t feel safe with this care provider and then being told, “No, there isn’t another provider,” I feel like there are going to be so many more interventions and so many things that are going to be done without my consenting because obviously, they already tried to do that once. I would rather sign an AMA and leave than to have you touch me and cause issues that shouldn’t have been caused at all. 

Meagan: Yeah. Yeah, exactly. I think it’s important to know that it exists and then know the pros and cons. It’s just one of those other things. Know the pros and cons of signing an AMA or what that entails and then having that backup plan. But just know that it exists because for the client of mine, she was like, “I couldn’t have stayed there. I was feeling so anxious. I was feeling so triggered and traumatized by what they were doing and what they were saying to me.”

She said, “The second I walked into this new hospital, I just truly felt 100% at ease. 100% at ease.” So yeah. It’s so important to feel that comfort, know your options, and look at you. You did! You went and you had an unmedicated, no-intervention VBAC. 

Carlise: Yeah. Honestly, it’s been amazing. The recovery has been fantastic and I am so proud of me and every mama who has had a VBAC and had to fight for it. That’s just awesome. 

Meagan: You should be so proud of yourself. Congratulations. Thank you for coming on and sharing this story. I also want to end with a preface by saying that sharing this story is not to bash an OB or anything like that. 

Carlise: 100%. 

Meagan: It’s not anything like that because OBs are great. I’m sure he was caught off guard. He had his stuff but at the same time very much acted in a very unprofessional way. 

Carlise: Absolutely. 

Meagan: It’s important to know all sides of things. 

Carlise: 100%. Absolutely. 

Closing

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

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Brittany’s first C-section came after a long and exhausting pushing phase with no progress. Her second C-section came after providers gave her a 50/50 chance of VBAC success due to the VBAC calculator. Brittany chose a repeat Cesarean for the comfort of a controlled environment following multiple traumatic pregnancy losses beforehand. She did not expect another horrible recovery with an elective Cesarean, but it was even worse than the first. 

Brittany immediately began devouring all information about VBAC after two Cesareans even before her third pregnancy. When she became pregnant, she found an extremely supportive provider 2.5 hours away which proved to be the best decision she could have made. 

Her VBA2C was everything she hoped it would be– raw, difficult, beautiful, redemptive, and empowering. Right after that birth, she wanted to do it all again! 

Additional Links

Brittany’s Instagram

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

 Meagan: You are listening to The VBAC Link Podcast and this is your host, Meagan. I am always honored to be on this podcast with you. I love the listeners. I love the storytellers. I love the reviewers. We just love everything about this community and I am excited to bring a VBA2C– I’m not even going to be bringing it actually. Our friend Brittany is going to be bringing it. We are having a VBAC after two Cesareans story. Our most requested podcast topic is VBAC after multiple Cesareans, specifically two. 

We know how hard it is to find providers to support a VBAC after multiple Cesareans even though ACOG themselves says that VBAC after two Cesareans is totally acceptable and reasonable to go for. It’s really hard and it’s frustrating. I know as a VBA2C mom myself that it’s so frustrating. It’s so frustrating, right Brittany, to feel total defeat over and over again, being told that you cannot, you should not, and being filled with horror stories. I mean, all of the things. It’s so frustrating and this is why we are here. We are sharing these stories. We are letting you know that you can. It is possible. 

It might not be easy along the way and you’re going to hear today in Brittany’s story that it’s not easy but it is possible. So we have our friend Brittany like I mentioned. She is from southern Minnesota. She has been through quite the journey which she is going to share with you. If you want to know what some takeaways will be from this episode, one thing is finding that supportive provider just like we were talking about. It’s so important. It’s so key but we know that it can be challenging being rejected multiple times and being told no, and then not finding a supportive provider until the very end of pregnancy. 

You guys, this is something that I want you to know. If you are not feeling like you are being supported, if you are feeling or seeing the red flags, if something in your gut does not feel right, you are not stuck. You do not have to stay with any provider because they saw you for 34 weeks, 28 weeks, 40 weeks, 41 weeks, or even 42 weeks. You are not stuck. You can change. It’s not always easy and we understand that, but you always have options to change. You can fire a provider at the very moment. 

We don’t necessarily encourage you to fire your providers. I don’t want to make it sound like, “Fire your provider!” but you can. If it’s not feeling right, if it’s not a good mix, you can say, “I would like to request a new provider at this time,” or you can start finding it through so many amazing resources like right here at The VBAC Link. Women of strength, if you are looking for a provider, write us. Go join our VBAC Link Community. We have a whole list of providers on there that have been known as supportive. I can’t tell you. I’m just here in Utah. I’ve not met all of these providers. I’ve not talked to them. I’ve not interviewed them. These are providers that are being suggested by our other women of strength who have truly gone through this experience and believe them to be VBAC supportive. Their names are being compiled on this list for you all over the world not just here in the U.S. as guidance for you to help you find a supportive provider. 

So go to The VBAC Link Community on Facebook, answer the questions, and go check it out. And if you are listening today to this episode, please PM us on Instagram, Facebook, or [email protected]. Tell us who your supportive providers are. If they are not on the list, we want to get them on. If you are a supportive provider listening, we want you on this list. It is so important and we as VBAC moms ourselves, and Brittany, I am sure you will attest to this. It is so important to have that provider on your side. It is so important. 

Review of the Week

Okay, I will jump off my soapbox and we will get to our Review of the Week so cute Brittany can share her stories. This is actually on our How to VBAC: The Ultimate Prep Course for Parents. Parents, if you didn’t know, we actually have a VBAC prep course for you. It’s filled with information on the history of Cesarean, the history of VBAC, the pros and cons, how to VBAC, and how to find these supportive providers. We will provide you with a lot of printables and things to take along with you on your journey to make sure that you’ve got the perfect team and that you feel confident in the birthing choice that you are choosing. 

This says, “This course was so helpful, especially with helping to educate my husband on the safety of VBACs. As he had previously been nervous about my choice, we watched all of the videos already and will also be reviewing the workbook again before birth. Highly recommended.” Thank you, Heather, for sharing that review. Yes, just like she said, this course is amazing. We have reading material and then we have a workbook that you can follow along. You can either download it or purchase a workbook to go along with it. We encourage your birthing partners to take this course with you because it is important for them to know this information. So check it out at thevbaclink.com if you haven’t already and we will see you on the other side. 

Brittany’s Stories

Meagan: Okay, Brittany. 

Brittany: Yes. 

Meagan: Thank you so much for taking the time today to share these stories. Like I said, we get emails and messages on Instagram and Facebook in our inbox saying, “Please share more VBAC after multiple Cesarean stories,” because there are times when we go in and we have an unplanned Cesarean and then sometimes we get coerced or we feel that it’s best to choose another one, but then we start learning more and we want a different experience. We know how hard that is. I welcome you and let’s turn the time over to you. 

Brittany: Absolutely. I am honored to be here. I am very excited to share my story. I know am a mama to three babies. I’m going to share a little bit about my C-sections before I move on to my vaginal birth. 

I found out I was pregnant with my first son in 2016. I’m sorry. I had him in 2016. I was actually newly sober. I’m a person in recovery so I was very new to a lot of things in life. I was going to be a single mom and I also was sober so a lot of big changes were going on at that time. 

I was very uneducated about birth, being a new mom, and everything at that time. I was going through so much at the time obviously and then I was nine days overdue which we know truly isn’t overdue but that’s what they say. At that point, I just wanted to have him. I was not educated about interventions or anything like that so I just went with the punches. Whatever the providers and team wanted, that’s what I did. 

I also knew as much as possible, I didn’t want as many pain meds as possible just because of my recovery from substances and I really liked narcotics so I knew that I didn’t want to go down that slippery slope. I allowed them to induce me with two doses of Cytotec. It started working but then they wanted to break my water and I allowed them because I truly didn’t know better or have any information on that. 

I got an epidural super early even though I think I panicked more than anything. I didn’t want to have pain so I just got it not knowing that I was going to have a long labor and being stuck in bed wasn’t going to do me any favors. 

After laying in bed basically for 24 hours, I pushed for two hours. He was not descending. At that point, I was truly done. I was exhausted. I had been up for two days being induced, so we decided on a C-section. He was sunny-side up so that’s what made it more difficult for him to come down which made sense. So he was here. Recovery was rough. I’ll talk about that a little bit more later. 

Fast forward to some time in 2017, I went into the ER. They couldn’t really figure out what was going on with me. I really wasn’t feeling well. Long story short, I actually had an ectopic pregnancy. I was on the IUD at the time so I had no idea that I was even pregnant. It was very traumatic. I went from not knowing I was pregnant then they had to take the baby out. I actually lost one of my tubes at the same time. I had to have lifesaving emergency surgery. I was in the hospital for five days and they couldn’t do it laparoscopically. They did have to cut me all the way open and take everything out. So that was very traumatic and a very big loss. 

Then I met the man that I eventually married in 2018. We experienced an early miscarriage in 2018 as well so another loss. In 2019, we found in late 2018 going into 2019 that we were pregnant with our rainbow baby. At that point, I was very unsure of what I wanted for my birth. I knew how terrible my C-section experience was but I was also terrified of laboring for that long and then ending up with another C-section again. I trusted my doctors. I was listening to them. 

Of course, they did the VBAC calculator and at that time, they told me I had a 50/50 chance. Being that he never descended, they said, “It’s up to you what you want to do” and I had lost two babies. I just wanted a baby here safe so I was like, “You know what? 50/50. Let’s just go with the C-section.” I was hoping that not having that long labor beforehand would really help with my recovery. I just wanted my baby here safely too. With it being my rainbow baby, I just wanted my baby here. 

Meagan: Absolutely. 

Brittany: Yeah. My C-section, the surgery itself went fine with my second son but it was an even worse recovery. I had a severe reaction from the adhesive tape that was on my belly. I broke out completely all over my whole body.  

Meagan: Oh man. 

Brittany: I had shoulder pain and I have high blood pressure so it was very scary to have shoulder pain. It was very scary because I instantly thought of heart problems. It was just shoulder pain from the C-section.

Meagan: It’s usually air actually crazy enough. Air gets trapped. I had that too. I was like, “What is happening? Is this my milk?” They were like, “No, it’s air.” Getting up and walking can really help but it can sometimes get trapped up in that shoulder or even the rib area. 

Brittany: Yeah, so strange. I was so sick and throwing up for 36 hours. 

Meagan: Oh, and with a new incision. 

Brittany: And then I was dehydrated and blacking out from that. It was just an absolute, awful mess. Basically immediately after he was born, I began researching vaginal birth after two C-sections because I knew I never wanted to do that again and I knew we were not done having babies. 

I binged every single episode that you guys have. I couldn’t listen to them fast enough because I knew I wanted all of the information before we had another baby. Even before we were trying, I was doing all of this. I read many books and watched YouTube videos. I was practicing meditation and mindfulness because the mindset is such a big part. I learned about HypnoBirthing and I was also so much healthier. I gained way less weight. I was eating healthier. I was being active and trying to be as mobile as possible to let the baby descend when that time came. 

Like I mentioned, I do have chronic hypertension so I really wanted to keep that in check because I knew that would be a big red flag for everyone. 

So then eventually, we did get pregnant with our third baby. I was still doing all of my research and things like that. At that time, I actually did hire a doula as well. I wanted to do everything I possibly could. She was very supportive of a VBAC after two C-sections. 

So then we started the hunt of trying to advocate for myself. I really worked on relaxing myself just to get in that positive mindset. Initially, where I gave birth to my birth son, they now do some VBACs but they will absolutely not look at people who have more than one C-section and then it’s case by case for just a single. They were like, “No, you either have to go to a C-section or go to the high-risk unit.” I said, “Okay, then send me to the high-risk unit. That’s what I want.”

At 32 weeks, they saw me at the high-risk and complex unit. This was basically to see. They would assess me and see if they believed that I had a fighting chance. My blood pressure at the time was in a great range and I was actually off medication because I was so healthy doing what I needed to do. 

Meagan: That’s awesome. 

Brittany: Yeah, it was great. I advocated for myself with them saying, “I hired a doula. I have a supportive husband. I have done all of this research. I know what research truly says,” and of course, they pull out the calculator. 

Meagan: Oh boy. 

Brittany: It kind of depended. Sometimes it put me at 20%. Sometimes it put me at 40% depending on who did it because of the blood pressure and because of the two repeat C-sections with no vaginal birth before that. They said they would work with me. That was their wording yet they said that they wanted me to have a C-section no later than 38 weeks. 

Meagan: No later than 38 weeks? 

Brittany: Yep, yep. Knowing that my first son came at 38.5 weeks, I knew that was probably not likely. I was also in the mindset that if I went to 42 weeks, I was okay with it because I knew that as long as they continued to monitor things, then it was okay. I knew that if I didn’t go into spontaneous labor myself, so say that my blood pressure spiked or anything like that, they would not do anything to help induce me. No low Pitocin, nothing like that, no breaking of water, nothing. I would have to do it all on my own. I knew that was a huge barrier too. 

Meagan: Yeah. They’re putting restrictions on you already. Listeners, if you are getting, “Yeah, okay,” but then you are getting restriction, restriction, restriction, then it’s probably not the right space. 

Brittany: Yeah, exactly. Those were my first thoughts. If I’m already knowing that these restrictions are being put up, I’m going to hold in more tension even when I come here and just wait for some kind of failure in the process for them to say, “Okay, we need a C-section.” So I truly wasn’t even getting a chance to try. 

I literally left the office bawling with my husband. And of course, my husband is not as educated as I am because he’s not going to be giving birth. He’s very supportive and educated just not to our level but they fearmongered him. They made us, not me because I knew the statistic and things, but he was more worried like, “Are you sure this is safe?” and things like that. I was feeling so discouraged. I was 32 weeks pregnant and I was like, “What am I going to do because I know this isn’t going to work?”

I actually have a very good friend who had her first baby by a C-section and then she had two VBACs after that. She was one of my biggest supporters. She rooted for me so hard. 

Meagan: She was your motivator and in your space. 

Brittany: She had to be induced at 37 weeks with her babies due to being high risk with medical complications and she still did it. She just really gave me hope. We began researching together. She literally lives in a different state and she was researching with me. 

Meagan: That’s amazing. 

Brittany: It is so amazing. That’s what’s great about this community. We found a provider that actually is 2.5 hours away from where I live. I knew it was crazy, but I was like, “You know what? What does it hurt for me to even go and see this guy once?”

Meagan: Listen, it’s not crazy. It’s not. I know it sounds crazy and the world we live in makes it feel crazy to go so far. It’s not crazy. It’s not crazy. It’s just you advocating for yourself and finding what you need for yourself. 

Brittany: I came on Facebook groups with you guys and other VBAC groups specific to our area. I just read testimony after testimony about how amazing and old-school he is. I called and even at this point, I was okay if insurance didn’t cover things. I just wanted this. He’s a different breed. He’s a lone wolf, one of those very rare people that we find. I made an appointment. I believe it was for about 34 weeks so it was still a couple of weeks away. 

When the appointment came, I actually had influenza so I had to cancel it. I was like, “Oh my gosh. Everything that could work against me is working against me.” I said, “Nope. At his next appointment, I’ll go.” I went and he had my medical records but he barely looked at me and he was like, “Yep. We’re going to do this.” He was so positive. 

Meagan: Wow. Wow. 

Brittany: Not that we were going to try, but that we were going to do this. That was great. I continued to go to appointments weekly until post baby’s due date. But also he was not naive. He told me the risks of both very realistically but not in a scary way. Just like, “This is what it can look like.”

Meagan: These are the facts, yeah. 

Brittany: The clinic has just a small-town, homey feel. It’s truly about the patient. It’s not like we are just another number. Truly at the end of the day, he gave me the empowerment that not only was I going to do this but he was going to allow me to try. That’s all I wanted was to be able to try this and to have hope in myself. 

At 38 weeks, we discovered that my blood pressure had skyrocketed. The next day, it continued to be so they monitored me for a little while. I’m also 2.5 hours away so they kept me for a little longer. The next day, it continued to be. Being that I was in a safe zone, the doctor said, “Would you be okay if we did a slow induction?” At that point, I trusted him even though I truly barely knew him. He gave such good vibes. My husband loved him. I said, “Absolutely.” 

I was completely closed so it did not seem like any baby was coming anytime soon from looking at it. At 7:00 PM that night, they inserted the Foley bulb to help me dilate. At 8:00 PM, my body actually took over and I had some major contractions. My job for the night was to rest, let the bulb do its work and just mentally get in the mindset that we were going to be in labor the next day. 

In the middle of the night, my COVID swab came back positive even though I had no symptoms. 

Meagan: Oh no and you had just gotten over influenza. 

Brittany: Yes. That was very interesting. My doula, this was the one weekend that she was unavailable of course, so she had her sub-doula available but she couldn’t come in because of COVID. She was only available by phone which was a bummer but we made it through. 

12 hours in the next morning at 7:00 AM, the Foley bulb was removed and I was 4 centimeters. That was great because with my first son, I had already gotten the epidural and I was panicking at that time. I was already in a great mindset. I was managing the discomfort so great. 

He started the Pitocin super slow and low. That’s what he’s known for, starting it super low and slow at the smallest amount possible. The baby’s heart rate had some decels so they turned the PItocin off for a while, no panicking. They were just going to go with the flow. 

At 10:00 AM, they broke my water. We just hung out. I was feeling good. My contractions picked up on their own without that Pitocin ever being restarted. My body began doing it with that very little bit of intervention. At about 1:30, I began struggling pretty badly with pain and pressure. I stated, “I want an epidural.” Everyone knew that I didn’t want that so I said that I would wait another 15 minutes and give it a minute. I still wanted it 15 minutes later and I knew in my mind that I was holding so much tension in. I just couldn’t let it go so I was like, “You know what? At this point, let’s do the epidural.” 

We did it. As soon as the anesthesiologist came in, I knew that I made the right choice. I was already feeling that relief that I was going to feel from just letting my body relax. I knew how important the mindset was that I just needed to let my body do it. Baby’s heart again had a few decels but the team worked great to reposition me after the epidural was in. I could still feel the pressure of the contractions. I could tell we were progressing but at 2:45, I progressed far enough to be able to push. I progressed very quickly from being completely closed to being here very quickly within less than 24 hours. 

The team was so supportive. I could feel the baby moving down still, that pressure. I was ecstatic. Once we started the pushing phase, I was very nervous because that’s how far I got with Benny, my oldest. I had pushed with two hours with him and he had never moved down. I was very scared that that was going to happen. With the first push, I knew it was different. I could feel him moving. I could feel the baby moving down. 

We were gender-neutral beforehand and at 3:44, our sweet baby girl was delivered vaginally. 

Meagan: Aww. 

Brittany: Yes. It was quite amazing to feel baby on my chest. It’s still shocking now feeling the baby on my chest and having my husband look. He was crying and was like, “It’s a girl.” After having two boys, it was the icing on the cake. It was absolutely amazing. 

Meagan: Yeah, and a different postpartum experience?

Brittany: Absolutely. My provider had known how traumatic my C-sections were and then of course with my ectopic, completely being cut open with that too, it was totally different. It was stunning. Even with the epidural, I barely had the epidural so it’s not like it was running for a long time. I was never able to eat right away after birth. I pretty much ate almost all labor until the epidural and then to be able to eat as soon as I wanted to right after without throwing up, that alone was huge. I could walk practically right after. No crazy abdominal pain because of the C-section. I could help the baby right away whereas I was stuck in bed for so long after the C-section. 

The doctor looked at me and he was like, “How is this?” I’m like, “Indescribable.” 

Meagan: Do you even need to ask? 

Brittany: It’s insane how different C-section versus pure vaginal delivery was. I was ready to do it again. My husband was like, “Okay, we’re done having babies because we got our girl.” I was like, “I’m ready to do it again.” 

Meagan: Yes. Oh, I was the same way. I was like, “No, I want to do this again. This was amazing. I got the birth that I wanted.” There is something special. I want to also point out that sometimes vaginal births can be traumatic too but there is something about that baby being placed on your chest after you’ve gone through some less ideal or traumatic experiences. Yeah. It’s hard because you compare it and you’re like, “This is a breeze.” It’s still hard. Recovery is still hard but it’s just magical. Oh, I love it. I love that you at the end of pregnancy were like, “No. We’re going to do something differently.” 

It ended up being an induction so it was like, “Hey, come. Drive and come and it’s planned.” But I would love to know or I’d love for you to share if you can any of your plans for listeners assuming that it was going spontaneously. I think a lot of people get nervous. It’s a daunting feeling. They get nervous about, “When do I go? What do I do? It’s a long drive.” Do you have any tips or suggestions of what your plan was to travel that distance assuming spontaneous labor went into play?

Brittany: Absolutely. We talked about that. That was one of my husband’s biggest worries because obviously, he would be driving me. We knew first of all that obviously every labor can be different but that my son’s took forever. He was also induced. We were hoping for that but then also, we knew and had great backup for the other kids for daycare at a moment’s notice. We had great people to be able to drop them off at. We had talked to the provider too. Basically, if my labor got at all semi-regular if it had happened at home, if my water broke, I was going to head right in because we knew we would be having a baby. We also knew with having two C-sections that we wanted to be near medical attention just in case. 

We knew that even if my contractions started coming semi-regularly that we would likely head in. I was ready to labor hard in the car if that’s what it had to be. Also, say all of a sudden, I got pushy and that’s how fast it was progressing, we were okay going to our hospital closer just because then, I’m in the thick of it. We don’t want anything to happen to anybody but we knew that it could possibly be a barrier having to drive all the way 2.5 hours to this hospital. 

Meagan: Yeah. That is a really good point. Preparing to labor hard in the car is no joke for sure. Obviously, that’s not what happened but preparing yourself mentally is so beneficial because if that does happen, it can take out some trauma because it could be traumatic in the car if you’re not prepared for that and labor is progressing, and then of course, having that plan of, “Okay, if things shift and I’m pushing that baby out, we’ll go to this nearest hospital.” 

Also, I would suggest, you were saying, “Oh, if things were getting active then we would go,” but you could also, when you get there, you don’t have to go straight in but just be in the vicinity. Grab a hotel or go to a park and walk around. Just be close by. Preparing for that financially as well if you’re getting a hotel or something like that is something that’s important because you don’t want to have anything crazy happen but also educate yourself on the signs of something going wrong so if you know that it’s happening in the car and you still have 45 minutes, you can just go to the nearest hospital at the next exit or whatever. 

Brittany: Yeah, absolutely. 

Meagan: Great tips. I seriously love that. Prepare to labor hard in that car because it can happen. Congratulations to you and I am so proud of you on all of your journeys. It’s hard because we’ve had these Cesareans, undesired, sometimes traumatic, or desired with unidentified outcomes where you wouldn’t think that it would have been like that. These are the stories that make us who we are today. It’s these stories that are changing others’ lives and empowering them. 

Whatever your takeaway is from today, maybe it is recognizing a supportive versus non-supportive provider. Maybe it is figuring out what you need to do for yourself. Maybe it’s traveling or whatever it may be. Maybe it’s scheduling that repeat Cesarean. Whatever it may be, know that it is your birth. It’s your birth. This is your body. This is your baby. This is your future and whatever decision you make that is best for you, we here at The VBAC Link support but do have all of these resources for you to turn to and learn so you can know what your options really are. 

Brittany: Yes. Information is key. That’s one of the biggest things I took away. I am all for people making whatever decision they want in regard to anything including birth, but I just want people to have the information, the correct information, to be able to make those informed decisions. 

Meagan: Absolutely. Absolutely. One other quick thing I wanted to talk about is how you went in for a VBAC after two Cesareans with no progress. There wasn’t any progress being made meaning that your body was not showing signs at that moment of labor beginning or progressing. They started with a Foley bulb or a Cook catheter depending on where you are or what your hospital uses. That can be something that a lot of providers will refuse to use if you’re not dilated to a 1. 

Now, I want to preface. You’ll have to tell us actually. It can be very uncomfortable getting a Foley in with no dilation because they’re putting a tiny little tube in something that is closed. 

Brittany: Yes. Yes. 

Meagan: That is definitely a little bit of a disclaimer there. It can be very uncomfortable but just like Brittany and I want to say it was Shannon? I could be totally wrong. It was a VBAC after three Cesarean birth. She ended up doing a little bit of Pit to try and get her cervix to do something and then got a Foley in. It barely opened if I remember right. It just shows that it is possible. It is possible. They may say that it’s not possible. I will say that it’s not common for them to do it but it is possible. You can request it. Yes, prepare yourself mentally because I don’t know Brittany if you want to describe it at all but it’s possible. It’s possible to do that. 

So if you’re in a situation and they’re like, “You are in no state to be induced,” but you’re really not feeling like you want to do a scheduled C-section, try it. 

Brittany: Yes, totally. It was very uncomfortable. It was truly painful. I had been induced with my first son so I knew what labor was like, but I was like, “Oh, this is pretty rough.” But hands down, I would do it again. After that initial insertion which took a little bit because I was completely closed– 

Meagan: And probably posterior a little bit so they had to send the tube up and forward. 

Brittany: It was rough. I was worried that it wasn’t going very well, but it just takes time because I was fully closed. I had pretty good contractions just from that for an hour. My body totally took over which was good. I mean, but then it was such good progress. I slept all night. By morning, I was 4 centimeters. I mean, can you honestly ask for more than that? 

Meagan: That’s amazing. 

Brittany: That was the perfect start to an induction. 

Meagan: Yeah, absolutely. Absolutely. That’s one of the things that the Foley can do is it can get your body to 4 centimeters, sometimes even to 5 centimeters. It’s also important to note that sometimes when it falls out, the cervix relaxes. Do you like my sound effects? It’s hard because we can see each other. She can get my emotion. It can relax and go backward. It doesn’t really go backward, it just relaxes. So sometimes keep in mind that if a Foley comes out at 4 centimeters, you might be closer to 3.5 or 3 but it stretches to a 4 because it just stretched to a 4. If you get checked again and they’re like, “Oh, you went backward. You’re a 3.” No. Don’t let that get in your head. 

And then they started low-dose Pit and things. That’s something I wanted to point out. It’s not something that is super common and oftentimes, providers say no but it is possible. 

Brittany: It was absolutely incredible. I mean, really the biggest thing is to educate yourself. I went to the chiropractor. I did all of the things. I was in so much pain at 37 weeks pregnant, 36 pregnant. I’m a firm advocate of the chiropractor anyway. I love it for everything. Helping my kids poop as weird as that is–

Meagan: Oh no, I know. I’ve done that too and it’s amazing. It works. 

Brittany: Yes. So I had been going very regularly anyway because I knew how much that can help get baby in place and help with pain, help with hips. I was in so much pain and I’m like, “Oh no. This is not good. I can’t be in this much pain going into birth.” My chiropractor actually got COVID of course right around that time so I was like, “I can’t even see her. Who knows if I’ll get to see her again before I have his baby?” 

I was lucky enough to find a very nearby chiropractor the day before I went in to be induced. I swear that helped a lot too. Just incredible. It turned out beautifully. 

Meagan: Absolutely. Yeah and if sometimes you’re having prodromal labor or if labor it just carrying on, carrying on, and carrying on, going and getting an adjustment can be a game changer. Yes. Awesome. Well, thank you so much for being here with us today and sharing these beautiful stories. 

Brittany: 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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Sydney joins Meagan on the podcast today to share her VBAC story and talk about her experiences going past 42 weeks for both of her pregnancies. Meagan shares a story about one of her doula clients who went past 43 weeks! Sydney and Meagan discuss how due dates are calculated and the flaws behind the method that is so widely used.

Meagan shares evidence-based information about the risks involved with being pregnant longer than 42 weeks as well as risks surrounding the choice to induce earlier. Having multiple sources of information along with your personal experiences and feelings will help you feel more empowered to make the right decisions surrounding when to birth your baby!

Additional Links

Birthful Podcast Episode on Due Dates

EBB: Evidence on Due Dates Blog

How to VBAC: The Ultimate Prep Course for Parents

The VBAC Link Facebook Community

Full Transcript under Episode Details

Meagan: Hello! It is The VBAC Link. My name is Meagan and we have another VBAC story for you today. In addition to the VBAC story, we’re going to be talking about postdates. This is a really hot topic especially in the VBAC world because we have a lot of people, I don’t want to say forced necessarily, but pressed to induce their labor. I think after the ARRIVE trial came out, it’s become even more pressing to have a baby by 39 weeks. I feel like the way we view the new due dates is that 40 weeks is 41. 39 is 40. 38 is 39. 

I feel like in a lot of areas in the world, that is how our mental state has shifted and we don’t really hear 41 weeks or 42 weeks as much anymore. Today, we have Sydney, and guess what you guys? She had 42 weeks and 5 days, right? Is that right Sydney with your first? 

Sydney: Mhmm, that’s right. Yes. 

Meagan: And then 42 weeks and 3 days with the second. So you are one of those mamas that carry further along than a lot of people. We’re going to actually make sure to have it here in the show notes but the Birthful Podcast, I don’t know if you guys listen to Birthful Podcast but I love it. I’m not even expecting anymore. I’m done having kids but I still love listening to it because the guests that she has on there are just filled with information. I want to say the guest she had, her name was Gayle I want to say. Don’t quote me on that. But she has an episode all about due dates and talking about how the body carries. 

Review of the Week

We are going to get some more into that at the end but of course, we have a review of the week and then we will have Sydney share her VBAC story with you. This review is by Rachelmademusic. It says, “Such a gem of a show. Thank you, thank you, thank you, Julie and Meagan, for creating this supportive and powerful space for mamas like me to learn and prepare for our VBACs. I’m currently 33 weeks pregnant and preparing for my own VBAC. I can’t begin to express just how thankful I am to have found this podcast. I am truly grateful for this resource and for all of the mamas who come onto this show and share their stories. There is such an incredible strength and collective wisdom to be found here and I highly recommend this podcast to anyone preparing for VBAC or not.”

Oh, thank you so much Rachelmademusic. I would agree. This podcast is such a great platform for first, second-time, third-time moms, fourth-time moms, and not even just VBAC moms because there is so much information that is shared on this podcast that talks about how to avoid a Cesarean. When we have a Cesarean in the US, it’s almost 32%. That’s pretty stinking high especially when it used to be 5% way back in the day. 

Although our VBAC rates are also going up, Cesarean rates have just skyrocketed. So if we can learn how to avoid an unnecessary Cesarean or undesired which a lot of us have had undesired and unplanned or maybe unnecessary Cesareans, we can start lowering that. I think it could be super impactful to a lot of the world because as part of these stories, we hear these first-time Cesareans or second-time Cesareans and they don’t always resonate with positivity. That is hard because we want our birth experiences to be positive. So yeah. I think that it’s super important that anybody listens to all of these birth stories. 

Sydney’s Stories

Meagan: Okay, welcome to the show, Sydney. Thank you so much for taking time out of your day to be here with us and share these stories. 

Sydney: Thank you. 

Meagan: Are you in Virginia? Is that correct? 

Sydney: Yep, I’m in Virginia. 

Meagan: Awesome. We’re going to start trying to say where people are because a lot of the times, we’ll get messages that will say, “Oh my gosh, I’m in the same area. Is there any way I could get their providers?” So it’s fun to be like, “I’m in Virginia. I will listen to this too because I want a VBAC and I want to learn who is supportive or who is maybe not supportive.” 

Yes, okay. Well, I would love to just hear your story and share this with all of you women of strength listening. 

Sydney: Yeah, great. Okay, thanks. Yes, I’m Sydney. I’ll just jump into my first birth story. I was pregnant actually during the pandemic. My due date was August 8, 2020. 

Meagan: Okay, in the thick of it, really. 

Sydney: Yes, right in the midst of it. We were planning to birth with our birth center here locally. I actually was living in Tennessee when I got pregnant then moved about halfway through and started prenatal care with a birth center here so I was planning for a natural birth and just sort of assumed everything would be fine. Women had been giving birth forever. I come from a lot of strong women having a lot of babies so I just did not even think. I assumed it would be fine. 

Meagan: Yeah, you didn’t think anything of it. Yeah. 

Sydney: Yeah, this is just what people do. I’ll be fine. Everything was pretty normal with the pregnancy. I got to 40 weeks and had no signs of labor. I was not really worried about it at that point. Then I started getting to the end of 41 weeks and I was like, “Hmm. Huh. What do I do now?” The midwives were really helpful and gave me of course all of the things to try. I tried all of the things. I was going to the chiropractor multiple times. I tried acupuncture. I was drinking tea. I was pumping and doing all of the things that they told me I should do to try and get labor going. I just was not having much luck. 

So finally we decided, “Okay.” I was going to be 42 weeks on a Saturday so we thought, “I’ll try the big guns, castor oil, on Saturday.” Something happened with the midwife. She wasn’t ready for me to do it on Saturday so we had to wait until Monday which was 42+2. I took it first thing Monday morning at 6:00 or 7:00 AM. I could not keep it down. I threw it up so I had to do it again which was horrible. I hated it. I was like, “I’m never doing this again.”

Meagan: Did you drink it straight? Did they have you mix it in a concoction? 

Sydney: They had me do a milkshake with vanilla ice cream, peanut butter, and castor oil. 

Meagan: Yeah, that’s actually similar to what I drank. 

Sydney: Really? Okay. 

Meagan: Yeah, with my second. It’s gross. 

Sydney: It was still so disgusting. 

Meagan: Yeah, yeah. 

Sydney: I did it a second time. The castor oil did its job. It got some contractions going but I was walking a lot to just keep them doing anything. That sort of continued through Tuesday. I was having just mild contractions on and off. Then by Wednesday morning which was when I was 42+4, they were strong and consistent. The midwives were like, “Okay, we think you’re ready to come in. Let’s get things going.”

I remember they had to meet us at the birth center. It was 7:30 in the morning. I got there and apparently, another mom had beat me there. She was also in labor. So as soon as I walked in, I’m a first-time pregnant mom, she is pushing her baby out and screaming. It was the most terrifying thing I had ever heard. Literally, I think my cervix just closed up and was like, “Nope. Not doing that.” I literally didn’t have contractions for a couple of hours after that. It all stopped. 

Meagan: Yeah. 

Sydney: That was unfortunate, 

Meagan: That can happen. That can really happen though. It doesn’t even matter. Maybe nothing significant like a woman screaming in labor, it doesn’t have to seem significant. It can be just shifting from the car to the hospital or your home to the car or downstairs to upstairs. Something off can calm things down. 

Sydney: It did, yeah. 

Meagan: Sometimes it’s just your body responding and needing a break. 

Sydney: Yeah, yeah and that’s really what happened. The midwives worked with me all day. We were doing Miles Circuit. I remember that it was August so it was scorching outside. They had me climbing hills and stairs and curb walking. They made my husband stay inside and take a nap because he was exhausted. I was doing all of the things, pumping every half an hour and they were giving me tinctures every 30 minutes. 

Still, by 5:00, I think I was maybe 3 centimeters but contractions were not picking up. They weren’t strong enough and we were both exhausted so the midwives were like, “All right. I think the best plan is for you to go home, drink a glass of wine and take some Tylenol PM. Let’s get these mild contractions to stop so you can relax and then you probably need to go be induced in the morning.” Because at this point, we were 42 and 4. I was starting to get uncomfortable. 

I was just exhausted. They were like, “It probably would be beneficial for you at this point to be induced and have an epidural so you can just rest and relax and let your body do what it needs to do.” That was our plan. We went home and did that. It worked for a couple of hours but the contractions actually really picked up overnight so by 4:30, I was like, “We need to go. I can’t do this anymore.” I think we did the wine and Tylenol PM again later in the night and it just was not working. So at this point, I was like, “Okay. We’re ready to go.” 

We ended up going to the hospital. By the time I got there, they were like, “You do not need to be induced. You’re already in active labor.” I was like, “Okay, great. Let’s do this.” We labored for a while and decided later that morning to try for an epidural so that I could just get some rest because we were so tired. 

As soon as I got into position for the epidural, the baby’s heart rate decelerated so there was panic. There were a ton of people in the room. They were doing oxygen. They wanted to check the baby’s position to see if the baby had maybe dropped or something but the baby stabilized almost immediately. They said I was at an 8. I was like, “Oh wow. Okay. Forget the epidural. Let’s just do it.” 

I continued to labor for a couple of hours and they checked me again. This was probably at 11:00 and they said I was at a 4. 

Meagan: What?!

Sydney: I was like, “Huh? What?” I don’t know if the first person got it wrong. I have no idea what happened but I was in a different position when they checked me. It was a whole thing. 

Meagan: It’s happened. I’ve been to births where that’s happened where they were like, “Oh, you are 9 centimeters,” and getting the cart out, then getting the provider to come in then the provider comes in and is like, “She’s 5 centimeters,” then we’re like, “What?” 

The one provider explained to me and the team said that sometimes if we have a really, really stretchy, favorable cervix, especially during a contraction or certain positions, it can feel thinner than it is or feel like it is dilated more than it is and then they change that or a different person checks and they’re like, “Yeah, no.” But man, that’s a frustrating scenario. 

Sydney: I was devastated. So at that point, I was like, “All right, bring me the epidural.” I’m only at 4 centimeters.

Meagan: Yeah. Change of plans, let’s do that again. 

Sydney: I cannot go much longer. So they were bringing the epidural. Meanwhile, they decided to break my water because she could feel the water and there was meconium in it so that gave them a red flag. When they went to bring the epidural and I got into position, the same thing happened. Baby’s heart rate went this time way, way down into the 20s. 

Meagan: Like something is being compressed. 

Sydney: Yeah, so at that point it wasn’t even a question. They rushed me out for a C-section immediately. By the time we got to the OR, baby had stabilized but they were like, “You’re both exhausted. We need to get this baby out. You’ve been doing this way too long,” and I was postdated and there was meconium so I think there was a lot of concern. 

Then they went to give me a spinal tap so I could be awake and it didn’t take. They did it twice and it didn’t take. 

Meagan: Did the baby’s heart rate react then?

Sydney: Not that I know of. 

Meagan: It’s not working. It’s not working, yeah. 

Sydney: So they put me under and I birthed my baby asleep which was a whole thing but she was on my chest not too much after she was born and I was able to nurse immediately. They tried to be really accommodating to me and they were very mother/baby friendly. 

Meagan: Yeah. Did they bring you back pretty quickly? 

Sydney: Yeah. 

Meagan: Like you were awake right after? 

Sydney: Yes, pretty much. I think they were still working on me while I was awake. 

Meagan: Okay, yeah. 

Sydney: And then my husband was able to be there. He got to see her first while they were examining her. It all was fine. We were both healthy and we were okay but it was a little bit of a traumatic experience and not what we were planning for at all from a natural birth to a total C-section. 

Moving on to being pregnant again, I was like, “All right. What do I want to do now because it feels like the natural birth didn’t go well but this time around–” I don’t know. I felt like I was more prepared and knew a lot more. There were a lot of choices I made with the first birth that I knew I wouldn’t make with the second. 

I had said, “I’m not going past 42 weeks.” Obviously, I didn’t but that was my mindset. I was like, “I’m going to do what I can to have the baby ahead of time.” 

So anyways, my second baby was due July 10, 2022, so just under two years later. I did decide to go with the birth center again, the same birth center. We had a good prenatal experience there and I love the midwives there. And again, I felt like I was more knowledgeable this time around. I knew that I was getting a doula. I did not have that the first time. I knew that I wanted to set myself up for success as much as I could. 

So again, I was doing everything I knew to do to shorten the pregnancy. I went to the chiropractor early and I went consistently every week. I drank lots of the Nora tea. I started pumping at 36 weeks every day. I was taking Gentle Birth and walked consistently. 

Meagan: So great. 

Sydney: I was doing everything. The pregnancy was fairly normal. This baby was breech at 34 weeks and I was so discouraged because I was like, “I’m a VBAC. A lot of people aren’t going to want to do that.” Even my midwives were a little bit hesitant to do that because I had never had a vaginal birth. They usually are good with breech births, but with my situation, they were like, “We’re not sure we want to take that risk.” So I knew my chances of VBAC with a breech baby were very low. So I was doing inversions. I did acupuncture. I put frozen peas on my belly. I did everything that people told me to do. He did flip by 36 weeks which I was very thankful for. 

So anyways, I’m doing all of these things to make sure that this pregnancy is shorter. At 40 weeks, I upped the walking. I started swimming but no signs of labor at all. At 41 weeks, the same thing. Not dilated at all, getting discouraged. And of course, during this time, we’re doing a lot of non-stress tests and trying to make sure that baby is still doing well. 

Around 42 weeks again, I said, “I’m not going past 42 weeks,” but of course when it gets to that point, I’m like, “Just a couple of more days. I want to do everything I can to have the birth that I want.” So at 42 weeks, I was 1 centimeter and we were all so thankful. The midwife did a sweep and I did castor oil again. I tried to hit it with everything in one day. I think I ended up doing the castor oil three times because it wasn’t doing anything. 

Meagan: Oh my goodness. 

Sydney: So eventually, it worked and I got some contractions at midnight to 3:00 AM and then it just sort of fizzled out. I just kept having really mild contractions. At 42 weeks and 3 days, I decided that there was not much more I can do at this point. I need to go be induced because we really were trying everything. They were not getting strong enough or consistent enough to make any progress. 

Meagan: Again, post date. 

Sydney: Right, right. My body is going this long, so do I trust that? I know that the risk goes up significantly after 42 weeks from what I’ve heard and read so it’s weighing that balance of, “I know baby’s okay but how long am I willing to wait this out and take risks?” So I decided to go be induced. 

They put me in triage at 7:00 AM on a Saturday and of course, the nurse was basically like, “You’re this huge fish that doctors never see because you’re a transfer. You’re a VBAC. You’re post dates.” Just all of these different things that made me an interesting patient. 

Meagan: All of the checkmarks against you here. 

Sydney: Yes. They were able to get us into a room later that morning. It had a tub. The nurse we had was really sweet. She knew that we were from a birth center. She was like, “I have this room with a tub. Someone’s in it but if you can wait a couple of hours, you can get into that room.” So we got into the room with the tub. They started me with a Foley balloon and that did not take very long at all and then they started Pitocin at a very, very low level, like a 2 I think. 

Meagan: That’s a really great, nice way to induce. A Foley with a low dose of 2 or 4 milliliters of Pit for a little bit. 

Sydney: Yeah, yeah. I was able to be in the tub for a little while. I stayed in there for a couple of hours and then I think around some time that afternoon at 3:00 I did ask for an epidural because again, I had been up for days at this point and needed to just rest. 

Meagan: So tired, yeah. 

Sydney: The anesthesiologist was in surgery so it was a few hours. I think they didn’t come until 7:30 that evening. This time, everything went fine. I was able to get the epidural and get some rest. It was just like, “Wow. I did not anticipate feeling this good right now.” It was such a relief and I was able to get some rest. 

My doula came around then and was very helpful and sweet. Then around 11:30 that night, I started throwing up. They thought maybe it was the epidural. They said that can sometimes make people nauseous. They were checking all that and my doula was like, “She might be in transition. Why don’t we check?” And I was fully dilated which was so exciting. I was getting ready to push and I was happy to finally be doing something and feeling productive. 

I was pushing for a while. After about an hour or so, the doctor that was with me switched out with another doctor. I think she had another surgery to be in or something. The doctor that came in was the doctor that did my first C-section. He almost immediately– he hadn’t been in the room very long but he said that if I couldn’t push the baby out that they would have to use forceps or do a C-section. 

Meagan: Had he been pushing with you at all at this point or did he just bluntly say these things before even assessing? 

Sydney: Yeah. He had been in there maybe for five minutes. I was so discouraged and my doula just looked at me and winked like, “Don’t worry about that.” 

Meagan: Don’t worry. Yeah. Ignore what he just said. 

Sydney: Yeah. I think it took me– we started pushing around 12:30 and then he was born I think at 2:30 or so. So 2-2 ½ hours of pushing. 

Meagan: That’s not long at all. 

Sydney: It wasn’t too bad. That was really sweet. I finally got to have a vaginal birth. My husband was there. He got to announce the gender and cut the cord. I got him on my chest immediately and it was really sweet. I did have a 3A tear which was–

Meagan: 3rd degree, yeah. 

Sydney: Yeah. It was a tough recovery with that but otherwise, it was a really, really good experience. Again, not in the birth center, not the natural birth that I had envisioned but it went so much better than I could have anticipated. 

Meagan: Good. 

Sydney: I’m really thankful for that. 

Meagan: I want to talk about that a little bit before we get into due dates. Like you said, it wasn’t the natural birth you anticipated, but in the end, you had an epidural that truly was such an amazing tool in your labor. At first, you couldn’t get it, but then you were able to rest, and like you said, “I didn’t anticipate feeling this good.” The world puts such shame on people for both sides actually of, “Hey, if you don’t go unmedicated then you’re crazy and you’re going to have a C-section,” or “Hey, if you go unmedicated, you’re crazy and then if you get an epidural then you’re crazy and you’re going to have a C-section.” 

It’s just not that way. We need to take out these absolute statements of, “If you do this, you won’t have this,” because it’s not true. I can’t tell you enough. We get so many emails of, “I really want to VBAC so badly but I just don’t feel I can go unmedicated. It’s not my personality. It’s not what I desire.” They’re like, “It just sucks that I can’t have a VBAC because I don’t want to go unmedicated.” I’m like, “Wait, wait, wait, wait. If you want a VBAC, you don’t have to go unmedicated.” 

It’s the same thing with induction. Are there some things around induction that may increase some risks or some chances? Yes. That doesn’t mean it’s going to happen though, right? This provider that started you out with this induction is a really great way to induce. Yeah. You had progressed a little bit before with your first so that’s also a really great factor, but yeah. You don’t have to go unmedicated to have a vaginal birth in general. 

I mean, look at all of the people that truly don’t go unmedicated. It doesn’t make you less of a person if you don’t have an epidural. Something I love about your stories, both of them, is that you had the discussion with the midwives but you had this thing of, “Okay. We’re going to go to the hospital now. I’m making this choice for me, for my baby, and this is what I feel good about.” I think that’s important to note too. Sometimes plans change and plans can change. 

Sydney: Yes, yes. I held it a lot more loosely the second time around than I did the first. 

Meagan: Yeah. Well, I think it’s just because in the world we get a lot of pressure and shame for decisions that we make. My kids are in a lot of sports and I get shamed for my kids being in sports and that has nothing to do with anybody else’s life. Yeah. Listeners, you guys birth the way you desire. If that’s a repeat Cesarean, that’s a repeat Cesarean. If that’s an induction, that’s an induction. If it’s unmedicated, medicated, or whatever it may be, birth the way you want. But on the way to birthing the way you want, make informed choices by getting the education and the knowledge behind every choice that you are making. 

Okay, so due dates. Here you have two babies that have gone over 42 weeks. Neither of them had many issues or anything. Maybe we had some mec which is common, especially in postdate babies. 

So I want to talk about what postdate means or what all of the terms mean. An early-term baby is between 37 and 38+6. That’s an early-term baby. A full-term baby is 39 to 40+6. A late-term baby is 41-41+6 and then a post-term baby is 42 weeks or later. Technically, you had two postdate babies. I had an early, a full, and a late baby. I had three different ones. 

One of the resources that we love so much is Rebecca Dekker at Evidence Based Birth. If you guys have not checked out that website, it’s so amazing. They turn studies into English for the people who can’t understand a lot of these studies because it’s really hard. They turn them into English. 

One of the things that she talks about on this specific blog which we’ll have in the show notes is titled “Evidence on Due Dates.” One of the things she talks about, and shame me if I’m pronouncing this wrong, but it’s called the Negel’s Rule. It’s something I had never really heard about until probably a year ago but back in the 40s, a professor in the Netherlands created this rule on how to calculate estimated due dates. 

She says, “Based on the records of 100 pregnant women, they have figured an estimated due date by adding 7 dates to their last period,” then that is 9 months. It’s crazy though because if you think about this world and our periods as women, we are not the same. Nobody. I can guarantee you that I am not the same as my neighbor or my friend or even my sister. We have different cycles and this was based on a 28-day cycle ovulating on the 14th day. That just doesn’t happen all of the time. 

I don’t love the method because it can be different. On the Birthful Podcast, we talk about how people sometimes carry longer. That doesn’t mean that they’re super, super, super overdue. It just means that they have carried longer. In her blog, she talks about a person that had a 44-day cycle so she may have been viewed as 42 weeks or 41 weeks + 2 days, but really, she was 40 weeks. So we were adding a week and two days onto this due date and we’re telling people that we’re got a higher chance of stillbirth and things like that but really because of her long cycle, she is 40 weeks. 

It’s just so hard. It’s so hard. I mean, there is research and this blog is amazing but even then, it’s hard. But we do want to talk about the risks of going past your due date. What risks, Sydney, did people tell you about going past your due dates? For you and baby, was there anything said that was very specific like, “If you go one more day, this is going to happen or more than likely to happen?” 

Sydney: The biggest thing that stands out in my mind is the meconium and the risk of baby aspirating and then also just the general risk of stillbirth going up after 42 weeks were the two obvious things that I remember. 

Meagan: Yeah. That is correct. The risk of moderate or thick meconium increases every week starting at 38 weeks. It’s interesting. We don’t know exactly why a baby has a bowel movement in utero all the time. Sometimes it’s due dates. Maybe sometimes it’s stress or a really fast transition or whatever. They just do. We don’t know exactly why all of the time, but it does seem to peak between that 38-42 weeks. It’s 3% at 37 weeks, 5% at 38 weeks, 8% at 39 weeks, 13% at 40, 17% at 41 and 18% at 42 weeks. An 18% chance that a baby may have a bowel movement within that 42 weeks. 18% might sound really, really high but to some people, they’re like, “Okay, well if it happens.” 

Then like you were saying, we worry about the risk of aspiration. Sometimes it happens and sometimes it doesn’t. If it does, sometimes we have other issues. Another risk for infants is the increased chances of NICU admission. They were the lowest at 39 weeks at 3.9% and rose up to 7.2% at 42 weeks. Again, some people may look at that and say, “That’s enough for me to have a baby at 39 weeks.” Some people might be like, “7.2%. I’ll take the chances.” It’s a totally personal preference. 

One of the other risks, and when I say risks, I’m really putting quotations around this because it’s one of those eye-rollers for me. It’s a big baby. A lot of providers will say, “Oh, your baby is going to get way big. You might not be able to have that vaginal birth.” Especially with VBACs, it’s like, “Last time, your baby was larger.” Let’s say last time your baby was 8 pounds, but this time it could be really big if you keep going. It shows that for greater than 9 pounds, 15 ounces rose during 38 weeks which is 0.5%, and then doubled at 42 weeks which is 6%. But I mean, we recorded a story last week with Morgan whose baby was 10 pounds, 12 ounces. Big babies still come out and they’re just fine. It’s hard to hear the risk of the big baby because why are we shaming these babies? It’s fine if they’re big. It’s fine if they’re chunky. We love when they’re chunky. 

And then some of the risks of having a lower APGAR score or stillbirth. The stillbirth I think is probably one of the most intense risks that we look at. It’s the scariest risk for obvious reasons. It says, “Absolute risk is an actual risk of something happening to you. For example, if the absolute risk of having a stillbirth at 41 risks was 1.7 out of 1000, then that means that 1.7 mothers of 1000 or 17 out of 10,000 will experience a stillbirth.” So you hear that and it’s very scary. 

Then it says, “Relative risk is the risk of something happening to you in comparison to somebody else. If someone said that the risk of a stillbirth at 42 weeks compared to 41 weeks was 94% higher, then that sounds like a lot but some people may consider that that actual or absolute risk is still quite low at 1.7 versus 3.2.” We’ve had a post like this. It actually stirred up a lot of angst because we talked about some absolute risk and some relative risk and actual risk, but really it can be very scary to hear a 94% higher chance than a 3.2% chance. 

Ultimately, yes. There are risks of stillbirth the longer we go. There are risks of placental issues or infections in moms because there is a whole other category of risks for moms that we a lot of the time don’t talk about too much. But yeah. It’s just a matter of what is best for you. At the beginning of the podcast, you said, “I haven’t met a lot of people who have carried as long as me.” 

I was telling you that in eight and a half years of being a doula, I have had one client specifically– I’ve had some 42-weekers at one or two days, but one client specifically who went 43 weeks and 1 day. It started at 40 weeks. Her provider was like, “You have to induce. You have to induce. You have to induce. She was like, “No, I don’t want to.” Then at 41 weeks, the same thing happened. “You have to induce.” At 42 weeks, she was like, “I’m over it. I don’t want to be here anymore.” She called me and she was like, “I’m changing providers. Does that change anything?” Her home was farther away from me than her hospital location so she was like, “I’m changing providers. Does that change anything to do with you supporting me? Because I need to know if I need to find a provider closer to you or if you’ll come to me.” 

I’m like, “Yeah. I’ll go wherever you go.” So she called I think it was the next day. At this point, she was 42 weeks + 1 day. She was like, “I found a provider. She’s out here by me. She’s going to support me.” I’m like, “Okay, great.” She goes to 42 weeks and the doctor is like, “We’re going to do two non-stress tests this week. We’re just going to check.” They did and they were like, “Everything’s great. No problem. Baby might be on the larger side, but other than that, everything’s looking great.” 

At the next one, she was like, “Yep. Everything’s looking good.” She’s now at 42 weeks and 5 days. I’m like, “Wow.” This is the first and this is in the very beginning of my doula career. I’m like, “Does this really happen? What is happening?” I was feeling nervous because I still didn’t know much then. 

Anyway, at 43 weeks or the day before 43 weeks, she went to her provider and they were like, “You’re really not showing a ton of progress. You’re barely effaced. You’re maybe a centimeter.” 

Sydney: Oh my gosh. So triggering for me. 

Meagan: Yes. Well and for her, she was like, “I’m never going to have a baby.” She said that. She was anxious. She was like, “I think I’m going to be pregnant forever.” I’m like, “No, you’re not going to be pregnant forever.” But you can understand where she’s coming from. 

Sydney: Yeah. I just don’t believe that people go into labor on their own. I just don’t get that concept. 

Meagan: Yeah because of your situation which I totally understand. Yeah. They were like, “How about you come in tomorrow? Let’s do this. Let’s induce this labor. Let’s have this baby.” So she called me and I was like, “Yeah, do it if you want to.” We went over everything so she was like, “Yeah, okay. I’m going to do it.” She actually started contracting through the night and we were like, “Oh, she’s going into labor.” I do think she was actually going into labor because we went in. She had only progressed another half a centimeter but she was contracting. I wouldn’t say that they were anything too crazy strong or anything but they were there. 

But then they did induce the labor with those contractions and at 43 weeks + 1 day, she had a really chunky little boy. Everything was really great. Nothing was wrong. He did have meconium. He pooped. They believe that he pooped on the way out so he wasn’t super gray or anything but yeah. It’s just very interesting. It’s very, very interesting. Due dates are interesting and it might be a hangup for you for a long time. 

Sydney: Mhmm. I always was so curious about this and they said, “We think you’re probably just one of those women that if we let you go, you would naturally go to 43 or 44 weeks. Some women just carry longer. Some women carry shorter. Everyone is different.” 

Meagan: Yep. Yep. I keep thinking Gayle. Gayle is what is coming to my mind for the podcast with Birthful. She talks about that. Some people just go to 43 and 44 weeks. It’s crazy but again, back to what was in that study on Rebecca Dekker’s blog is that it’s not that she was 42 or 43 weeks. That’s where the hangup in my mind comes from. This is where she is based on her last period based on this calculation that Google does or the little wheel. My doctor back in the day had a little wheel to tell me when I was due. That doesn’t mean that that’s when my baby is due and it doesn’t mean that I had that 28-day cycle and I ovulated at day 14. 

Really, that’s my hang-up in my head. What more can we do with these due dates? How can we calculate these due dates better because, in my opinion, induction is also really, really high? We’ve got a high Cesarean rate, a high induction rate, and a lot of people going in. Induction is just fine if that’s what you are wanting but a lot of people are getting that pressure to induce and they are getting these scary things being said. Let’s figure out what these due dates and these guesstimation dates really mean. 

Honestly, there is not enough evidence without induction and stuff like that, I don’t think, to really, really, really, really know what the average length of pregnancy is. 

Sydney: Yeah, that’s probably a good point because people just don’t go that long. They get induced. 

Meagan: Yeah, they just don’t. In your mind, you’re like, “I wholeheartedly do not believe that anyone can go into spontaneous labor. I don’t get it,” because you’ve had two experiences and it makes sense. You’re welcome to feel that way but at the same time, it’s like what is missing here? Like your midwife said, “You’re probably one of those that we would let you go and you would go.” But does that really mean you’re 44 weeks? Does that mean you’re 41 or are you actually 42 at that point?”

Sydney: Yeah. We do plan to have more at some point, but I’m going to track my cycle consistently and track the actual conception date if I can and make sure I know exactly when and probably even do an early ultrasound which I haven’t done before just because it’s always the question people want to ask. “Well, are you sure about your due date? Are you sure about your cycle?” I can’t be 100% sure about my cycle but I can be 100% sure about when my last period was. I know what that is. Yeah. I field that question a lot. 

Meagan: You know, it’s an interesting thing that just popped into my head. Remember when I told you earlier that I’ve had an early term, a full term, and a late term? With my third baby, we were crazy. We were trying for a boy specifically and my friend was like, “Read this book.” I was like, “I’m going to follow this to a T.” We had two girls and my husband was like, “This is the last. You have one more try to get your VBAC.” He was really, really stern on this one more baby. I was like, “Okay, fine.” I was waiting for him. Before he was ready, I started temping. I mean, going more extreme. It consumed me a little bit but I really got familiar with my body because I really wanted to try for this boy. 

Anyway, so I had temped and done everything. We conceived. I knew almost the hour. It was ridiculous. It was absolutely ridiculous. I knew exactly when I got pregnant and I was 41 weeks, 5 days but with my first, they said that my due date originally was October 26th and then she was measuring small so then they bumped it up to November 6th, 10 days later. She ended up coming November 4th but then I wondered, “Was I early? Was I late? What was I?” because I wasn’t tracking. 

With my second, she came at 38 weeks, 5 days so it makes me wonder there too because I wasn’t really paying attention but I felt very pregnant. But then she was small so they were like, “No, it was totally fine.” I’m like, “She was measuring small from the very beginning.” It always makes me wonder. Maybe I was closer to the 40-week mark or maybe I was almost 41 weeks. I don’t know. It’s fascinating. 

Sydney: It is, yeah. 

Meagan: And it’s hard. It’s hard because we don’t know and we are only trying to do what’s best. We are only trying to do what we are given the information on. As always, we have to follow our gut and decide what’s best for us. We’ll make sure to include those studies. If you guys are listening and you find this interesting too, go down to the show notes. Find it. Read them. Listen to the podcast. It’s a really, really great episode. 

Anyway Sydney, thank you so much. 

Sydney: Thank you for having me on. 

Meagan: Thank you for bringing this conversation to the table because it’s not one that we talk a lot about. But I’m sure you’ve got some frustration. Like you said, “It’s kind of triggering to hear that.” 

Sydney: Yeah. It’s not fair that I have to do all of this work before I actually go into labor. We’ll see what I do for the next one. I’ve said, “I’m not going to do anything. I’m just going to get induced at 42 weeks.” But I’m sure when the next one comes along, I’ll be like, “No, I really want to try and do it naturally.”

Meagan: Let’s do the castor oil again. There are some ways to naturally induce like breast stimulation or sex and starting sex earlier on or evening primrose oil and things like that. Things that we can start doing at 38 weeks leading up. But even then, it’s not a guarantee and sometimes it can be frustrating when you’re like, “I’m doing all of the things. I’m taking castor oil and I’ve puked it back up three times and I’m still not having a baby.” 

Sydney: Yes. Well at this point, it will probably be a matter of, “I’m just going to trust my body. My body knows. My baby knows when they’re ready to come out.” I just need to follow my intuition and weigh that risk like you talked about. 

Meagan: Yeah. 

Sydney: Yeah, but we’ll see. I don’t have to worry about it yet. I’m not rushing it. 

Meagan: You don’t. You don’t. You don’t have to worry about it but keep grabbing the information so then you’ll be prepared. 

Sydney: Yeah. Yeah. Thank you very much. 

Meagan: Awesome. Thank you. 

Closing

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