The VBAC Link

It can be difficult to find VBAC support with gestational diabetes and most who are supportive of VBAC highly recommend a 39-week induction. Heidi’s first pregnancy/birth included gestational diabetes with daily insulin injections, a 39-week induction, Penicillin during labor for GBS, pushing for five hours, and a C-section for arrest of descent due to OP presentation. Heidi wasn’t sure if she wanted to go through another birth after her first traumatic experience, but she found a very supportive practice that made her feel safe to go for it again. Though many practices would have risked her out of going for a VBAC due to her age and subsequent gestational diabetes diagnosis, her new practice was so reassuring, calm, and supportive of how Heidi wanted to birth. Heidi knew she wanted to go into spontaneous labor and try for an unmedicated VBAC. With the safety and support of her team, she was able to do just that. At just over 40 weeks, Heidi went into labor spontaneously and labored beautifully. Instead of pushing for over five hours, Heidi only pushed for 30 minutes! It was exactly the dreamy birth she hoped it would be. ThrombocytopeniaReal Food for Gestational Diabetes by Lily NicholsInformed Pregnancy Plus Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 05:50 Review of the Week08:04 Heidi’s first pregnancy with gestational diabetes12:05 Taking insulin18:08 39-week induction 20:59 Pushing 24:29 Arrest of descent and opting for a C-section27:06 Researching providers before second pregnancy38:04 Discussions around induction41:45 NSTs twice a week47:10 Testing for preeclampsia54:53 Spontaneous labor57:43 Going to the hospital1:02:03 Laboring in the tub1:06:22 Pushing for 30 minutesMeagan: Hello, Women of Strength. It is Meagan and we have a friend from New Hampshire. Her name is Heidi. Hello, how are you? Heidi: I’m doing great. How are you?Meagan: I am so great. I’m excited to record this story today because there are so many times in The VBAC Link Community on Facebook where we see people commenting about gestational diabetes and for a really long time on the podcast, we didn’t have any stories about gestational diabetes. Just recently, this year really, we’ve had some gestational diabetes stories. I just love it because I think a lot of the time in the system, there is doubt placed with the ability to give birth with gestational diabetes or there is the whole will induce or won’t induce type thing, and with gestational diabetes, you have to have a baby by 39 weeks if they won’t induce you and it just goes. So I love hearing these stories and Heidi’s story today– she actually had gestational diabetes with both so with her C-section and with her VBAC. It was controlled. It was amazing. That’s another thing that I love hearing is that it is possible to control. We love Lily Nichols and the book about gestational diabetes and pregnancy. We will make sure to have it in the link, but it is so good to know that it doesn’t have to be a big, overwhelming thing. It can be controlled and it doesn’t have to be too crazy. Right? Did you find that along the way? Heidi: Yes. Yes, definitely. The first one was pretty scary, but then the second one, you know what you are doing and you can control it and you can keep advocating for yourself. Meagan: Absolutely. And then in addition to gestational diabetes, she had advanced maternal age barely with her second, but that is something that also gets thrown out. A lot of the time, we have providers saying, “We shouldn’t have a vaginal birth. We should have a C-section by this time,” so that’s another thing. If you are an advanced-maternal-age mama, listen up because here is another story for you as well. We don’t have a lot of those on the podcast. We are so excited to welcome Heidi to the show. 05:50 Review of the WeekMeagan: Of course, we are going to do a Review of the Week and then we will dive right in. This was from stephaniet and it says, “Inspiring and Educational.” It says, “As a mother currently in her third trimester preparing for a VBAC, I was so happy to find this podcast. The stories shared are so encouraging and it is so comforting to know that I am not alone in feeling that once a Cesarean, always a Cesarean.” 100%. That is 100% true. You are not alone here. And once a Cesarean is not always a Cesarean. It says, “This does not have to be my story. Thanks, Meagan and Julie, for providing the support and education to women who are fighting for a chance to have a natural childbirth. I would love to encourage anyone wanting to learn more about VBAC to listen to this podcast.” Thank you, stephaniet. This was quite a few years ago, actually. This was in 2019. We still have some reviews in 2019 that weren’t read. It’s 2024, so that’s really awesome and as usual, if you have a moment, we would love your reviews. Your reviews truly are what help more Women of Strength find these stories. We want these stories to be heard so leave us a review if you can on Apple Podcasts and Google. You can email us a review or whatever, but definitely if you listen to the podcast on a platform, leave a review and that would help. 08:04 Heidi’s first pregnancy with gestational diabetesMeagan: All right, Ms. Heidi. Welcome to the show and thank you for being with us. Heidi: Thanks for having me. This is awesome. Meagan: Well, let’s talk about it. Share your story with us with your C-section. Heidi: Yeah. We were planning for a child and we just decided. We were like, “Okay. Let’s shoot for an April birthdate.” We just thought that we could just have a child, but we got lucky and we did on the first try. Meagan: Amazing. Heidi: We went to our local hospital that was about five minutes away for care and it just seemed good enough. At the time, I thought you just go to the hospital. You get care. You can trust the provider and you don’t really need to do anything other than a hospital birth class for prepping. We just went along that journey. They assured me, “This will be a normal pregnancy. Everything is great.” The pregnancy was uneventful until about 20 weeks when I found out my baby was missing a kidney during a routine ultrasound. That sent us down Google rabbit holes and all kinds of fun things. Meagan: I’m sure, yeah. Heidi: Yeah. So at that point, we were assigned a Maternal-fetal medicine OB. I was offered an amniocentesis if we wanted to check and see what else was wrong and things like that. That was a major curveball. Meagan: Did you end up participating in the amnio? Heidi: No, we didn’t. We had a couple of detailed ultrasounds after that. At first, they didn’t actually tell me what they were looking for. I had three ultrasounds in a row that were not the more detailed ones. Meagan: Oh, okay. Heidi: I was like, “Why am I having all of these ultrasounds? Nobody is saying anything.” I finally got a phone call telling me that my daughter was missing a kidney so that’s what they were looking for. I was like, “Okay. Good to know.” Meagan: Yeah. You would have thought some communication before then would have happened though. Heidi: Yeah. It was pretty scary. So what seemed pretty uneventful–Meagan: Got eventful. Heidi: Yeah, it did. So right around 28-30 weeks when they do the gestational diabetes check, I went in for my check and found that I would need to start tracking my blood sugar and diabetes does tend to kind of run in my family even though everybody is very healthy. I was wondering if it would come up and also being older, sometimes they say there is a link but it still took me by surprise because I’m a very active person and I eat really healthy. I felt like a failure basically. Meagan: I’m so sorry Heidi: Yeah. All of a sudden, I’m meeting with a nutritionist. They give me this whole package of a finger pricker. Yeah, exactly. All of a sudden, I’m submitting logs four times a day checking blood sugar, and the fasting numbers for me just weren’t coming down so it was about one week of that, and then all of a sudden, they were saying, “Okay. You probably need insulin.” 12:05 Taking insulinHeidi: It came on so fast, so strong. Meagan: Wow. Heidi: It was really scary so then I found myself going to the pharmacy. I am a very healthy person so it was just all really weird going to the pharmacy buying insulin and learning all about insulin and learning almost how little the medical field understands about gestational diabetes. That was something bouncing in my head bouncing off the wall trying to understand the plan there. Meagan: Yeah. Heidi: Yeah, so after that, then I got phone calls from the nurses. They said, “You know, now you are on insulin. Now, you are going to have twice weekly NSTs required at 35 weeks.” I’m thinking, “Well, I’m working full time. How am I going to do all of this?” There is just so much sick time and it was really, really difficult to hear all of that. Meagan: Yeah. How do I have time for all of that? Plus just being pregnant. Heidi: Yeah. Yeah. Insulin and just for anyone that doesn’t know, basically you inject yourself. I was injecting myself every night with an insulin pen and it was all just very weird because you’re also thinking, “Well, I’m pregnant. I’ve never been on this medication. What is it going to do to me? What is it doing to my baby?” Very nervewracking. It’s all normal to feel that way. Meagan: Yeah. I think sometimes when we get these diagnoses, we want to either recluse because it’s so overwhelming, and sometimes then, our numbers can get a little wonky, or we dive in so much that it consumes us and we forget that we are still human and we don’t have to do that. Heidi: Yeah. Now that you say that, I definitely did a little bit of both. Meagan: Did you? Heidi: I did a little bit of denial and then I did a little bit of obsessive researching. Meagan: Yeah, because you want to know. You want to be informed and that’s super good, but sometimes it can control us. Heidi: Yes. Absolutely.

Today we welcome Jayne Havens, the founder of the Snooze Fest sleep training course and The Center for Pediatric Sleep Management™ sleep consultant certification program. Just like how Meagan’s birth experiences led her to become a doula and VBAC advocate, Jayne talks about how the knowledge she gained by teaching healthy sleep habits to her own children helped her create a passionate career.Jayne answers Meagan’s questions about sleep consulting in general, how to help children feel safe in their bedrooms, ways to effectively communicate, developmental milestones in both babies and children that can affect sleep, how to become a sleep consultant, where to find them, and even earning potential from a career as a sleep consultant!Jayne's Course - Use code VBACLINK for a discount!Becoming a Sleep Consultant Facebook GroupBecoming a Sleep Consultant PodcastNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:24 Review of the Week05:35 Jayne’s journey to sleep consulting13:35 How can a sleep consultant help?19:43 What to do when a child feels unsafe in their room21:08 The life of a sleep consultant25:17 Sleep consultant qualifications30:36 Ages covered in Jayne’s course36:00 How to find a sleep consultant40:59 Cost to hire a sleep consultant and potential earnings as a sleep consultant46:57 Where to find “Becoming a Sleep Consultant” Meagan: Hello, Women of Strength. It is Meagan and we have my friend, Jayne Havens on the podcast today. Hello, Jayne. Jayne: Thank you so much for having me. I’m so excited to be here. Meagan: Thank you. Me too. We actually just met this year, 2024 in January and we met at a business doula retreat. Jayne is actually not a doula. She is a mom and a successful business owner. When we connected, I just felt so much that our stories related in different ways but very much in the same ways and I was like, “I want you on the podcast.” So today, we’re not sharing a VBAC birth story, but we’re sharing a business birth story and some tips on sleep and how to help your babies sleep because we know as mamas with newborn babies, we don’t get a lot of that sometimes and it doesn’t have to be that way. I’m so excited to have Jayne Havens who is a certified sleep consultant and runs her own sleep consulting practice, Snooze Fest by Jayne Havens and you also have a podcast. Jayne: I do. It’s called Becoming a Sleep Consultant. Meagan: Becoming a Sleep Consultant. As a new parent overwhelmed by exhaustion like I just said we all have with a newborn, Jayne found herself reading everything she could find in order to get her own son to sleep through the night. Now, if you are driving, don’t raise your hand because keep your hands on the wheel, but you can nod if you understand that sentence right there. I definitely was that with my son and my daughter and my first. I’ve had three and we have to figure it out and every baby is different. So friends, quickly after she mastered this, started asking her, “Help, please!” She started doing that and helping all of these moms and babies sleep better, feel better, and just live better. Jayne’s children were both fabulous sleepers and they began coming to her for that help because they saw it. We are so excited to have Jayne today. 02:24 Review of the WeekMeagan: I do think that a Review of the Week is needed so I”m going to hurry and share a Review of the Week and then we will dive right into this amazing episode. Okay, so this review is from sarahgb and it says, “Full of knowledge, fun, and strength-filled stories.” It says, “First off, I would like to say that I am 16 years old and a doula in training and lover of anything pregnancy, birth, and baby related. This podcast is literally exactly what I have been looking for and wanting. I have been listening for a long time and cannot stop. I think I’ve listened to four or five episodes in one day.” Wow, that’s definitely some binge-listening. It says, “I love the variety of stories and listening to all of the Women of Strength share in their successes. I also love the few minutes at the end when Julie and Meagan give information, facts, and tips on certain pregnancy and birth topics related to the birth story. I have learned so much from listening to these birth stories and it helps me prepare for things I might come into contact with as a doula. I absolutely cannot wait to have my own kids and we will be listening to this podcast forever especially when I’m pregnant. I could say so much more, but Julie and Meagan, I am thankful for all of your hard work, sacrifice, and spirits as this has made all of this possible. “God has truly blessed y’all. By the way, I am going to take your VBAC course and when I graduate high school, I cannot wait.” I love that. That was a little while ago back when Julie and I were podcasting together, so hopefully, sarahgb, you are graduated and with us today. 05:35 Jayne’s journey to sleep consultingMeagan: All right, Ms. Jayne, how are you today? Jayne: I’m good. Thank you for having me again. I actually am just getting over sickness from last week so if my voice sounds a little weird, that’s why, but I feel fine and I’m excited to be here. Meagan: Good. Well, you sound great to me and I’m so excited that you are here. I wanted to start right off with your story. I mean, we are storytellers here on this podcast and I think that your story goes obviously so much into why we are here today. Jayne: Sure. So I am a wife and a mother. I live in Baltimore, Maryland with my husband and two kids. They are 7 and 11 now and I got into this journey of becoming a sleep consultant back really when my son was born. Prior to having children, I worked in catering sales. I was an event planner. I planned weddings, corporate holiday parties, and graduate celebrations. I worked nights, weekends, and holidays. I loved it, but it was really hard work. I always knew that it wasn’t going to be a great fit for me when I had kids one day. I wanted to be more present for them. I was raised by a stay-at-home mom so that’s all I ever knew. My life’s dream was to be a mom who is first in line in carpool with the best snacks. That’s the mom that I wanted to be with the station wagon. Remember station wagons? Meagan: Yes. I sure do. Oh my gosh. Jayne: I wanted to drive a station wagon and be first in the carpool line and have the best snacks and take my kids to tennis lessons and that be my life’s work. So I quit my job in catering when my son was born and I had four glorious years as a stay-at-home mom. My son was delightful and delicious and he was just perfect in every single way and then I had my daughter and she was a really tough baby. I can say this with love now because she is 7 and she’s amazing, but it was really, really hard when she was born especially because my son was just such an easy baby and he was so smiley and happy. Everything just worked out as it should. My daughter had a milk, soy, and protein intolerance and was colicky. She just literally cried. She cried and that was it. Meagan: That’s so hard. Jayne: It was so hard. It gave me a run for my money because I thought I was this amazing mom and I would look around at all of these other moms who had babies that were crying and I’m like, “What’s wrong with you? Why can’t you get it together?” Then I had one of my own and I was like, “Oh, now I get it.” It really put me in my place. I really didn’t enjoy motherhood the second time around if I’m being completely honest and transparent. So I was looking for an outlet. I needed something else to fulfill me because that stay-at-home mom life that I thrived on for four years was no longer serving me in the same way. My husband is a lawyer. At the time, he was traveling a lot for work. Everybody had gotten really used to me being the primary caregiver and the one who maintained the children and the house. None of us could really see that changing. Jayne: Going back to work in the traditional sense didn’t even seem like a possibility. I started thinking about, “What could I do from home? What could I do not even to make a ton of money but just to do something to keep me fulfilled and entertained and inspired?” I kept coming back to sleep consulting because I actually was really good at getting my own kids to sleep. I had sleep-trained my son when he was four months old. He took to it beautifully. It was really– as a first-time mom, he cried for 27 minutes and so did I. It was hard at the time, but he really took to it beautifully and it was life-changing. I understood very early on the value of having routine and order and rituals and a set expectation around what sleep could and should look like in my home for both my husband and I and for our children. The same thing with my daughter– as much as she cried during the day, she slept beautifully. The only time she wasn’t crying was when she was sleeping. Meagan: When she was sleeping at night. Jayne: Yeah. She was a beautiful sleeper, but when she was awake, she was crying. So I was really good at getting my own kids to sleep. For years, I was the friend who just helped other friends with their kids’ sleep. I didn’t have a formal process. I wasn’t formally trained. It was just like, I would get onto a call with them and give them advice and text message them some tips and I would help them. I would get them results. It was working. I did that for years. I helped friends, friends of friends, and eventually, I just decided, you know what? I’m going to get certified. It turns out there are courses online where you can get trained to do this and turned my hobby into a business. My intention was really just to dabble. I wasn’t looking to build an empire. I just wanted to be able to help families and if I could bring in a little bit of money to contribute to our family’s income, great. Very quickly, after launching my business, I realized that this wasn’t just going to be a little passion project, that this

“If you don’t know your options, you don’t have any!”April is Cesarean Awareness Month and we hope this month is one of information, empowerment, and love from us here at The VBAC Link to you. Referring to the amazing resources provided by the International Cesarean Awareness Network (ICAN), Meagan and Julie break down the mission of Cesarean Awareness Month. Whether you are a first-time mom, VBAC mom, CBAC, or RCS mom, there is space for all of you! This month is meant to not only reduce Cesarean rates overall. It is also meant to inform everyone about birthing options, hospital rights, and ways to make Cesarean births better. We need all of our experiences to make positive changes in the birthing world for future generations! ICAN's WebsiteCesarean Awareness Month ToolkitInfant Mortality Statistics from 2022Informed Pregnancy PlusNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 07:03 Review of the Week09:29 Why we need Cesarean Awareness Month13:12 ICAN’s Cesarean Awareness Month toolkit16:00 Ways to make Cesarean births better21:20 Common reasons for Cesareans25:59 Your hospital rights32:10 The safety of home birth36:52 Lower Cesarean rates = lower infant/maternal mortality rates40:38 A message to the CBAC communityMeagan: Hello, hello everybody. It is Meagan and I have Julie with us today. I always get so happy. Julie: Hello, hello. Meagan: We are going to be talking about International Cesarean Awareness Month. Now, this is sensitive. It’s sensitive. It can be sensitive. It’s a month, a whole 30 days or 29 days. I don’t actually know how long April is. Julie: April is not 29 days you crazy. That’s just February once every four years. Meagan: That’s just February. Maybe 30, maybe 31. I don’t know. Julie: April is 30 days always every year. Meagan: Is it? I don’t know my months apparently. Julie: Apparently. Meagan: It can be a long month for people and we’re going to talk a little bit more about that. But it stands for International Cesarean Awareness Month and it is a month that is truly just brought to create awareness around unnecessary Cesareans, around advocating for vaginal births after Cesarean, improving Cesarean recovery after, and really just spreading the word and getting the information out there because as someone who has been in the VBAC world before, we have been told many times that VBAC isn’t possible and Cesarean is a must. You know, Cesarean isn’t desired by everyone, and a VBAC isn’t desired by everybody, but it’s important to know the options. One of the coolest things is that ICAN which is a nonprofit organization created this mission and I’m just going to read it. Does that sound appropriate? “ICAN is a nonprofit organization whose mission is to improve maternal/child health by reducing preventable Cesareans through education, supporting Cesarean recovery, and advocating for vaginal birth after Cesarean for VBAC.” We are really grateful for ICAN. They do a lot of amazing things and I know that they were a big part of my journey. I mean, wouldn’t you say yours too, Julie? I think that’s actually where we might have met is an ICAN chapter meeting maybe. Julie: Where did we meet? Now I’m going to think. Meagan: I feel like I can picture you in a living room in a chair up front. You were very involved with the presenter and I was just there. Julie: Wasn’t it at your house? Meagan: No. Julie: Okay. Yeah, I remember that one. Meagan: It was at someone else’s house and anyway, that’s the first day I remember seeing your beautiful face. Crazy, but we love ICAN and we support them. Julie was just looking and they had a t-shirt. One of the things it says is, “You have options.” That is going to be one of the things that we are talking about today. Julie: Yeah. That was last year’s theme but they haven’t posted this year’s theme yet. I mean, we’re recording this in February so they haven’t gotten a lot of the information out yet, but I love last year’s theme. Meagan: I know. You have options. And you do. You have options even though a lot of the time we don’t feel like it. 07:03 Review of the WeekMeagan: Julie, do you want to read a Review of the Week before we get going? Julie: I was going to say, yeah. I feel like we are already getting going. Yes. Let me read a review and then we will do the intro and then we will go. Hold on. Now, I’ve got to get back to it. Perfect. This review is from unhappyggfan so hopefully she’s unhappy about GG and not The VBAC Link. Unhappyggfan. She says, “Truy helped me achieve my VBAC.” She says, “I found and started listening to this podcast a couple of days before my due date.” Oh, that’s cool. “I was walking a ton every day to encourage labor so I just binge-listened to these episodes one after the other. My due date came and went and I got more worried about having a successful VBAC. I kept listening to these episodes while I walked for hours every day. Fast forward to 12 days past my due date,” oh, poor thing “when my water finally broke right at the beginning of a massive storm and flooding in my city. My doula was unable to make it to my labor and delivery due to flooding on her street and the stories from the women on this podcast truly acted as my virtual doula.” Aw, that’s sweet. “As I labored for 16 hours, I thought back to the many stories I had listened to and the words of encouragement and wisdom from the podcast hosts and their guests. I thought of things I had learned and learned as I pushed for an hour and then my son was born. I truly believe that listening to the stories shared on this podcast helped me to have my VBAC. I wish I could thank every guest whose words gave me strength, but I will just say it here. THANK YOU. This podcast truly means so much to me now. A must-listen if you are preparing for a VBAC.” I love that. Virtual doulas. Meagan: I love that. Thank you. 09:29 Why we need Cesarean Awareness MonthMeagan: Okay. All right. I know the motor started and we were gently tapping on the gas before we started reading that review, but yeah. Let’s dive into it. So we kind of talked about ICAN and what their mission is, but Julie, when you hear Cesarean Awareness Month, what do you hear or feel? What does it mean to you? Julie: I feel like here at The VBAC Link, it’s always Cesarean Awareness Month. Do you know what I mean? We are always focusing on that. But I feel like I love the collective call to action for the entire birth community and hopefully, even the world to focus on this. I was just thinking about this and ICAN hosts this big month for awareness to rally for donations and pushes for things like increased access to VBAC and lower Cesarean rates and things like that, but I was like, “Okay. What more is it? What more is it?” I wanted to get into maybe a little bit more about why we need awareness about Cesareans. What’s the point? Why are we worried about this? Why are they worried about this? I really love that they have it on their ICAN website. It’s ican-online.org/cesarean-awareness-month-toolkit and I’m sure that will be updated for 2024. I will link it in the show notes, but it has a whole toolkit that you can use with all sorts of things you can do. What I really like about their page is that they talk about why we need awareness for Cesareans in the first place. I love the bullet points that they show. Researchers estimate that almost half of the C-sections performed could be safely prevented. The next one is, “If families don’t know these options don’t exist, they can’t advocate for them.” Obviously, we are huge proponents of that here. If you don’t know about your options, you do not have them. You do not have options if you do not know what they are. The next is, “Cesareans can be more or less family friendly depending on the practices and protocols of the facility and the support level of providers. Preventable Cesareans may be responsible for up to 20,000 major surgical complications a year including sepsis, hemorrhage, and organ injury.” I feel like sometimes we forget that C-sections are major surgery. They are a major surgery that comes with all of the risks that major surgeries come with. The last one is, “The future risks to birthing people and their future pregnancies and children are not even mentioned when we are talking about Cesareans.” What are the future risks to these mothers and their kids and their families? I feel like that’s the big need to protect our women and the children that are being born and to reduce the amount of people suffering from major birth complications. It’s just a medical safety issue. Yes. We probably should put a plug in here that we have literally seen C-sections save the lives of both moms and babies. We have seen it. We are not arguing that. We are not questioning that. What we are questioning is their frequent use, how overused they are, and how quickly they are jumped to for many reasons besides the true risk to life and health of the people they are trying to save. 13:12 ICAN’s Cesarean Awareness Month toolkitMeagan: Yeah. Yeah. It’s so hard. I feel like there’s this line of– I think I still even have anger about how many unnecessary C-sections happen. I kind of want to talk about, okay. We have a large chunk. We are really high. 32% of Cesareans are happening and I want to know that percentage truly how many of those people didn’t desire it at all. I’m going to guess a large chunk of them didn’t desire it, but I’m also going to guess that a large chunk of those went on to have future Cesareans which again, is fine. But like she was saying, you have options, and a lot of the time, the options aren’t presented so if we don’t know that we have these options, we just keep having Cesareans. They might not be desired. Julie: You’re right. It’s true. I feel like everybody listening right now should go and download this Cesarean Awareness Month Toolkit because I feel like there is so much value here. It gives you so much informati

Hayley joins the show today sharing her breech Cesarean and unmedicated hospital VBAC stories. Meagan and Hayley dive deep into the pros and cons of getting an epidural and why providers tell women so many different things when it comes to epidurals and VBAC!While Hayley had the dreamiest birth she could have imagined and everything went according to plan, her postpartum experience with prolapse was not something she was prepared for. Hayley shares her symptoms, what she wished she knew, and what she has done since to recover and feel like herself again. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:47 Just-in-case epidural04:16 Dr. McGuire’s insight on epidurals08:42 Using an epidural as a tool10:44 Hayley’s first pregnancy and birth12:00 Doing VBAC research before pregnancy13:51 Hayley’s second pregnancy18:15 Labor begins20:16 Going to the hospital24:20 Pushing27:05 Hayley’s prolapse experience32:01 Symptoms of uterine prolapse35:29 Prolapse can happenMeagan: Hello, hello Women of Strength. You guys, I am excited about today’s episode. I love talking about VBAC obviously, but specifically, we are going to talk a little bit about unmedicated versus medicated. Our friend, Hayley, from North Carolina has had a beautiful unmedicated hospital VBAC so I want to also talk about the opposite side of that and talk about medicated VBAC. We have so many people in our community that I see type, “I want a VBAC, but I don’t want to go unmedicated and my doctor says I have to. I can’t have an epidural” or the total flipside of that where, “I really want an unmedicated VBAC, but my doctor says I can’t go unmedicated. I have to have the epidural.” Did I just say that correctly, Hayley? Hayley: Yes, yeah. Meagan: It’s either one or the other. We’ve got providers telling people they can’t have an epidural or they have to have an epidural. So I wanted to just talk a little bit today before we get going on those two topics. First of all, let’s talk about unmedicated birth. Hayley and I are living proof today. We are on this episode that unmedicated VBAC is 100% possible, achievable, and safe. A lot of those providers come out and say that they can’t go unmedicated because they say it’s not safe. In the rare chance, we know that uterine rupture happens but it is rare. In the rare chance of a uterine rupture, that is where they say that is not okay. Or they will say things like, “But you wouldn’t want to be knocked out for your birth,” which is scary. I don’t want to be knocked out for my birth and I know people have. A lot of the time, it is not the most pleasant experience. Yeah. Okay, so let’s talk about that. Unmedicated vaginal birth is unmedicated vaginal birth. That’s what it is. I’m just laying it out there. Yes, we have a slight increase in uterine rupture. Yes. What happens if we have a uterine rupture and we are unmediated? A lot of the time, we are noticing that there are signs of uterine rupture. When we get an epidural and a spinal, we go back and have a C-section. Simple as that. Or if it is a true medical emergency, yes, there is that small risk of needing to be put under. Small risk and small risk equal risk of course, but it’s low. 02:47 Just-in-case epiduralMeagan: What about if we have the just-in-case epidural? I seriously sometimes just want to sock someone who says “Just in case”. We don’t need to be placing an epidural just to have it ready to dose because guess what? In the event that it is a true emergency and we really do need to go in for an immediate Cesarean, it’s the same thing. We get knocked out. I know that these words are kind of big and harsh words. We get knocked out, but we get put under general anesthesia if we don’t have anything in our system. Now, let’s talk about an epidural. You actually have an epidural placed. It’s running. It’s dosed and we have a uterine rupture. Guess what? Women of Strength, more than likely, it still has to be dosed further because an epidural is not like a spinal. It’s just not. They have to dose it further. With my first Cesarean, I had an epidural. They had to come in, dose it to a deeper extreme so I wasn’t feeling my surgery and I had to wait. Right? We are still waiting. It’s the same thing. There is always a wait and it takes time. It takes about 15-20 minutes for any epidural to kick in deep enough. 04:16 Dr. McGuire’s insight on epiduralsMeagan: Dr. McGuire wrote for Yale Medicine. She talks about this epidural and is it safe and how are they different. She talks about how they truly are different than they were back in the day because they are dosing them lighter. We know that. We have seen that, but we still have some pretty serious risks as well with epidurals even though again, they are smaller. There are blood clots, spinal infections, spinal headaches, them not working, and things like that, and blood pressure. I’m going to say as a doula, I’ve attended over 350 births. As a doula, I will say a large portion of any client, not just VBAC, who receives an epidural has a blood pressure dip. Even when they have a large amount of fluid because a lot of the time they will cram fluids in to try to help this, but there is some sort of blood pressure dip and baby seems to struggle when that happens. Then it’s the cascade– rolling over, move, move, move, move. Baby doesn’t recover or mom’s blood pressure doesn’t recover and we are off to an OR. One of the biggest questions that I think is a really hot debate in the medical world is does an epidural raise your chances of a Cesarean? Most people out there are going to say, “No, it doesn’t.” The studies are pretty low, though. I think in one study there were 2,000 people or something like that and they showed it didn’t. But I mean, from a doula’s standpoint, I know I don’t see as many births as these OBs, but I definitely see it seems to do that– the blood pressure drop thing. So is it safe? Yes. Do you have to go unmedicated if you have a VBAC? No. Do you have to get an epidural if you have an epidural? No. Do what is best for you. What she says is, “Those studies we know that have a higher concentration of epidural medicine was associated with an increased risk of Cesarean, though lower concentration we now use actually promotes normal, spontaneous vaginal delivery without assistance.” When she says assistance, a lot of the time when we have epidurals, we have vacuum or forceps assistance because we have lack of mobility. That’s what she was saying here. I want to make sure to provide the link and some other links on our blog for epidurals so you can decide what is best for you. But for now, we are going to get into a story of an unmedicated, vaginal birth. 08:42 Using an epidural as a toolMeagan: Okay, Ms. Hayley. Welcome to the show. Hayley: Thank you for having me. It’s really crazy to be on here sharing so thank you. Meagan: I talk about how it’s crazy to be full-circle where you are listening. You are preparing. All of the people in your ear are motivating and then here you are today sharing your story motivating others in your same space x, y, z months ago. Hayley: Yeah. It’s crazy. It really is a full-circle moment like you mentioned. Meagan: Yeah. Well, I am so honored that you are here. I would love to turn the time over to you. Hayley: Sure. So yeah, I also love what you were saying really quickly on the epidural versus not. Full transparency, when I went into this, I definitely recognized that an epidural is a tool and I knew and wanted to prepare myself. If I am– obviously, birth is not pleasant. It’s not going to be a walk in the park. But I knew there was a difference between being in pain versus suffering. I really wanted to know that for myself. It if turned into that suffering, I wouldn’t have been opposed to helping my body to get my baby. Meagan: To the next point, yeah. Hayley: But there is a difference between being in pain and suffering. Meagan: As a doula, we talk about that a lot where we are like, okay. We are planning to go unmedicated. That is fantastic and then we talk about that pain versus suffering and that transition because when we are suffering, we start having things that come up later. We don’t think about it. We are suffering now, but postpartum depression, postpartum anxiety, and postpartum trauma. We have these things that are not worth it, so in the end, you have to do what’s best for you and keep you in that positive space and recognize pain versus suffering. Hayley: Yeah. Exactly, so I love that. 10:44 Hayley’s first pregnancy and birthHayley: To start this whole story I guess, is back in April 2021, I had my daughter. She was breech. For me, I knew pretty early on that she was breech. She was so active. I knew that, “Oh, you are trying to flip in there.” I did all of the things. I did Spinning Babies and tried all of the things, but it was still COVID time so I just didn’t go to acupuncture. I feel like if it wasn’t COVID times still, I maybe would have tried more things. But with that being said, I felt like she was literally trying to turn because I’m like, “What are you doing? If you’re not flipping, then I’m not sure. Then you can’t.” I just felt in my body that there was a reason. I didn’t try manually flipping her or things like that. To help with peace of mind, I opted for a Cesarean even though that was the last thing I wanted. I’m terrified of surgeries and needles. I was like, “I do not want this. This is the absolute last thing I want,” but at the same time, I was happy that I could mentally prepare for that instead of it being sprung on me. And honestly, I feel like I had a pretty good recovery with that. At the same time, I knew for any future children, I did not want to have another C-section. 12:00 Doing VBAC research before pregnancyHayley: So fast forward. We moved across the country when she was about 9 months old. I was definitely not pregnant yet, but we were thinking about expanding our fa

Though Karen did research and took birthing classes before her first baby, she didn’t realize how much advocating for herself could change the course of her birth. She wanted to be the “good” patient and told herself she could do without the things her body told her she needed during labor. Karen ended up pushing for over four hours and consenting to what she was told was an emergency C-section, even though the actual surgery didn’t happen until hours later.Karen had some serious postpartum symptoms of swelling and difficulty breathing that were dismissed and even laughed at until things came to a point where she knew something was very wrong. She was diagnosed with postpartum cardiomyopathy, admitted to the ICU, and transferred to cardiac care. Doctors told Karen very different things about her condition. She went from being told not to have any more children to hearing that VBAC was absolutely safe. Karen discusses how her gestational hypertension came into play with the different advice as well. Karen found her voice. She advocated for herself. She knew what her body was saying and what it was capable of. Her labor was so smooth and she WAS able to birth vaginally!Informed Pregnancy PlusNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 3:46 Review of the Week06:27 Karen’s stories08:50 First labor10:47 Pushing for four hours15:11 Karen’s C-section17:43 Postpartum swelling and difficulty breathing21:03 Fluid in her lungs23:52 Moving to Florida and getting answers25:13 Getting pregnant again29:53 Advocating for a VBAC32:14 A spiritual dream34:34 Gestational hypertension39:36 Signing an AMA41:31 Going to the hospital45:20 Pushing for 20 minutes47:30 White coat syndrome51:59 Symptoms of hypertension and preeclampsia54:52 Tips for hypertension and preeclampsia 56:55 Karen’s final tipsMeagan: Hello, hello. We are getting into almost our 300th episode, you guys. Every single time I’m recording and I’m looking at these numbers, I am blown away. I cannot believe that we have almost put out 300 episodes. Oh my goodness. I am so glad that you are here. I have this energy this year. I don’t know what it is. You’ll have to let me know if you notice it, but I have this energy every time I’m recording this podcast. 2024 is vibing. I’m vibing with it. I’m really liking it. We have our friend Karen and are you from Florida, Karen? Karen: Yep. I’m in Orlando, Florida. Meagan: Florida. That’s what I was thinking. So if we have Florida mamas looking for providers, this is definitely an episode. I feel like probably weekly we would get 10 messages asking about providers and Florida is huge so Florida is actually one that is really common where we are getting messages for supportive providers. So Karen, along the way, if you feel to name-drop some providers that are supportive, feel free to do so but we are going to get into sharing her story in just one moment because we do have a Review of the Week. 3:46 Review of the Week Meagan: This is from louuuhuuuu. So louuuhuuuu, thank you for your review. They say that this is “very inspirational.” It says, “I knew I wanted a VBAC with my third pregnancy, but I wasn’t sure if it was possible. However, I knew I didn’t feel like being flat-out told, ‘No’ at the first appointment. Listening to the podcast was definitely the start of me really researching birth and looking into my options. I ended up with a successful HBA2C and I definitely don’t think I would have had the courage or believed it was possible without this podcast. Thank you, Meagan, for all of the work that you do to provide this information.” I love that review so much. I think that through time in my own research, I was told no. I wasn’t told, “No, no.” I was told, “Sure, probably yeah. You could VBAC,” but I never really got that positive vibe. I feel like this community that we have created with all of the people on the podcast and all of the people in the community on Facebook truly is something that I lacked when I was preparing for my VBAC. I’m so grateful that we have this community for you today. Thank you, louuuuhuuuu, and huge congrats on your HBAC, your home birth after two Cesareans. If you didn’t what HBA2C meant, that’s home birth after two Cesareans. Just like louuuhuuuu, you can too. Make sure to follow us in our Facebook community. You can find it at The VBAC Link Community on Facebook. Answer all of the questions and we will let you in. You can find out as well that it is possible. VBAC is possible. 06:27 Karen’s storiesMeagan: Okay, Karen. Welcome to the show and thank you so much for taking the time to share your story today, well your stories today. Karen: Yeah. Thank you for having me. It’s a little wild actually being on your show. I’ve been thinking about what I was going to say even before you invited me like, “What would I say if I finally get my VBAC? It’s crazy to actually be sharing my story now so I’m really excited to be talking to you today.” Meagan: Well I’m so excited that you are here and sharing your inspirational message. You know, going through your submission, it sounds so similar to so many of us. You went in for a totally planned unmedicated birth that switched to the complete opposite where you had a C-section. There are so many of us. When I was reading that, I was like, “I bet I could probably find hundreds of stories not even just in our own community that start out like that.” Karen: Yes. That’s why I love listening to your podcast so much because for the first time, I didn’t feel alone. But yeah. I can get into my story now if you’d like. Meagan: Yes. I would love it. Karen: Okay. So back in August– or, I’m sorry. My son was due in August 2023. This was our first baby and he was a little bit of a surprise baby, but he was very much welcome and we were excited for him. At the time, we were living in Virginia. My husband had just gotten out of the Navy and he was about to start law school. I did prepare for the birth but I don’t think I prepared enough. I took a Hypnobirthing class and the doula who was leading the class was super supportive. She was just like, “You’re just going to birth beautifully. I can just tell.” The midwives, the nurses at the practice were like, “Oh, you’re going to birth beautifully. I can just tell.” I just kept hearing that over and over again. My ego was a little over-inflated and I was like, “I don’t need to do much. I’ve got this.” I don’t think I was prepared enough. I didn’t know what I was really getting into. 08:50 First laborKaren: So when I actually started going into labor, I got there way too early. I got to the hospital too early. Like you mentioned, I wanted an unmedicated birth. I got there, I think my contractions were about every seven minutes. Now I know that I definitely should have waited at home longer. But everything seemed to be going well. I arrived. They admitted me. They seemed a little bit hesitant, but they were like, “Oh, well she’s in labor. Let’s just bring her in.” My water broke on its own that afternoon. Things seemed to be going well until the pain really started kicking in. I had a really hard time working through the pain even with everything I learned in HypnoBirthing. I still hadn’t quite found my voice yet, my mama voice. I couldn’t tell people, “Hey, you’re distracting me. I’m trying to do HypnoBirthing.” I felt embarrassed about putting up the sign outside my door saying, “Hey, HypnoBirthing in progress. Please keep quiet.” I just didn’t speak up. I was just trying to be a good girl and just listen to what everyone says. I heard so many times in different episodes being a good girl and just doing what I’ve been told. Meagan: Right. We are people pleasers. I think a lot of us are people pleasers. We don’t want to ruffle feathers. We want to stay in line. We want to follow this path that we are being told we have to stay on. Karen: Yes. I mean, I just didn’t realize it was something I needed to form as a mama to be able to stand up for myself because pretty soon there was going to be a baby that needed me to stand up for them. Like I said, during the birth, there were just so many distractions, people coming in and out, nurses, and visitors. It was too much. I did end up getting an epidural because I just couldn’t hold out any longer. 10:47 Pushing for four hoursKaren: Around 2:00 AM, the labor and delivery nurse told me, “Oh, you need to start pushing.” I was on my back. I pushed for about two hours. I had some breaks but the baby was just stuck. For part of it, we could see that he was crowning but he just would not come out. During this entire time, no one really looked at me. I just had this one labor and delivery nurse. She was so sweet, but the midwife didn’t come by. The OB didn’t come by. No one really came by and I wanted to move into different positions. I felt my body telling me, “Hey, try this. Try this,” and they would tell me, “You can’t move. You have to stay like that.” I pushed for four hours. Baby was in distress. I felt fine but the midwife came in and told me, “You’re going to need a C-section.” This was the first time I had seen her. She told me. Meagan: Wow. Karen: Yeah. So she says, “You need a C-section. He’s not going to come out vaginally.” I didn’t know. I didn’t know what to do. I mean, I felt that was my only option. I got really upset. I started crying. I felt like a failure. I know now that I’m not a failure. That wasn’t it. But that’s how I felt at the moment and my husband was devastated. He was such an amazing birth partner and he felt like he failed me. I was like, “No. You didn’t fail either,” but at that moment, we just felt so let down that one, I had to ask for an epidural, and two that I was going to need a C-section. Karen: They told me. I don’t remember if the word “emergency” was used or not, but they made me feel like it was an emergency and it needed to happen immediately. When I look at the paperwork and all of that s

Jennifer joins us today sharing her HBA3C story! Each birth was a stepping stone that gave her more education and wisdom which ultimately led to her home birth after three Cesareans. Jennifer’s first Cesarean was due to meconium in the water, slow progress, and heart rate issues. Her other two Cesareans were scheduled, but her third was particularly difficult because in her heart, Jennifer really wanted a VBAC. After regretting her decision to get her tubes tied during her third Cesarean, Jennifer opted for a reversal and it worked! Once pregnant with her fourth, she traveled two hours each way across state lines to find a home birth midwife. When labor began, Jennifer booked an Airbnb, called in her team, and had the beautiful home birth she knew she was capable of.Jennifer’s WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:20 Review of the Week05:02 First C-section06:48 Second C-section08:02 Third C-section during COVID10:09 Getting her tubes tied and reversal13:38 Fourth pregnancy16:39 Finding a home birth midwife in another state19:02 Going into labor and reserving an Airbnb24:04 Complete dilation26:37 Pushing and catching her baby31:24 You are worth itMeagan: Hello, hello everybody. This is Meagan, your host here at The VBAC Link and we have our friend, Jennifer. Hi Jennifer. Jennifer: Hi. Meagan: You guys, her story– we were just talking about this before the episode. It has a lot of surprises like, “Oh, I didn’t expect that. Whoa.” So I’m so excited to– I’ve read a summary of her story and am now excited to hear it in her own words. I also thought it was kind of fun. She was just saying her kids are excited to hear her story because they know The VBAC Link podcast too. Jennifer: Yep. It was part of our preparation for the birth just having them hear stuff and hear how births are because obviously, they’d never had any experience. Meagan: Yes, so how old are your kids? Jennifer: 11. 9, 3 and now newborn. Meagan:  And now newborn. We have very similar-aged kids. 11 and 9 and then I have an 8-year-old this year. And then we jump. That is so exciting. I’m excited to get into your HBAC after three Cesareans and all of the fun things away. 02:20 Review of the WeekMeagan: But I do have a Review of the Week and this review is from mcgrace. I actually think I know who this is. It says, “Must listen for every mom-to-be.” It says, “This podcast is a must-listen not just for the mom preparing for a VBAC but anyone who is giving birth and has given birth or plans to give birth in the U.S. Meagan wonderfully walks through personal stories while preparing helpful advocacy tips and a solid dose of empowerment in each episode. If you want to hear people discussing their path to VBAC, if you’re curious about what giving birth looks like in the U.S., and if you want tips on how to mentally, emotionally, and physically prepare yourself for the best birth, listen to this podcast.” Thank you so much for that review. Jennifer: Totally. I 100% agree. Meagan: That is so sweet. I do agree with her. Yes, VBAC is in the title of this podcast, but it really is for anyone. Jennifer: Totally. Meagan: And everyone wanting to give birth. Jennifer: Definitely. Meagan: I feel like if I had this podcast when I was preparing for my daughter Lainey, that would have changed a lot. Jennifer: Yes. If I had listened before my first birth, I feel like so much would have and could have been different. Meagan: Could have been different. I know. I’m so grateful for all of the Women of Strength who are sharing on this podcast and who are sharing on social media. By the way, we are accepting stories for our social media because we do have a lot of submissions on the podcast and we can’t get to everyone. We would love to still share every story possible, so if you are interested in sharing your story on our social media, email us at info@thevbaclink.com with your subject “Share My Story” and we will get that posted. 05:02 First C-sectionMeagan: Okay, girl. Let’s dive into all of these stories. They are all– I don’t know. I feel like each one is the stepping stone to this final birth. Jennifer: Yes. Yes. Meagan: And I’m not saying you are done having babies. Jennifer: Well, yeah. Most recent. Meagan: I don’t want to say final like you are done. But this birth that you are sharing, I feel like each one came with learning and growing and all of the steps it took to get you to this point.  Jennifer: Yeah. I feel like I was so young with my first and I didn’t have any education at all which is common. Meagan: That’s how I felt. Jennifer: But yeah. It was a slow, long labor which is pretty typical for a first. I went to the hospital right away and I just had in my mind, I didn’t know about physiological birth. I just knew. I was like, “Oh my gosh. This hurts.” I thought I needed to be in the hospital because this hurts and something must be wrong because it hurts. Then I had an epidural and things were slow. He did have meconium. They broke my water and he had meconium. It was that cascade of interventions and it was just kind of one thing after another. It slowed down after the epidural and at 4 centimeters, his heart rate wasn’t looking great and they said, “You need a C-section.” In my mind, it was like it was an emergency. “Oh my gosh, I need a C-section.” So I had the C-section and yeah. That was the first stepping stone like you said. I didn’t know anything. 06:48 Second C-sectionJennifer: Then with my daughter, I wanted a VBAC. I heard about VBAC and was like, “Oh, that’s a thing.” Someone who I look up to told me the dangers and the big risks. They really had good intentions. They really thought it was dangerous so were trying to look out for me, but I was very vulnerable and they really scared me out of it. They were like, “You’ll both die if you rupture within a couple of minutes.” Now, after I’ve learned more, I’m like, “That’s not even true,” but at the time, I was like, “Uh, I just don’t think it’s worth the risk,” so I just scheduled that C-section. I think each recovery was also more difficult. The first one was a fairly easy recovery and then the second one was a little harder and then my third was that bigger age gap. I had educated myself a little more or at least I knew what I wanted. 08:02 Third C-section during COVIDJennifer: I knew that I wanted a VBAC. I didn’t want to deal with the drugs again postpartum and the numbness and everything. I just didn’t want to deal with it all with a C-section. That was during 2020 COVID year so that was a whole other level of difficulty added in with that year. That was the one where they did a bait and switch on me. I said from the beginning with my OB/GYN, “Would you let me have a VBAC?” They were like, “Yeah. We can definitely do that. We’ll just look at your scar in an ultrasound later on and as long as it looks thick enough, yeah. You can have a VBAC.” Of course, my scar was not thick enough. I’ve since learned and I think on one of your podcasts you talked about it in great detail. But that test is super– I mean, you talk about millimeters on this fuzzy black screen. Meagan: Yeah. Not necessarily something that should be a determining factor for VBAC. We’ve even had a doctor on the podcast that was like, “No. The evidence is just not strong enough to go off of.” Jennifer: Yeah. I was still in the mindset then of, “Doctor said no so I can’t,” so I scheduled the C-section and that one was really hard. I think it was because I knew that I wanted a VBAC and I wasn’t getting it. With the other two, I didn’t know I really wanted it so I was like, “Well, this is just how it is.” With the third, I was so anxious during the C-section. I remember my doctor down there and she yelled to the anesthesiologist, “You need to give her something to calm her down,” because I was just crying and yeah. Meagan: I’m sorry. Jennifer: Yeah. It was a rough one. 10:09 Getting her tubes tied and reversalJennifer: And then this is one of the twists in my story. That’s when I had my tubes tied. Meagan: The big twist. Jennifer: Yeah. I had my tubes tied during that third C-section. Meagan: Did your provider offer that or suggest it or did you say, “We’re done having babies”?Jennifer: No. It was suggested multiple times throughout my care. I feel now like it was a little bit of coercion but it was my choice. My husband and I made the final decision as we were driving to get the C-section. Now I’m like, “You don’t decide to get your tubes tied when you are 9 months pregnant.” Meagan: That’s a hard decision. Jennifer: That’s not when you make that decision. Any decision, but definitely not that one because you are so tired of being pregnant at that point.  Meagan: You are vulnerable, yes. Jennifer: So I had my tubes tied during that C-section and then the next day, it was instant regret. I was like, “I cannot believe we did this.” My husband felt the same way. We were both just like, “Ugh, what have we done? Why did we do that?” Meagan: Mhmm, yeah. Jennifer: It was really hard to grieve through that. It felt like a loss even though it wasn’t. It felt like I had lost a baby almost because of how intense the grief was knowing that I could never have another baby. Meagan: I understand that so much when my husband got the vasectomy that I didn’t want him to get. I felt like, “I’m grieving a kid I’ve  never had but I’m grieving a kid that I had in my mind.” You know? Jennifer: Yeah, totally. It’s a very real grief. My husband right away suggested reversal, but I dealt with a lot of guilt about that like, “No. We chose this. My insurance paid for this. We can’t go and spend money on getting it reversed. We have to live with this.” I had to work through that guilt and shame and finally, we were blessed to be able to get it reversed two years-ish after. Meagan: How was that? How was the process of that? Jennifer: That was hard. It was like another C-section, the operation it

"She was in my arms while she took her first breath and she was just so calm and beautiful. It feels like time just stops at that moment. It was so, so special to me."From turning down the opportunity to take a childbirth class during her first pregnancy to now passionately teaching her own classes (She Births Bravely) as a childbirth educator and attending births as a doula, Suzzie shares how birth has changed her. Located in Seattle, Suzzie talks about how her birth team created a safe place for her to have a peaceful home birth that was still very intense but didn’t feel that way. Meagan and Suzzie discuss pushing, continuous care, the importance of education, and their best tips on what to do during pregnancy to have an empowering birth experience no matter the outcome. Suzzie’s Childbirth ClassSuzzie’s WebsiteWhat Does Your Birth Plan Say About Your Personality QuizReal Food For PregnancyNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:28 Review of the Week03:53 Suzzie’s molar pregnancy06:27 Beginning labor with fear and doubt09:01 “It has been over 24 hours. It’s time for you to have a C-section.”10:51 Making friends with a student-midwife14:41 Suzzie’s second pregnancy and labor18:50 Baby Hazel’s birth27:06 OBs attending home births30:40 Continuous care during home birth36:23 Birth preparation tips43:29 Knowing what questions to ask48:18 Waters being broken for 24 hours50:31 Checking in if labor stallsMeagan: Hello, hello Women of Strength. How are you? This is Meagan, your host here at The VBAC Link. I’m excited to talk a little bit today about what can we do before we have our baby or what should we do when we get pregnant to start preparing for birth. We have our friend, Suzzie, with us today. Hello, Suzzie. Suzzie: Hi. Meagan: She is actually a doula and childbirth educator who has a lot of passion in sharing a message of what to do and how to prep and how to navigate through this amazing journey that we call pregnancy and birth and motherhood. She had an unexpected Cesarean just like a lot of us. If we go through most of these stories on the podcast, you’re going to hear that trend of it wasn’t expected. It wasn’t planned. It maybe wasn’t desired. That’s a common thing in our VBAC community. It’s important to know what to do and what to know because most of us just didn’t know what we didn’t know. 02:28 Review of the WeekMeagan: So we are going to dive into a little bit more of how to prepare and a message from our darling Suzzie, but of course, we have a Review of the Week so we are going to get into that before we get into the next part. This is from kimberlyspair. Thank you, Kimberly. We love her. She says, “Thumbs up from us! Sharing such an essential message with love and compassion.” That is exactly what we are going to do today, sharing another message with love and compassion. As always, if you have a minute, we would love your review. You can leave it on Apple Podcasts, Google, message us at info@thevbaclink.com. Remember VBAC is V-B-A-C and let us know what you think about the show. 03:53 Suzzie’s molar pregnancyMeagan: Okay, cute Suzzie. So we were talking right before we got on the episode. You guys, she had her C-section birth at a hospital local to me here in Utah then went on to have an HBAC. Was your HBAC in Washington? Where was your home birth? Suzzie: It was. I live in Seattle and it was here in Washington. Meagan: Okay, cool. So Seattle, Washington mamas, listen up if you are looking for options for a provider. Yeah, so you talked a little bit about how birth taught you how much more capable you really are than you thought. I think that is something that happens a lot with us, right? We walk through this birth journey and we are like, “Dang, we are amazing.” We really, really, really are. Yeah, so Suzzie, tell us about your stories. Share your message with us. Suzzie: Yeah, yeah. I’d love to. I think that my birth story actually started before my first birth because I had losses and a molar pregnancy before. Molar pregnancy is a very complicated, unviable pregnancy where you ultimately– it took me about a year to be cleared healthwise after that to be able to start trying again. So I came into birth with a strong sense of knowing things could go wrong and also fear. I also worked in finance and I was very busy. I just didn’t really have a lot of time to prepare. I didn’t have a lot of support at home so when, for example, I had a really great friend that I worked with and he and his wife were having a baby around our same due date and they had hired somebody to teach them private childbirth classes in their home. They invited us to come and join them in that process. I was like, “No, can’t. Too busy.” That whole thought of, “Okay. I’m going to prepare really mindfully,” was too much for me for where I was at that point of life. I also dabbled a little bit in HypnoBirthing. There was a little bit of pressure to do a natural birth and as I was learning about that, the desire for that was growing and evolving, but the fear of labor and birth also wasn’t necessarily dissolving. 06:27 Beginning labor with fear and doubtSuzzie: So I feel like when I went into labor, I had a lot of really complex expectations and fears that weren’t really worked through because even though I had done some reading, the true preparation is truly very emotional. Meagan: It is. Suzzie: And a lot less fact-driven than it is learning about what we really need and how to speak up for what we need and how to ask the right questions and how to develop strong and open and trusting relationships. Meagan: And also trust yourself. Suzzie: Yes. Yes, that’s a really big one because I definitely did not have that factor either. When I had Zoe, my first, it was just such an overwhelming day for me. My water broke at night and I had called the doctor. I was like, “I’m not having contractions. Can I just stay home?” “Sure.” In the morning by around 8:00, I had been having pretty steady– I was probably making that transition from early labor into active labor where you are close to those 5-1-1 rules when you can go in and you can be admitted. My water was broken so of course, if your water is broken, you can be admitted. They have to admit you. Now, it seems like they encourage you to go in as soon as you can. Meagan: They do. Suzzie: Yeah, which has its pros and definitely has its cons. Meagan: Let’s talk about that later too. Suzzie: Yes. That’s definitely something to learn about because water breaking happens in about 10% of people before labor starts, about 10% of the time. It’s not crazy common but it’s way more common than at least what I thought before. You know and realize something like that could throw off my whole birth story or my whole birth experience. When I checked in, the nurse was really upset that I hadn’t come in earlier even though I had cleared that decision with my doctor so there was an initial conflict as I was checking in and signing the waivers. That instilled a lot. What she said to me put a lot of fear into me that I had done something wrong and that I had put my baby in danger and that things might not be okay. I also had those layers of having gone through a pregnancy that wasn’t viable and a lot of health complications from that so when I heard that, the amount of fear I felt was insane. Then my labor completely stopped. The contractions that had been steady and consistent for hours were gone. 09:01 “It has been over 24 hours. It’s time for you to have a C-section.”Suzzie: The rest of the day was about using Pitocin and trying to get labor started in other ways. Ultimately,  nothing ever worked. Zoe, I guess was having some kind of heart rate dips. At this point, if I could go back to what I know now, I would ask a lot more questions about how big they were or what they looked like, but at the time, I didn’t have enough knowledge to ask good questions or be proactive about movement and things like that that can sometimes help especially in inductions and especially when you are using medicine or Pitocin to push your labor. By midnight, they had just decided, “Okay, it has been over 24 hours. It’s time for you to have a C-section.” I truly do not know if this is a cascade of interventions story or if there was something wrong. It didn’t sit well with me at the time and it still doesn’t because I still have unanswered questions and that was a really not-great feeling. I feel like it wasn’t a great start to motherhood for me because it was very scary. I was very worried the whole time and then even after she was born by surgery, they had spent at this time more than 12 hours telling me that something could go wrong. They swaddled her up. They let me take a picture of her cheek to cheek with me and then she and her father disappear and are swept off somewhere. After the surgery, they put me in a recovery room and I was in there for several hours by myself shaking from the medication in the dark because it was night not knowing, “Am I okay? Is my baby okay? What’s normal in this picture? What’s not?” That was just overall not a great experience. 10:51 Making friends with a student-midwifeSuzzie: I had actually kind of written off. I had just thought, “Oh, this birth thing must not be for me. It’s hard. I don’t like it.” All of the stories that you hear, I felt like, “Okay, great. That’s fine. I’ll move on with my life.” But then I moved and I joined a new moms group where we would go hiking every week. One of the friends that I met there was a student midwife and as our friendship evolved and we would talk, all of these stories revolved around the families that she was working with. I started to see that I had missed out on so much of the journey that I had never learned to ask good questions. I never really did have a great relationship with a care provider. There are care providers that will take more time and help you when you need it a

Cesareans can be peaceful, beautiful, and so healing. Though Alexis didn’t have the VBAC she planned for, she still had the euphoric birth she dreamed of. Alexis unexpectedly experienced PPROM and preeclampsia at 36 weeks with her first baby. Trying to labor and push under the effects of magnesium and all of the other interventions was incredibly exhausting. When baby started having decels, she knew it was time for the Cesarean. After a rough NICU stay and having to exclusively pump, Alexis knew she needed to be proactive about healing from her birth PTSD. She went to EMDR therapy and found the healing her heart needed. Alexis shares all of the ways her second birth was different from the first. She went into labor spontaneously. She progressed quickly and felt strong. But when baby flipped breech mid-labor, Alexis knew it was time for another Cesarean. Her team took their time honoring every wish Alexis had and truly gave her the birth of her dreams!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:05 Review of the Week05:29 Alexis’ first pregnancy during COVID09:41 PPROM and preeclampsia 13:27 Pushing turned emergent Cesarean16:54 NICU stay and exclusive pumping20:45 EMDR therapy and postpartum healing 22:24 Second pregnancy26:21 Beginning of labor29:47 A picture-perfect labor31:26 Baby flipping breech and going for a C-section38:03 The game changer40:56 A euphoric birth43:45 Ways to have a gentle Cesarean46:36 Music, skin-to-skin, clear drapes, mirrors, conversation, and maternal-assisted Cesareans50:32 Vaginal seeding, advocacy, and backward dilation52:29 Swelling in pregnancy and nutritionMeagan: Hello, hello everybody. Today’s episode is one that I am actually really excited to hear and share. I think a lot of the time when we are listening to The VBAC Link, we are looking for empowering VBAC stories, positive VBAC stories, and sometimes when we are sharing these stories, it is accompanied by traumatic Cesareans. We know that through all of these stories, I have personal experiences that a lot of these Cesareans are traumatic, and a lot of the time they are traumatic because they are undesired or they are pushed really hard or people feel like they are backed in a corner or so many interventions come into play that they happen in a traumatic manner. But today’s story is going to talk a little bit about how Cesarean doesn’t have to be traumatic and it can be peaceful. I relate personally to it because my second C-section, I didn’t want actually. I didn’t want it at all. It wasn’t what I planned on, but I still found so much healing through that birth and I think that in a lot of ways, it shifted my mindset of how to view Cesarean. I also want to recognize that our community doesn’t always want a VBAC, right? We are here learning about the options for birth after Cesarean but that doesn’t mean we only want VBAC so I’m excited to share this story today for everybody, especially for those who are unsure of what to do or want to maybe go the Cesarean route but want to have maybe a better experience than their last Cesarean. We’re going to talk about how to have a peaceful Cesarean. We have our friend, Alexis, with us today going to be sharing her peaceful journey with you. 02:05 Review of the Week But of course, we have a Review of the Week, so I want to dive into that and then turn the time over to her. This is from Apple Podcasts and it says lilylalalala. Lots of la la la. It says, “Inspiring and uplifting.” It says, “I first found this podcast in 2020 in the depths of the postpartum after a very traumatic, unplanned Cesarean with my first baby. I listened to every single episode as I struggled to process what had happened to me. I finally gathered up the courage to seek help for postpartum PTSD that I was experiencing. “This podcast is a treasure trove for inspiring stories which helped me regain confidence in my body to have a beautiful VBAC with my second baby last year. Thank you for being such a huge part of my healing journey.” I feel like so often, we hear little things like, “Oh, I loved hearing it” or “That was inspirational” or “That helped me learn the knowledge” but I love hearing that it was a part of the healing journey. It healed. That is so amazing. Thank you so much lilylalalala for sharing your review. If you haven’t yet, you guys, we would love your review on the podcast. You can review our Instagram or our Facebook community. Give us a review of The VBAC Link. You can leave your review at Google. You can just Google “The VBAC Link” and leave a review there. You can leave a review on the Apple Podcasts. I’m pretty sure you can on Google Play. Or guess what? You can even email us at info@thevbaclink.com subject “Review” and leave us your review there. 05:29 Alexis’ first pregnancy during COVIDMeagan: Okay. I am so excited for you to share with us today. Remind me. Okay, so we are going to be talking about preeclampsia, EMDR therapy which I think is something that is super powerful. We are going to be talking about repeat Cesarean and it can be better. Yeah. Anything else that you’re like, “This is what my story is going to touch on?” Alexis: NICU time also. We had some NICU time. That was a big part of my postpartum experience. Yeah. Meagan: Okay. Yes. Okay, well without further ado, I would love to turn the time over to you to share your story. Alexis: Thank you. Yeah. There is a lot that goes into this story, a lot of different factors that made my first experience really hard, but I got to learn so much through it and I’ve been able to help a lot of other friends and family just through my experience so I’m super excited to share my story with everybody. Meagan: Can you remind us where you are at as well? Where you are located? Alexis: Yes, Joplin, Missouri. Meagan: Missouri. Alexis: Yep, so southwest Missouri. We are originally from Oklahoma City. My husband and I have lived here for six or seven years now and we call it home. Yeah. We got married in 2017 and we were about ready to have a baby around this time the pandemic hit so fun timing there. I’m sure a lot of mamas can relate to that. I think that’s a lot of our story. We got pregnant at the end of 2020. Things were kind of normalizing but not really medically. I mean, I never saw my OB’s face. We were all wearing masks. My husband couldn’t come to our first appointment because the regulations were still iffy on that. I Facetimed him to hear the heartbeat which was so sad for our first pregnancy.But as things kind of went on, the rules lessened a little bit, but still, it was COVID. We got pregnant really easily. We were so blessed for that experience. For the most part, my pregnancy was really healthy. I did have a lot of nausea and morning sickness. That kind of lasted the whole pregnancy and it probably was the reason that my nutrition was so terrible. Nothing sounded good. All I really wanted was french fries so I could never– the smell of our gas oven made me gag so cooking really wasn’t happening. Meagan: You’re not alone and that’s one of the reasons why we talk about Needed, our partnership, because there are so many of us who go through this morning sickness and the smell of anything is just barf so we’re not getting those nutrients, right? So we’ve got to try to get them in other ways because we’re not getting them through food because we can’t. Alexis: We can’t, yeah. That is totally me. So yeah. My diet was terrible and I didn’t know at the time. Of course, everyone says to eat healthier and a lot of protein, but I’m already not a good eater of protein, and certainly not when I am nauseous, so yeah. My diet was a big factor. I had pretty rapid weight gain and I’m a petite person so that was not normal for me. My midwife really kept an eye on that, but I was still doing CrossFit my whole entire pregnancy somehow. I felt good enough to do that, but yeah. I was probably just wearing my body down. I was not eating well and working out really hard. What’s funny is I was working out because it is proven to decrease your chances of getting preeclampsia and that didn’t happen. Meagan: Which ended up happening? Alexis: Yeah. I was like, “I’m going to be so strong. This birth is going to be so easy. I’m just going to squat down on the floor and pop this baby out, no problem.” Meagan: I love your confidence, though. That is important in any birth. The confidence in your body’s ability is wonderful. Alexis: For sure. I think that because I was working out so hard, maybe my pelvic floor is tighter. I’ll get into all of that. Anyway, that was the pregnancy. Everything was good and healthy. I didn’t have any other issues. 09:41 PPROM and preeclampsia But around 30 weeks, I started swelling really badly. It was a summer pregnancy, so no one really thought anything of it. I knew it was unusual for me. It was a lot of swelling. My midwife was keeping an eye on it. I never had high blood pressure and no protein in my urine. There were no markers and technically, I think according to what ACOG says, swelling isn’t a red flag necessarily for preeclampsia. I think they won’t diagnose you unless, of course, it’s blood pressure and protein. No one was worried about it. Yeah. We were just trucking along. Everything is good, just extremely swollen. My husband travels for work all of the time during the summer so one night, he had gotten back that day and I was about 36 weeks on the dot. He got back that day from California and I woke up in the night to go to the bathroom and sit up in bed and I felt a little bit of a gush. I was like, “That’s weird.” I get up and go to the bathroom. Toilet paper is a little bit pink, watery-tinged so I kind of knew immediately. It smelled different. I knew something was up. I’m calling for my husband to come in there. He is very confused. At 36 weeks, we did not expect that. The chances of your water breaking are less than 10% or something? Meagan: They say 10% or less,

During her first pregnancy, Selah’s doctor predicted that her baby would be over 10 pounds. She insisted that it was not safe to deliver vaginally. Selah went right into her first Cesarean. She didn’t even have the chance to try. Her baby went to the NICU shortly after birth due to lung and blood sugar complications.When her fluid levels were low with her second pregnancy, Selah consented to another scheduled Cesarean remembering how her first one went pretty smoothly. Unfortunately, a turn of events resulted in an emergent situation, another NICU stay, and once again, Selah was not able to bond with her baby like she thought she would. Selah’s journey to her VBA2C included discovering The VBAC Link, building her supportive community, prenatal chiropractic care, and relentlessly educating herself to make sure she was set up for success. Though her labor was MUCH longer than expected, the spiritual, emotional, and physical transformation she experienced was completely worth it. Selah had a beautiful, empowering VBA2C with no complications. The best part– she got to hold that sweet baby immediately and for as looong as she wanted. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:04 Review of the Week 04:08 Selah’s first pregnancy07:25 First C-section 09:36 NICU11:10 Second pregnancy13:02 Low fluids16:29 Scheduled Cesarean turned emergent21:39 Surprise third pregnancy27:33 Changing providers36:33 Going into labor39:20 Going to the hospital44:54 Pitocin48:35 The final hours56:47 A crack in the catheter1:00:00 The best feelingMeagan: Hello, hello everybody. You are listening to The VBAC Link and this is Meagan, your host. We have our friend, Selah, today. Hi, Selah. Selah: Hi. Hello. Meagan: Thank you so much for being here with us. I feel like there are so many parts of your story that truly are things that people are going to relate to. We’re going to be talking about bigger babies. We’re going to talk a little bit about that. We’re going to talk about changing a provider really late in pregnancy. I actually love this topic because I did it myself and it’s one that is scary sometimes to do. Selah: Yeah. Meagan: It’s intimidating. We’ll talk a little bit about low fluid. She’s got a NICU stay. There are lots of little things. Selah: A little bit of everything. Meagan: You are going to have relations to her story. She is a VBAC after two C-section mama story so if you are a VBAC after two C-sections, listen up. It’s going to be amazing.01:04 Review of the Week Meagan: We have a review of the week so we are going to get into that then we are going to turn the time over to you, my love. Selah: Yay. Meagan: This review is– if I can find them. I just lost my reviews. It is from hannahargentina and it was on Apple Podcasts back in 2023 in February so just over a year ago. It says, “I have had a natural birth center birth, then moved out to the country and had a very traumatic C-section. I am now 37 weeks pregnant and back stateside working with an amazing birth team. I am really hoping for a VBAC in a few weeks and I love listening to all of the stories. Hearing different perspectives, and outcomes, and gaining wisdom, I feel so much more confident in my VBAC after listening to this podcast.” Well, it’s been just over a year so hannahargentina, if you are still with us, reach out at info@thevbaclink.com and tell us how it went. Selah: Aww, that’s awesome. Meagan: I know right, and here we are for you and your baby’s birthday is in a couple of days. Selah: I can’t even believe it and I got tears in my eyes listening to that review because that was me. That was me listening to every single podcast, your story, all of the stories, and it helped so tremendously. I can’t even tell you. To be on today is such an honor because I was so helped by you and your podcast and the community. I could not have done it without you so thank you. Thank you for having me. Meagan: Yes. Thank you and I also want to toot the horn of the community. They are so special. If you guys have not checked it out yet or if you are not on Facebook, I would say create a secret Facebook just to be in that community because the Facebook community is amazing or join us on Instagram. These other Women of Strength truly do provide so much power. Selah: So much power and help and resources. I mean, I was on there every day just looking and posting every single worry and concern. Yeah. It’s a lot. It’s a lot to learn and to do. You need that community. You need that support. Meagan: Absolutely. Well, let’s dive into that first story of yours that began this journey to you being here right now. 04:08 Selah’s first pregnancySelah: Yes, so the back story is I had my first son in 2018 and he was an IVF baby. We struggled with infertility for four years about, I think. Finally, we did IVF and we were successful on our first try which was great. However, toward the end of my pregnancy, my doctor looked at me and said, “How big are you willing to push out as far as baby goes?” Meagan: Oh. Selah: Yeah. I looked at her and by the way, I considered myself very well-educated. I was not in hindsight. I had read a few birth books but I did not know what I know now thanks to you and the community. I did, by the way, do The VBAC Link Course so I did all of it. Meagan: Oh you did? Selah: Yes. Yes. So I was not educated to the point that I am now, but I thought I was. I looked at her and very confidently said, “12 pounds.” I didn’t even flinch. Meagan: I love that. Selah: Her eyes turned really wide and was like, “No, no, no, no, no. You cannot push out a 12-pound baby.” Meagan: Then don’t ask me what I’m willing to do here. Selah: Exactly. I was a personal trainer. I was a group fitness instructor. I consider myself very strong so I thought, “I could do that. No problem.” She said, “No. I will not let you do that. This baby is measuring bigger than 10 pounds.” At that point, I think I was just at my 40-week mark so she was like, “He’s only going to get bigger. You’re not going to be able to deliver this baby vaginally. In fact, I won’t even really let you try.” Meagan: Wow. Selah: I know. Meagan: That took a really fast turn from, “Hey, how big are you willing to? Hey, let’s offer an induction” to “Hey, I’m not even willing to let you try.” Selah: Exactly. And looking back, I’m pretty shocked at that that I wasn’t even offered an induction or anything. In fact, my water– so we scheduled the C-section for three days from then and my water ended up breaking naturally the day before the C-section. I know. I was like, “Oh. I’m going to do this. I can do this. I don’t care how big the baby is.” Meagan: Yeah. Selah: Even then, they would not let me try because there was meconium in the water. Meagan: Which isn’t a reason for a Cesarean, right? Selah: It is not. Right. Right. That’s what I know now, but back then–Meagan: You didn’t know. Selah: I didn’t know and ironically, I had a doula who said, “Oh, you need to go straight to the hospital.” I know. Meagan: Interesting. Selah: Very interesting. That is also a lesson in really interviewing your doulas, understanding birth more really, and also knowing what the doula’s experiences with both C-sections, of course VBACs, and with everything. This doula, looking back, did not have a lot of experience, I don’t think, especially with big babies, but in general. I think also she was older and not that there is anything– listen. I am older. But I think she was from a medical mindset where that would be very scary to her, meconium in the water, where now, the doula that I had for my VBAC was much more like, “No. This just means the baby is ready to come out and it means a lot of things.” 07:25 First C-sectionSelah: I rushed to the hospital. They said, “Yes. There is meconium in the water. Yes, you have a very big baby. We’re going straight to the C-section. You don’t even get to try.” I never even felt a contraction. I was pretty devastated. I had all of these plans for a drug-free birth. I had read The Bradley Method. I had done HypnoBabies. My mom– I’m one of eight kids– had pushed every single one of us out naturally without drugs. I knew I could do it. Do you know what I mean? I just was like, “Wow. This is not happening for me and I’m shocked.” I was very shocked. Meagan: Yeah. Yeah. Selah: So we went into the C-section but I also felt like I had no choice at that point. This was definitely–Meagan: You were stuck. Selah: Yeah. “You’re going in. That’s it.” Everything was just black and white to the medical team and even to my doula frankly. So we went in and my doctor was lovely. I have to say she was very empathetic and she knew I really wanted a natural birth. She was as lovely and empathetic as you can be. She let me play music and set up the room in a way that felt very loving. She let the nurse and everyone take pictures and videos which they are not always supposed to do. So it was as good as it could be. I got to hold him right away. We had the first 12 hours together. But then because he was so big– 10 pounds, 15 ounces, his blood sugar started dropping, and his lungs, because of the C-section, weren’t fully developed. You know how they get the practice. Meagan: Yeah. Yeah. Sometimes there is fluid left in the baby’s lungs too so they can have a harder time. Selah: Exactly. There was fluid left in the lungs. It’s like that sponge where not all of the sponge is there. Meagan: That’s a really good analogy. Yes. Selah: That’s what they told me which is what happened. When they go through the canal, their lungs get that practice going back and forth. 09:36 NICU Selah: So he went to the NICU after about 12 hours with me and that was a terrible experience for lack of a better word. My heart just goes out to every NICU mama who has had that experience. It’s really, really hard. I was only there for five days. I can’t imagine where you have been there for months. There are so many

Kara joins us today from the Los Angeles area sharing her VBA2C story! Kara’s first birth was a scary and chaotic emergency Cesarean. Though her second planned Cesarean went smoothly, Kara did not love how her birth felt like such a medical procedure. After experiencing a miscarriage during her third pregnancy, Kara experienced heartache and grief, but also shares how she gained a deep reverence for her body throughout the process. She just knew that her body was capable of having a vaginal birth. Kara pulled out all of the stops with her VBA2C prep. She built a birth team she felt great about. She prepared physically. She processed past fears and trauma. Though her birth had some intense twists, Kara was able to achieve the VBA2C she fought so hard for. She took the leap of faith, trusted her body, and saw what it could do.Kara’s WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:45 Review of the Week 05:09 Kara’s first pregnancy 08:17 Kara’s second pregnancy and planned Cesarean10:57 Miscarriage16:45 Fourth pregnancy and VBA2C prep22:30 Beginning of labor25:08 Thoughts about the hospital system28:49 Breaking waters32:28 Pushing, hemorrhaging, and the NICUMegan: Hello, hello Women of Strength. It is Meagan and we have got a VBAC after two C-sections story. Of course, I love VBA2C stories because I’m a VBAC after two C-sections mama. Her name is Kara and she is amazing. I’m just going to read your bio because you are just amazing. It says, “She is an award-winning creative marketer and mother of three. She is in LA.” If you have been listening for a little bit, she actually was on the show quite a few months ago at this point of being aired with her OB. Kara: Oh yes, with Dr. Brock. Oh my gosh, when I was pregnant. I don’t know why I forgot about that, but we interviewed my practitioner, Dr. Barry Brock, together who is a very VBAC-supportive provider. That was a really fun conversation. I think I was 4 or 5 months pregnant at that point. Meagan: Yeah. We really wanted to ask him some questions about VBAC. He was with you along your journey and he was so gracious to come on and talk with us. So yeah. She has worked on so many amazing things, some of your favorite things I’m sure like Netflix, Stranger Things, which is definitely one of my favorites, Patrone Tequila, and some of your favorite women’s apparel brands at Target which is also my favorite store. She started her own brand consulting agency, Always Friday, in 2019, and after the birth of her first daughter, Hadley, she experienced an emergency C-section with her and then a planned C-section, and then a miscarriage, and then went on to have a VBAC after two C-section story. We are going to hear all of the stories today. Thank you, Kara, for being here. Kara: Yes. I’m so excited to be here. I love this community and I don’t think that I could have gotten to a place where I was having a VBAC without your podcast, without finding The VBAC Link Facebook group and just hearing other women really give me the encouragement to not do a third C-section. I am really happy. I’m just about three months postpartum now, so forgive me if I make no sense. Yeah. I’m just grateful for your guidance, your expertise, and all of the things that you pour your heart into as an expert on all things VBAC. Meagan: Aw. Kara: Thank you for that. Meagan: Well, thank you so much. I’m so excited to hear this story because I haven’t even heard the full story. I just have this little blurb right here on my form, so I’m really excited to dive into it. 02:45 Review of the Week Meagan: We do have a review of the week and I put Kara on the spot you guys because she actually took Needed during her pregnancy and first, I’m obsessed with Needed and love and trust Needed. You took it throughout pregnancy and I would just love to hear your review on Needed today. Kara: Yes. I have obviously looked at all of these different types of prenatals and I ended up going with Needed and loved it. I did their prenatal multi and at first, I was like, “This is a little wild.” It’s eight capsules which felt aggressive, but it actually was so much of the nutrients that I needed. I broke it up to four in the morning and four towards the evening. I felt the most energized during this pregnancy. I felt the strongest. I obviously did all of the things, drank all of the tea, had the protein, the dates, and all of that, and my baby was much– I mean, I don’t know if this is correlated or not, but my baby was almost a pound and a half bigger than my previous biggest baby and I felt the strongest, the healthiest that I’ve ever felt during any of my pregnancies. I wish I would have taken it with the other two, but you live and you learn, so yeah. I highly recommend that to all of my friends and I always send people the link for the Needed vitamins whenever I can. Meagan: Yes. I believe it so much too. It’s interesting that you said you have felt the most energy during this pregnancy because I feel like once you have one, two, and three– once we have more kids, during those pregnancies, they are more exhausting because we are not just able to rest and relax. Kara: They are. Meagan: We are being mom, right? So I love hearing that. 05:09 Kara’s first pregnancy Meagan: Okay, let’s get into your stories. Kara: Let’s do it. Cool. I’m excited. Meagan: Perfect. Let’s talk about Hadley’s birth. Kara: Yes. I got pregnant pretty easily and had a healthy pregnancy. I think maybe had this false sense of confidence that my delivery would match my pregnancy. I did not do a lot of prep work. I went into maybe how everyone does to some degree, what you don’t know you don’t know kind of thing. I went into labor naturally. I was a little bit overdue and ended up sort of with the classic cascade of interventions. That was challenging. They broke my water and just set off a bunch of other things that then her heart rate went up, sort of the classic stories you hear, and they rushed me into an emergency C-section which was really scary. It felt like a true emergency like Grey’s anatomy style just being rushed down the halls, with no time for really conversation. I finally asked for my operating notes and it was a class 2 which I guess if it’s a class 1, you guys talk about it. If it’s a class 3, you or the baby didn’t make it. It was really scary and honestly, I was terrified after. I think it took three weeks for my shoulders to come down from that C-section. I’ve said this before, but the only way I could describe it was it felt like a car crash and I wasn’t sure if my passenger made it. It was quiet in the room. I didn’t hear a baby crying. Nobody was really talking. I just remember tears streaming down my face while I was on the operating table completely unsure if my baby had made it. Luckily, she’s healthy and fine, but I don’t think that took away from the birth trauma that I experienced with that first baby. Meagan: Yeah. That just gave me the chills when you described it like that. How scary. Kara: It was so scary. I’ve never seen my husband look so afraid before. I’ve never seen him pray out loud before. So yeah. It was just one of those things where I wasn’t mentally prepared for that. I was not up to date on how many women have C-sections and what you can do to prevent it. I guess in this Instagram world that we live in, you see your friends pregnant and they are cradling their bump and then the next square you see in their feed is a baby announcing its name and weight. You never get to hear unless you ask people how you got from point A to point B, right? That was very just this naivety that you go into the hospital and you come out with a baby and you’re fine. I don’t know why I didn’t maybe do a better job researching all of the options. That was baby number one. 08:17 Kara’s second pregnancy and planned CesareanKara: Baby number two– I got pregnant about a year later. Again, quickly and easily thank God and all of that. It was the middle of COVID. It was 2020. I found out I was pregnant in March 2020 so it was sort of the peak of absolute fear and scare tactics to a degree. I kept trying to wrap my head around going into labor again naturally and I just couldn’t get there. I would have borderline panic attacks every time I would think about it. The word birth trauma wasn’t a word or a phrase in my vocabulary so I just thought you kind of toughen up and figure it out. I just really couldn’t get there. COVID every day, a new study came out basically saying that pregnant women are going to die. Meagan: Yeah. Lots of scary stuff was coming out. Kara: I opted for a planned C-section. That just seemed like the logical thing to do at that point. My husband couldn’t come to any of the appointments. I couldn’t have anyone else in the room. I was delivering with a mask on. It was all of these things that just took away from what is a natural birth experience so to speak and all of the things that you need. It eliminated a lot of that and made it this very sterile process that resulted in a great, planned C-section. I can’t describe it any other way than it just felt like surgery. I hate to say that because you get a beautiful baby at the end of it and you created this beautiful baby. I’m not trying to take away anyone’s experience with a planned C-section. But for me, it felt like I scrubbed in for surgery and went into this sterile environment. I was put on a lot of different drugs, laid on the table, cut open, and a baby was handed to me. I have a beautiful three-year-old named Hazel from that experience, but it ultimately left me feeling– I don’t know how to describe it, but not fulfilled in the way I wanted to feel. Meagan: Yeah. I can understand that. I can understand that. Like you said, not everyone is going to experience this, but there is often this disconnect. You went in. You scrubbed in and had a baby. Everyone is sterile and quiet. It’s bright. There is beepin

Danielle Duboise, the co-founder of Sakara Life, has changed millions of lives through her advocacy for wellness and nourishment both of the body and the soul. Danielle is also an HBAC mama and shares with us the valuable lessons she has learned from both of her births about the mother-baby connection, surrendering, and the true meaning of an empowered birth. Danielle and Meagan have just the sweetest conversation that we know will leave you feeling inspired and uplifted. Danielle encourages birthing women especially to care for themselves on the deepest levels. Her words align so perfectly with all of the things that are important to us at The VBAC Link. Meagan had chills throughout the entire episode as Danielle spoke and we know you will too!Sakara Life WebsiteDanielle’s PodcastEat Clean, Play DirtySpirit Babies BookNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:51 Sharing your birth plans with others9:13 Danielle’s first pregnancy with vasa previa11:29 A humbling birth experience14:09 Going into labor17:06 Danielle’s C-section23:31 Connecting with your baby32:26 Surrendering36:06 Choices in birth39:14 The ripple effect of birth42:34 Ways to release fear53:02 Which risks are you willing to take?56:07 Nutrition and nourishmentMeagan: Hello, Women of Strength. We have an amazing guest for you today. Her name is Danielle and she is the co-founder of Sakara Life. It is a wellness company providing the tools to achieve optimal health and vitality. If you haven’t caught on already listening to our Needed ads and other episodes, health is so important, and optimal health and getting the nutrients and the things that you need in your life is so important in how we handle life. She is a true pioneer in the health industry and launched the brand in 2012 with her best friend, Whitney. Creating their unique nutrition philosophy which merges modern science with ancient healing wisdom. Since its conception, Sakara has transformed millions of lives through its signature program, functional products, and supplements. Leading the global movement as an advocate for plants and medicine, Danielle became a nationally bestselling author with Sakara’s debut cookbook which is called Eat Clean, Play Dirty, and is the co-host of the wildly popular, which I also am obsessed with, Sakara Life podcast. A certified holistic health coach, nutritionist, and expert in plant-based living and the microbiome, Danielle is currently pursuing her Master of Science in human nutrition and functional medicine. You can continue to see both personal and professional features of Danielle in things like Vogue, New York Times, The Wall Street Journal, and the Couverture– I think is how I say it- and Goop. She was born and raised in Arizona and Danielle is true to her Sedona roots while living in New York City with her husband, daughter, and son. She is joining us today to share with you her journey. She had a C-section and then went on to have an HBAC as well as giving us some more of her amazing wisdom. 03:51 Sharing your birth plans with othersMeagan: Hello, Women of Strength. We have an amazing guest today. Her name is Danielle. And did I say your last name? Is it Duboise? Danielle: It’s Duboise. I think technically, Duboise is maybe proper, but we’ve always said Duboise. Meagan: Duboise. That sounds– I always sat it Duboise in my head because I think I just read it and don’t– anyway. Welcome to the show. Danielle: Thank you. Thank you for having me. Meagan: Oh my gosh. I’m so excited. So so excited. Okay, we were talking a little bit before about HBAC, home birth after Cesarean, so she of course is going to share her Cesarean and her HBAC, but we were talking about how it’s something that happens obviously but a lot of people don’t talk about their plans to do it. They don’t want to share it with people, so we will get into that but I’m curious how you felt about it when you were doing it. When I was pregnant and I had my two C-sections, I didn’t want to tell anyone that I was planning on going out of the hospital because I didn’t want the negative. Danielle: Yeah, I think there are layers. It’s probably multi-faceted. Certainly, when you are pregnant and about to give birth, you have to be very protective of your space. I think people can’t really control their fear. It incites fear in people who aren’t even having children at that moment. It’s crazy how much fear it brings up when you say you’re going to have a home birth. When I was pregnant with my first, I was planning on a home birth and then I could get into the details of why I risked out of a home birth, etc., but before I risked out, I told a dear friend. It was a couple and they were pregnant with their second. I said, “Yeah. We are thinking about a home birth.” I don’t think I said home birth. I said midwife and then later it came out it was a home birth and his response was, “You know your baby could die, right?” Meagan: Right? Danielle: I was 8 months pregnant. I was so emotional. Normally, it wouldn’t have bothered me because I think he learned to put up barriers and that was the fear he was putting on me, but it was such an important reminder of how much you have to protect your space. I think every mother, mother-to-be, parent, and parent-to-be gets to define how they protect their space but I think one of the ways we do it is we don’t talk about how we are going to birth. Meagan: Yeah. It sucks. We shouldn’t have to hide how we want to birth especially if we are making that decision confidently. Danielle: Yeah. I think even after you give birth, it’s still something that I shout from the rooftops because now, I think it has a way, same with prolonged breastfeeding, of making other mothers feel less than when it’s just my story. It doesn’t mean it’s the best way to breastfeed. It doesn’t mean it’s the best way to birth. It’s what worked for me. But I think inherent in the complexities of our birthing system, of our culture, the demands on women, me talking about a home birth might make another woman feel like she couldn’t do it or didn’t do it, so I’m careful about how I talk about it in the world too balancing both I want to empower women who want to make that choice and also empower women who don’t want to choose a home birth. Meagan: Right. That’s what we do here at The VBAC Link. We empower people who want to have a VBAC and women who were like, “This is what I want. I want this.” But then also, we empower those who are unsure and help them find what’s right for them by also not judging anyone for just scheduling a C-section. Danielle: I think the most important thing and what I want for all birthing bodies is just an empowered birth. You get to define it, but inherent and empowered birth is you get to decide. You are in the driver’s seat. You are in control. You feel supported. You feel safe. You can define what are all of the things that make you feel that way, but the point is that you get to decide. It’s very easy to be a victim to the medical system and I’m careful to use that word, but I really think the way most of the medical system is set up is you can feel very bullied in it not even just in birth. If someone in a white coat comes up to you and says, “You have to do it this way, otherwise you are risking the life of your unborn child,” it’s a pretend choice they are giving you. “You could do this. You don’t have to, but your baby might die.” You’re not giving a woman a choice. You’re masquerading a choice. I think you can feel really bullied in those scenarios. That’s the antithesis of an empowered birth. Meagan: I love that you pointed that out. I can connect to that just in my own birth and as a doula watching hundreds of people give birth, seeing that come in and happen. Danielle: Yeah, I bet you see that all the time. 9:13 Danielle’s first pregnancy with vasa previaMeagan: Okay, so you mentioned that your first birth was a planned home birth and there were some things that happened that shifted, and obviously, it was a C-section. Tell us more about that. Danielle: Yeah, so I live in New York City where I would say home births are not maybe as popular as they are in other parts of the country. The insurance rates for midwives are pretty insane. Even just to decide I wanted a home birth in New York City was a feat and to find the right midwives. I had planned for it. I had a really great pregnancy, but then at around week 32, we went in for one of our scans and they found vasa previa. Vasa previa is kind of like placenta previa but it’s where the veins, the fetal vein come out of the Wharton’s jelly and is in the way of the birth canal. If I were to have gone into labor when that happened, then the fetal vein could burst and they say it’s about seven seconds before the baby would bleed out. So I went from, I had this beautiful home birth planned. I had the bathtub. I had this midwife I loved to, “You have vasa previa. If it doesn’t move–” it had to move a half a centimeter. “If it doesn’t move in the next two weeks by the time you hit 34 weeks, you have to sit in a hospital bed until you are full-term and then we’re going to induce you.” It was one of those moments where you just kind of watch reality melt in front of you. It went from my home birth to the most medicalized birth you could imagine. Meagan: Yeah. Danielle: I wouldn’t say I’m a religious person, but I’m a deeply spiritual person and my husband and I were praying every single day. We were visualizing the vein moving. We were doing so many things. We had this little baby shoe that we would pray over and put all of our energy into just– it could make me cry. Just bring her here. Get her here.11:29 A humbling birth experienceDanielle: That’s where you are very humbled. We can talk more about this later, but this idea that the most important thing is a healthy baby. I very much disagree with that. I think that’s one of the missing pieces in this conve

Hearing about risk is hard. Interpreting risk is even harder, but deciding which risks are comfortable for you is an essential part of birth!Meagan and Julie discuss how to tell the difference between relative and absolute risk, and what kind of conversations to have with your provider to help you better understand what the numbers mean. They also quote many stats and risk percentages around topics like blood transfusions, uterine rupture, eating during labor, epidurals, Pitocin, AROM, and episiotomies.  And if you don’t feel comfortable with accepting a certain risk, that is OKAY. We support your birthing in the way that feels best to you!Risk of Uterine Rupture with Vaginal Birth after Cesarean in Twin GestationsJournal of Perinatal Education ArticleWhat are the chances of being struck by lightning?Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:52 Review of the Week06:08 Determining acceptable risk for you and your provider 08:00 Absolute versus relative risk15:21 More conversations need to happen25:29 Risk of blood transfusion in VBAC, second C-section, and third C-section30:37 Understanding the meaning of statistical significance 32:05 “The United States is intervention intensive” 36:27 Eating during labor and the risk of aspiration under anesthesia43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentages44:43 The perspective of birth doulas and birth photographersMeagan: Hello, hello everybody. Guess who I have today? Julie!Julie: Hello. Meagan: Hello. It’s so good to have you on today. Julie: Of course. It’s always fun to be here. Meagan: It really is. It’s so fun. When we sit and chat before, it just feels so comfortable like that is the norm still for me even though it has been a while, it just feels so normal and I love it. I miss you and I love you and I am so excited to be here with you today. You guys, we are going to talk a little bit about risk. We know that in the VBAC world, there’s a lot of risk that comes up. I should say a lot of talk about risk that comes up whether it be is it safe to even have a VBAC? Is it safe to be induced? What are our real risks of uterine rupture? Is it safe to VBAC with an epidural or without an epidural? What about at home out of the hospital? Is that safe? I don’t know. Let’s talk about that today. Julie: Let’s talk about it. Meagan: Let’s talk about it. I think it’s really important to note that no matter what— and we’re going to talk about this for sure today, but no matter what, you have to take the risks that you are presented and that is given and still decide what’s best for you. That risk doesn’t mean that is what you have to or can’t do. Right? So I think while you are listening, be mindful or kind of keep that in the back of your mind of, “Okay, I’m hearing. I’m learning.” Let’s figure out what this really means and then let’s figure out what’s truly best for you and your baby.02:52 Review of the WeekI do have a Review of the Week so I want to hurry and read that, then Julie and I will dive into risk and assessing. Julie: Dun dun, we’re ready. Meagan: We are ready. Okay, holy cow. This is a really long review, so—Julie: You can do it. Meagan: Thank you to Sara R-2019 on Apple Podcasts for leaving this review. I love how Julie was like, “You can do it,” because she knows that I get ahead of what I’m reading in my mind and then I can’t read, so let’s see how many times it takes to read this review. Julie: You’ve got this. Meagan: Okay. It says, “A balanced and positive perspective.” It says, “As a physician myself I think it is unusual to find balanced resources for patients that represent the medical facts but also the patient experience and correct for some of the inaccuracies in medicine. This podcast does an amazing job of striking this balance!“I had an emergency C-section with my daughter 2 years ago. Despite understanding that the CS was medically appropriate and my professional experience, I still found the whole experience to be mildly traumatic and disappointing. This podcast was the main resource I used to help prepare for my second child’s birth and my plan to have a VBAC. I am now holding my new baby in my arms with so much pride, love, self-confidence, and trust because I had a smooth and successful VBAC.“I am thankful for this podcast which gave me ideas, confidence, strength, and a sense of community in what is otherwise a very isolating experience. I especially appreciate the variety of stories that are shared, including VBAC attempts that result in another C section so that we can all prepare ourselves for the different outcomes. No matter what happens we are strong women and have a welcome spot in this community, even when we may feel alone with our thoughts and fears. Thank you, Julie and Meagan!Julie: Aw, I love that. Meagan: Yes, that was phenomenal. Congratulations Sara R-2019. If you are still listening here, congratulations and we are so happy for you and thank you for your amazing review. 06:08 Determining acceptable risk for you and your providerMeagan: All right, Julie. Are you ready? Julie: Here we go. Here we go. Can I talk for a minute about something you mentioned before the review? You were talking about risk and how it’s not a one-size-fits-all because we were talking about this before. We all know that the uterine rupture risk is anywhere between .2%-1% or whatever depending on the study and what you look at. The general consensus among the medical community is .5%-1% is kind of where we are sitting, right? Now, some people might look at that risk and be like, “Heck yeah. That’s awesome. Let’s do this,” especially when you look at a lower risk than that that it’s a catastrophic rupture. Some people might look at those numbers and be like, “This feels safe. Let’s go.” Some people might look at those numbers and be like, “This feels scary. I just want to schedule a C-section.” Meagan: No, thank you. Julie: And that’s okay. It is okay. However you approach risk and however you look at it is okay. We’re not here to try and sway anybody. Obviously, we’re The VBAC Link, so we are going to be big advocates for VBAC access, right? But we’re also advocates for having all of the information so you can make the best decision no matter what that looks like. But also, I think another very important part of that is finding a provider whose view of risk is similar to your view of risk so that you guys have a similar way to approach things because if you find a provider who thinks that 1% risk of VBAC is really scary, it’s not going to go good for you if you think a 1% risk for a VBAC is acceptable. So yeah, I just want to lay that out there in the beginning. Meagan, you touched on it in the beginning, but I feel like provider choice in risk is really important there. Meagan: It is. Julie: For sure. 08:00 Absolute versus relative riskMeagan: It is and also, one of the things we wanted to talk a lot about is absolute risk versus relative. So many times when people, not even just the actual percentage or 1 out of 5 is shared, it’s the way it’s shared. The way the words are rolling off of the tongue and coming out can be shared in a scarier way so when we say 1 out of 5, you’re like, “Okay, that’s a very small number. I could easily be one of those 5’s.” It’s the way these providers sometimes say it.  A lot of the time, that’s based on their own experience because now they are like, “Well, I am sharing this number, but I’m sharing a little extra behind the number because I’ve had the experience that was maybe poor or less ideal.” Does this make sense? Julie: Yeah. Meagan: Sometimes the way we say things makes that number seem even bigger or even worse or scarier. Julie: Right. It really comes down to absolute risk versus relative risk, right? Relative is your risk in relation to another thing that has risk. Absolute risk is the actual number. It’s like 1 in 10. That is an absolute risk. You have a 1 in 100 chance of uterine rupture. That is an absolute risk. Your chance of uterine rupture doubles after three Cesareans. That’s not true. That’s not true. But that’s a relative risk. I really like the example that I feel is really common for people to relate to is stillbirth after X amount of weeks. Evidence-Based–Meagan: That’s a huge one. Julie: Yeah, it’s a big one that gets thrown around all of the time and it sounds really scary when people say it. I love Evidence Based Birth. They have this whole article about due dates and risks associated with due dates and why due dates should really be adjusted and look at differently. They don’t say that. They just present all of the data, but what I really like about that is they have a section here about stillbirth and they talk about absolute risk versus relative risk. I feel like that would be a great thing to start with. I’m just going to read it because it’s so well-written. They said, “If someone said that the risk of having a stillbirth at 42 weeks compared to 41 weeks is 94% higher, then that sounds like a lot.” Your risk of stillbirth doubles at 42 weeks than if you were to just get induced at 41 weeks. Your baby is twice as likely to be stillborn if you go to 42 weeks. Meagan: Terrifying. Julie: Okay? 94% higher. That’s almost double. That is scary. For me, I’d be like, “Uh, yeah. That is super scary.” Meagan: Done. Sign me up for induction. Julie: Right? Sign me up for induction. But when you consider the actual risks or the absolute risks, let’s just talk about those numbers. 1.7 per 1,000 births if they are at 41 weeks. Stillbirth is 1.7 per 1000 births. At 42 weeks, it’s 3.2 per 1000 so it’s a .17% chance versus a .3% chance so you are still looking at really, really, really small numbers there. So yeah, it’s true. 3.2 is almost double of 1.7 if you do the math. Sometimes math is hard so that’s fine. We have to get out the calculator sometimes, but while it’s true to say the risk of stillbirth almost doubles at 42

“Your diagnosis of preeclampsia is not forever. It will pass. You will get through it. You can do it.”Meagan invites her dear friend and doula client, Emily, on the podcast today to share her two very different birth stories and what she has learned along the way. During her first pregnancy, Emily was diagnosed with severe preeclampsia at 27 weeks and 6 days. She talks about specific symptoms to watch for and explains why she advises every pregnant woman to have their own blood pressure cuff. Emily had to shift her home birth plans to focus on staying pregnant as long as she safely could. Six weeks later, Emily shares her daughter’s wild birth story and tough NICU experience. Having preeclampsia the first time around does not mean it will come back in the future. Emily talks about the nutrition and lifestyle changes she made during her second pregnancy and how preeclampsia was not an issue at all with her second delivery. Emily was able to have a beautiful home birth and a big, healthy baby boy!Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:52 Review of the Week04:02 Emily’s first pregnancy10:25 Preeclampsia diagnosis14:48 34-week induction21:26 Giving birth29:25 Learning about and knowing your body34:37 Second pregnancy46:16 Working through trauma53:36 Shifting plansMeagan: Hello, Women of Strength. It is Meagan, and I am so excited to dive into today's episode with you. The episode that we have today, or the guest, I should say, that we have today is someone so near and dear to my heart. And I'm just gonna kind of give a little bit of a spoil alert.She is not a VBAC mama so this is not going to be a VBAC story but our guest today is someone that I think is going to leave you guys with a wealth of knowledge through her experiences and so I want to welcome my own personal friend and doula client, Emily. Welcome to the show. Emily: Hi. Meagan: Hi, you guys were going to be talking a little bit, well, a little bit about a lot of things, but we're gonna be talking a little bit about preeclampsia. We're gonna be talking about shifting gears from our birth desires and birth plans and so much more. I wanted her to be on the show because you guys, seriously, she really needs to write a book. She can talk all day to me and I just stare at her with amazement in my eyes, because she just is so incredible to listen to with her knowledge, her research, and all the things to make birth different the second time around, and do what she could do the first time around, which also goes along with mindfulness.There are so many things, you guys, about Emily that I just love and adore. I'm so excited to have her on the show today and I know that you're going to be taking a whole bunch of nuggets away from her episode. So make sure to take maybe some notes, or get your pen and paper out and join us in just one moment.01:52 Review of the WeekMeagan: But of course, we have a Review of the Week, so I'm gonna hurry and read that, and then we'll get going. This review was left in 2020, so a few years ago. It says, “I love these ladies and this podcast.”She says, “I love listening to your podcast. I listen almost every day in the car so often that my oldest son knows you by both of your names.” I love that. I love that your kids know our names.It says, “Since the stories shared here have inspired me so much, I wish that I had the information with my first baby. I've had two C-sections, and I'm not pregnant at the moment but still have to get my husband on board for a third. But I'm so excited to start planning for my VBA2C to see when the time comes. Thank you, Julie and Meagan, for creating the amazing VBAC community. I'm so grateful for the education and support.” This was a really long time ago. So eecc3, if you have talked your husband into another baby and gone on to have your VBA2C let us know. You could email us, at info@thevbaclink.com. If you want to share your story or share your review please do so. You can email us your review again at info@thevbaclink.com. You can Google us at “The VBAC Link”. You can leave us a review on Apple or wherever you listen to your podcast. We love, love, love, love getting them, and can't wait to read yours on the next one.04:02 Emily’s first pregnancyMeagan: Okay, cute Em. This has been an episode that we talked about forever ago and ever ago, right?Emily: Yeah. And ever, it's been a while. It's been a while.Meagan: I think you probably think I forgot about you after I talked to you about this, and then never really reached out, but we are here and I'm just so excited to have you on.Emily: Thank you for having me. I'm really excited. No, I think that I just realized that mom life happens. It's just busy. I knew you'd get back to me. I knew. Meagan: Yes, yes. Mom life does happen and The VBAC Link has been busy which has been an amazing thing. I cannot believe that we are heading into the 300s episodes here soon. It's been such an amazing journey. But, so, okay. We talked a little bit about why I want you on here, but let's talk a little bit about your first and how the journey has led you to where you are today.Emily: Okay, well, I got pregnant back in 2020. Oh yeah, that was a rough year for a lot of us. It was especially rough, I think, for just everything that happened. I initially did not want to do a home birth. I just assumed you would birth in the hospital and then I was like, “No I don't want to. I want do a birth center.” So I was on that boat for a minute then I was like, “No. I’m birthing at home.” I just wanted to stay out of the hospital. I was seeing my midwife, Heather, with Sego Lily Midwifery and everything was really good until it wasn’t. It was fast. It was really, really fast. It was actually so fast that I didn’t call you until after everything had happened. Meagan: Yes. Emily: That’s how fast it happened. I was diagnosed with preeclampsia at 27+6. For those of you who have experienced preeclampsia, that 27+6 is kind of a big deal. People are like, “Oh, so 28 weeks?” No, it was 27+6. Every day counts when you have preeclampsia. Every day your baby is still inside your body growing is so important. It’s a lot of rollercoasters of emotions. I went from my home birth was planned, getting ready to prepare for that last trimester of nesting and my midwife coming in, setting up, and then it just kind of blew up. It blew up. Meagan: Plans changed really fast. Emily: It changed really fast and it was like, “Hold onto your butts.” It was quick. You know, a week before I was diagnosed, I happened to get my teeth cleaned and they took my blood pressure. It was a little elevated. I didn’t even think anything of it because during that time with more blood flow, that is normal for your blood pressure to rise a little bit when you’re pregnant. I just didn’t think anything of it. You feel like garbage. I felt like garbage throughout my pregnancy so I didn’t think anything of it when I wasn’t feeling good because I wasn’t feeling good in general. 07:56 Preeclampsia symptomsEmily: When I really started noticing when something was wrong, my swelling was insane. It wasn’t normal pregnancy swelling. The best way that I can describe it was my feet felt like they were hotdogs in a microwave. That’s how bad it was. It was so bad. My husband took me on a date to Barnes and Noble and I remember standing in front of the bookshelves like, “I have to sit. I can’t stand anymore.” My feet hurt that bad. I was wearing slippers because I couldn’t fit into any of my shoes. He had to help get me up. It wasn’t like that normal, “Help me up, I’m pregnant.” It was like something was wrong. Meagan: Physically hard for me to do. Emily: I’m in pain. I’m actually in pain. That morning, I was taking a shower and I saw white stars, like white dots everywhere but I was shaving my legs. My head was down. It was really hot. I was starting to rationalize what was happening. This is where preeclampsia really sneaks up on women because a lot of the symptoms are disguised as regular pregnancy symptoms and they’re not. We got home. I was like, “You know what? I’m going to check my blood pressure.” I had a blood pressure cuff. I was a CNA for a while and I had a sister who had preeclampsia so I knew a lot more than some women do. Luckily, I did. I took my blood pressure and it was– oh my gosh. I don’t even remember. It was 120, 130 over 100, and something. It was insane. I remember sitting there looking at my feet. I had no ankles. I took a picture. I texted Heather. I didn’t even call her. I was like, “So this is my blood pressure.” She immediately called me back and was like, “You need to go to labor and delivery. That is too high.” 10:25 Preeclampsia diagnosisEmily: I went in and the way that they told me too was matter-of-fact. Well, yeah. I remember looking at the nurse and being like, “Do I have preeclampsia?” She was like, “Uh-huh. Yeah. Your bloodwork shows that you have preeclampsia.” I just remember yelling. The anger that I felt, I can’t remember feeling anger like that. I just knew. I knew everything was going to change and it was really hard. They were also kind of panicking too because my platelets were so low as well. My blood pressure was insane, but I did not have the ability to clot. Meagan: Clot, mhmm. Emily: I was on this really thin wire of, “Okay, she could seize and have a brain bleed and then have brain damage,” Meagan: Which is scary stuff to think about and hear. Emily: It really is. It’s really scary. “And then we could do a C-section, but she could bleed out because her blood’s not clotting.” I was in this really weird balance. They gave me magnesium. Ugh. Ugh.” That stuff is the absolute worst. I have never– that’s the closest, I think you could get to being lit on fire. It was pretty terrible. The good news was that Ripley was fine. Her vitals were good. Everything about her was awesome. It was me. My body was just tanking.

“Birth is birth and we just want our babies here safe, but I also think that we all deserve to be empowered to have the birth that feels right.”One night, a few months after her second C-section, Arianna had a dream that she was giving birth vaginally to a sweet baby boy and pulled him right up to her chest. The next morning, she took a pregnancy test and it was surprisingly positive. Coming from a small town in Wyoming, she already knew from her second pregnancy that VBAC was not allowed locally. But at that moment, Arianna knew she was going to do whatever it took to have her VBA2C. Arianna traveled 2.5 hours each way for routine midwife and OB appointments in Montana to have VBAC-supportive providers. She faced many roadblocks including a short pregnancy interval, gestational diabetes, preterm premature rupture of membranes (PPROM), a medical induction, other interventions she wasn’t planning for, and slow progress. But her team was patient and encouraging, Arianna felt divinely watched over, and her VBA2C dream literally came true!  The VBAC Link Blog: What to do When Your Water BreaksThe VBAC Link Blog: VBAC With Gestational DiabetesThe VBAC Link Facebook CommunityNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:44 Review of the Week03:52 Arianna’s first birth story07:04 Requesting a C-section08:34 Arianna’s second birth11:36 VBAC preparation15:37 Signs of preterm labor20:34 Going to the hospital24:04 First cervical check27:10 Slow effacement 31:05 Catching her baby33:59 Importance of support36:35 Dual care tips44:56 Traveling tipsMeagan: Hello, Women of Strength. We are on episode two of the week and I am just so excited that we are doing this. It is so fun to bring double doses of VBAC, CBAC, and educational stories to inspire and encourage you during your journey. Today, we have our friend, Arianna, and she is from Wyoming. Is that correct?Arianna: Yep. Meagan: Yes, Wyoming. Where in Wyoming?Arianna: Buffalo. It sits under the Big Horn mountains.Meagan: Awesome. You guys, she actually traveled quite a distance to find her provider and that is something I think we get often in our community where it’s like, “I don’t know how far is appropriate to travel.” I think the answer literally depends on what’s appropriate for your family and your living situation and your needs and everything like that. But Arianna– I just started butchering your name. Did you travel 2.5 hours?Arianna: About 2.5 up to Montana. Meagan: Okay, so we are definitely going to want to talk about that because I know this is going to be something that people are going to be interested in. Also, you had gestational diabetes. Arianna: Yes. Meagan: Yes. So okay, you guys, any story right? But if you are looking for knowing how to travel or gestational diabetes or anything like that, this is definitely the episode to listen to. 01:44 Review of the WeekMeagan: But of course, we have a Review of the Week and this is a fresh review, well fresher review. It’s in 2023 so just last year which is crazy still to me to say that this is last year, but it was in 2023 by sayerbaercooks. The review title is “Educating and Empowering.” It says, “Just had my VBAC. My pregnancy and birth changed all for the better thanks to this podcast and the women who shared their stories. This tool gave me the information I needed to advocate for me and my baby. I learned about the medical system and about myself and I had a fantastic birth which was the icing on the cake. I cannot thank you all enough.”I love that so much. I love that this podcast is doing exactly what we created it to do. So Women of Strength, one, if you have shared your story on our podcast, thank you. Thank you so much for creating such an amazing space for all of the Women of Strength listening. And if you are interested in sharing your story, definitely email us. Reach out or you can go online at thevbaclink.com/share and submit your podcast story. We’re sharing both on social media and we’re sharing on the podcast. We are hoping to get to some more of our submissions. 03:52 Arianna’s first birth storyMeagan: Okay, darling. I am excited to hear your story. I feel like as I was reading your blurb about your story, I feel like there is so much that you did, truly, that you did between hiring a doula, driving 2.5 hours, going to a chiropractor, reading all of the books, listening to the podcast, eating really well, finding the true support that you deserved– you did a lot and that is hard to do. Sometimes we do all of that and our birth still doesn’t end up the way that we wanted, but sometimes I feel like when we look back, we at least know that we did all that we could, but I’m so excited for you to share your VBAC after two C-section story with us right now. Arianna: Thank you so much for having me. I am so excited. I’ll just start with my first. I feel like that’s where we go. I was a single mom with my first pregnancy and I was young. I was only 22, or almost 22, and I think really the only thing I did was the 2-hour hospital birth class. I think I just had this expectation of, “Well, women push out babies and that’s just what I’ll do.” I didn’t feel prepared. I felt very alone. I was induced at 41 weeks and 6 days because my body was just not having it. I did everything I could think of and acupuncture and he just didn’t want to come out. I had a pretty easy induction. We started with Cytotec and Pitocin. After I got my first dose of Cytotec, my water broke two hours later. I was 2 centimeters. Meagan: Darn it. Arianna: That was rough and the contractions were just insane. Pitocin contractions are the devil’s work, I think. There were super painful. I had my mom with me, but I just didn’t feel like I was in a supportive environment looking back especially. I got the epidural right away because I was like, “Oh my gosh, it’s not supposed to be this painful.” Meagan: Yeah. Well, Cytotec, Pitocin, water breaking– all of those things packed together, that’s tough. Arianna: It was intense. I labored in bed all day. All day long. I progressed really well. I got to 10 centimeters. I started pushing and I was like, “La, la, la. I’m going to have a baby. This is great. I’ve got my drugs. I can’t really feel anything.” But I think within the first hour of pushing, I was like, “Well, I’m doing something wrong because nothing is happening.” The doctor kept saying, “He’s so high up. He’s not coming down.” So I think what broke me though is the older nurse. I will never forget her face, but she just made a snide comment of, “Girls these days just don’t know how to have babies.” Meagan: Oh.07:04 Requesting a C-sectionArianna: I was like, “Oh, okay.” I pushed for three total hours and then I started to just really feel like something was wrong. I asked for a C-section. Meagan: Okay, yeah. Arianna: Looking back, I’m like, “There are so many things that could have gone differently.” We ended up with a C-section and he was OP, so he was face up and he was slanted. Meagan: I was just going to ask that. Arianna: Mhmm. He was a little slanted and OP. You know, later I found out he was kind of having some developmental things and he was struggling with the right side of his body so I ended up finding out that he had actually gone without oxygen and had a blood clot and had a stroke during delivery. I’m grateful for that C-section and trusting my body that things didn’t feel right, but it came with a lot of trauma over all of it. Arianna: Around that time, my son was about 2, I met my now husband and we went down the road of diagnosis and specialists finding out he has mild cerebral palsy. Meagan: I was just going to ask if he has cerebral palsy. Arianna: He is a rockstar, truly. He has saved my life in so many ways. I am so proud of him. He works so hard with PT and OT and all of the things. 08:34 Arianna’s second birthSo moving on, I got married to the most amazing man ever. He loved every part of me. I struggled pretty intensely throughout my teenage years with mental health stuff, suicidal ideation, depression, and all of those things. At the time, I was pretty heavily involved in suicide prevention. That is always a huge part of my life. We got married and we got pregnant right away. I had a miscarriage pretty early on and then we got pregnant again. I had heard of this little fairytale thing called a VBAC. I was like, “Ooh, yeah that’s cool.” I brought it up to my doctor at our little small hospital. Immediately, he was like, “It’s not really safe, but if that’s what you want to do, we don’t do them in the state of Wyoming.” So I was like, “Okay. Well, we’ll just have a C-section,” because I really didn’t know and I was still dealing with the trauma of my first birth. Five years had gone by and I wasn’t aware I was so traumatized until I was having another baby. Meagan: That’s often the case. We don’t really recognize it until we are in that new situation and all of the flooding memories come in and we’re like, “Oh crap. Wow, I have trauma.” Arianna: Yeah. My doctor was amazing. He really validated where my anxiety and my fears were coming from. I didn’t want a C-section, but in my mind, we are told, “If you’ve had one, everyone says you have to have another. It’s the safest option,” so I trusted that.At 38 weeks, my water broke. Meagan: Okay. Arianna: I was like, “Oh, my body could do it.” I still had my C-section, but that for me, was redemptive because I was like, “See? My body could do it,” and that was okay. That was an adventure. When my daughter was 6 weeks old, I got mastitis and was septic and in the hospital for a week and a half.Meagan: Yikes. Arianna: That was insane and I was on heavy-duty antibiotics for three or four months but I was also on the pill so those two things counteract each other if people don’t know that, so when she was 7 months, we found out we were pregnant in a wild way. I had a dream one night that I had a baby boy vaginally

We know that unique circumstances in pregnancy can make a VBAC feel farther out of reach. Do your chances of having a VBAC go down if you had preeclampsia in a previous pregnancy or your current one? What if you have a special scar? What are the chances of having a VBAC if you were diagnosed with “failure to progress”? What about fibroids or gestational diabetes? Julie Francom joins Meagan on today’s episode discussing evidence-based research around all of these topics. They share personal experiences as birth workers and overall takeaways that can help you confidently navigate your VBAC journey no matter what complications arise during your pregnancy. Additional LinksSpecial Scars StudiesThe VBAC Link Blog: Why Failure to Progress in Labor is Usually Failure to WaitAJOG ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Timestamp Topics02:54 Review of the Week5:51 Preeclampsia08:57 Ask questions12:51 Special scars17:58 Failure to progress26:15 Fibroids27:54 Gestational Diabetes35:06 Find a supportive provider, ask questions, and educate yourselfTranscriptMeagan: Hello, hello everybody. We are getting out of winter and maybe into some spring weather, hopefully. I always hope for spring weather in March because it’s my daughter’s birthday and she always wants sunshine, not snow for her birthday. So I’m crossing my fingers that this is the month we have sunshine, not snow. I hope you guys are having a wonderful beginning– well, I guess it’s not actually spring, but I hope you’re having a wonderful beginning of March. We are kicking off our very first Monday episode for 2024. You guys, we have a little surprise for you. We are going to be sending out two, not just one, but two episodes a week. Make sure to tune in on Mondays and Wednesdays for stories and information. Today, we are kicking it off with Julie. Hello. Julie: Hey. I’m so happy to be here and yes, I’m hoping it’s warm or getting there because I am just a popsicle permanently from November to March so let’s just thaw out a little bit, please. Meagan: Just a little bit. Even if we just get some little sprinkles, let’s have April showers in March. Julie: Yeah. Meagan: You guys, I am so excited for today’s episode. Julie and I feel like these are some questions, I am definitely getting these questions on the weekly Q and A’s, but these are some questions that are often asked and we want to answer your questions today. We’re going to be talking about a whole bunch of things. Julie: A whole bunch of things. Meagan: What are the chances if I have preeclampsia? A special scar? Failure to progress?Julie: Gestational diabetes. Meagan: Gestational diabetes and maybe uterine fibroids. We are going to talk a little bit more about those. What are your chances for VBAC or vaginal birth if you have these things or have had them? Maybe you are not pregnant yet and you had preeclampsia last time or gestational diabetes last time. What are your chances? 02:54 Review of the WeekMeagan: So without further ado, I’m going to turn the time over to Julie for a review and we’ll dive right in. Julie: Without further ado, here is Julie. Okay, this review is from Google. It is from Christa and she says, “This podcast is beyond empowering. After my C-section after multiple unnecessary interventions, I knew immediately I wanted a VBAC for my next baby. I found this podcast not long after and have been an avid listener for four years.” Four years, wow! Meagan: That’s amazing. Julie: I know. “The VBAC link lifts the veil on birth and allows women to educate themselves and make their own decisions instead of just blindly trusting providers as many of us have in the past. Because of this podcast, the topic of birth/VBACs has become such a passion of mine and I now feel confident in my knowledge and ability to advocate for myself next time. I recommend this podcast to every mom and expectant parent I know. I am now pregnant with my second due March 2024–” Hey, that’s right now– “and am already preparing and relistening to every episode and have the honor to have Meagan as my doula–” What?! That’s awesome. “Hopefully you’ll hear my successful VBAC story soon.” Meagan, this is your client. That’s awesome. Meagan: I love it. I love it. Thank you, Christa. Julie: Maybe you’ll be at a birth soon for her. Holy cow, that’s amazing. Meagan: I know. I love it so much. I love that she said that we lift the veil. That was so cool. Yes. Julie: Yes. Meagan: Thank you. You guys, these reviews, as you can see, we are over here smiling and gleaming on this Zoom podcast. Julie: Smiling and gleaming. Meagan: Yes, we are. So if you wouldn’t mind dropping us a review, your reviews truly help other Women of Strength find this podcast and find this platform. You can leave it on Google just like Christa did. You can go to Apple Podcasts. You can go to Spotify. Can you? I don’t know if you can on Spotify. Google or you can just email us. Email us at info@thevbaclink.com with the subject “Review” and you never know, you might be read on the next podcast. 5:51 PreeclampsiaMeagan: Okay, Julie. Are you ready? Julie: Let’s do it. Meagan: Always, right? Okay. Let’s talk about preeclampsia. You had preeclampsia with your first that did end up ending in a Cesarean. However, you went on to have three HBACs. HBAC if you are just new with us is Home Birth After Cesarean. So yeah. I guess right there I want to point out is it possible to have preeclampsia and then go on and have a vaginal birth? Yes. Julie: Yeah. Yeah. Heck yeah, it is. Meagan: Yes, it is. Julie: I did it. You are speaking to the girl right here. Now, preeclampsia is kind of tricky because a lot of research shows according to the Preeclampsia Foundation. You can find it at preeclampsia.org. According to them, there is a suggested risk that you have a 20% chance of having preeclampsia again after you’ve had it the first time. However, there are some experts that site a range anywhere from 5% to 80% just depending on when you had it in your prior pregnancy, how bad it was, and any additional risk factors that you have. So I have had clients, most of my clients that have had preeclampsia once don’t have it again, but I have had one client that has had it both times. My pediatrician had preeclampsia in both of her pregnancies. It really just depends on a lot of different risk factors, but preeclampsia also doesn’t exclude you from having a VBAC. You’re just going to have to get induced earlier for the safety of your baby usually around 37 weeks unless it is severe. They might want to induce you a little bit earlier than that. But yeah, I just feel like me and Meagan– I’m going to go off on a little bit of a tangent and then I’ll bring it back. But me and Meagan were just talking about how a lot of these things– the biggest risk of VBAC is uterine rupture, right? That’s what we talk about. But a lot of these other things like gestational diabetes and preeclampsia and big baby and all of these other things, the risks of those or the perceived risk sometimes don’t have anything to do with VBAC. It’s completely separate. It doesn’t increase your risk uterine rupture. Not even big baby increases your risk of uterine rupture. There are no studies that support that. Preeclampsia and VBAC should be treated separately although a lot of times, providers don’t treat it separately. They think, “Oh, you’ve had a C-section and preeclampsia so we should just schedule a C-section.” That is where provider bias comes into play and these perceptions when there are just not a lot of studies and evidence to support any of that, right? Anyways, circling it back to preeclampsia, there are lot of things you can do to make your body healthy overall that may reduce your chances of preeclampsia although I guess we are still not entirely certain about how preeclampsia comes about in the first place. But yeah. I don’t know. What do you have to say about that, Meagan? 08:57 Ask questionsMeagan: Yeah. I think it’s important to do what you were saying and separate the thought of, “If I have this, I have to do this,” when a lot of providers, especially if it is severe and we’ve got really, really high blood pressure and we are severe, they may specifically say, “You need to schedule a C-section,” but that doesn’t necessarily mean you have to and if you have preeclampsia in general, it doesn’t mean you are going to have a C-section. I think that’s one of the biggest takeaways from this episode. Julie: There is no “have to” ever. There are no absolutes. Meagan: There is no “have to”. Yes. There are no absolutes. There are things where you may be at increased risk of Cesarean, but that’s typically because of those things like induction, right? So yeah. There’s really no concrete evidence on what mode of delivery is best if you have preeclampsia. So again, it comes down to your provider. Get a supportive provider. Talk about it. Really ask them. If they tell you, “Okay, because you have preeclampsia, we are going to have to schedule a C-section,” ask them. Do not stray away from getting the evidence and the information that you need. You can say, “Okay. Can we talk about the evidence of why I have to?” Right? Ask questions. Don’t feel bad for asking questions. It’s okay. If you have that question, ask it. Meagan: So yeah, I think that’s kind of it. Julie: Yeah. I think the overall theme of this episode and maybe the whole entire VBAC Link period is asking questions to your provider, talking with your provider, and having a mutual trust with your provider where they trust you and you trust them. Right? It’s a two-way street where you guys can collaborate together and create a plan of care that is comfortable with you and comfortable with them. I know that a lot of care is centered around the provider and what they are comfortable with. Some providers are not comfortable with doing VBAC for preeclampsia or after two or more Cesareans or aft

We love hearing stories of how our Women of Strength navigate birth in an empowered way, no matter the outcome. Rebecca’s story shows how she carefully selected the most supportive homebirth midwife, created a safe birth space in her home, labored hard and beautifully with her husband, took time to process information, assessed her situation, and consented to her second Cesarean when the time felt right to her. Meagan also talks about the different types of positioning and some signs that your baby might be in a less-than-ideal position. Rebecca and Meagan discuss tips and tricks to help prevent a swollen cervix and what options you have if that happens to you!Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Timestamp Topics01:54 Review of the Week04:31 Rebecca’s first pregnancy07:25 Consenting to an unexpected C-section for breech presentation8:53 Fertility Fridays11:02 Sparked interest in VBAC and getting pregnant again13:53 Planning for a HBAC18:00 Tachycardia and GBS positive21:27 Early labor24:18 Calling the team30:10 Laboring through the night39:02 Making the decision to transfer44:53 Consenting to a C-section46:43 Tips for when things don’t go as planned50:43 Signs of wonky positioning53:31 What to do57:00 Why you shouldn’t skip the repeat Cesarean storiesMeagan: Hello, hello. It is Meagan with another amazing story on The VBAC Link podcast. Thank you so much for listening to us, you guys. I love this community. I know I talk about it. I know it’s weird that I don’t even know you, but I love you. I love you so much and I’m so glad that you are here with us today. We have our guest today from, let’s see, Virginia. I think it’s Virginia. That’s what my mind is saying. Rebecca: Yep. Meagan: This is Rebecca, so welcome, Rebecca. Rebecca: Thank you. Thank you for having me. I’m really excited. Meagan: Absolutely. Me too. Her story, you guys, today is a repeat Cesarean story so if you didn’t know on The VBAC Link, we do share repeat Cesarean stories because they are important to share as well. I’m excited for you to share more about your story and we’re going to talk a little bit about swelling of the cervix at the end of this episode because this is something that we see and is a little bit of a part of your story. 01:54 Review of the WeekBefore we dive into the story and all of the things, we of course want to share a Review of the Week. This review is from shotsie3 and it says, “Amazing is not a strong enough word.” That is really awesome. I love that. It says, “I cannot say enough good things about The VBAC Link. Listening to this podcast not only saved my mental health but gave me the knowledge and confidence to take control of my second pregnancy. After my home birth turned into a hospital transfer and Cesarean with my first child, I felt broken. When I unexpectedly found out I was pregnant just 7 months postpartum, I felt scared and lost. I was afraid of failing again and doubted my body’s ability to birth naturally, but I knew I absolutely could not have another Cesarean so I started obsessively researching VBAC. That’s when I found The VBAC Link. I’ve been binging episodes ever since. Listening to these stories has been incredible. Each episode is like giving a shot of confidence into the arm.” Oh, I love that. A shot of confidence into the arm. We’re giving you guys a little vaccine of confidence. It says, “Both my midwives and doulas have commented on how far my mental prep has come and I know it’s all thanks to The VBAC Link. Julie and Meagan have given me lots of tools and resources to control my birth.” I love that. Control your birth. “I am now looking forward to welcoming my second child via HBAC in just five short weeks. I want to shout it from the rooftop, ‘EVERYONE SHOULD LISTEN TO THE VBAC LINK!’”This review was a little while ago, so shotsie3, if you are still listening with us, which we hope you are, email us. Let us know how your birth went. 04:31 Rebecca’s first pregnancyMeagan: Okay, cute Rebecca, thank you so much for being here with us today. Rebecca: Yeah, thanks for having me. I’m really excited to share. Meagan: Absolutely. Well, I’d love to turn the time over to you. Rebecca: All right, well I guess I’ll start with just a little recap of my daughter’s birth who is my first C-section. My daughter was born in January of 2021. We got pregnant with her during kind of the height of COVID. That pregnancy went really smoothly other than it was COVID times so of course, my husband couldn’t come to any of the appointments or anything like that. I didn’t really do much prep with her because I wasn’t going to go to a birth class. There weren’t a lot of resources available. All I really did was watch some YouTube videos. I kind of knew I wanted to try to have a natural birth, but I didn’t prepare that much for it really. I read Ina May Gaskin’s Guide to Childbirth and stuff, but I didn’t do too much preparation. She went to 41 weeks with no complications. I didn’t want to be induced, so my OB was like, “We’ll go to 41 weeks and then we’ll bring you in for an NST and an ultrasound.” So we went in on January 10th for her NST. She passed that with flying colors and I had asked them if they would give me a membrane sweep before they would induce me. They said they could try that, so they were going to come in and give me the membrane sweep, but luckily, one of the doctors there was like, “Well, let’s do her ultrasound first just to make sure that everything’s fine because that just makes sense before going down there and doing the membrane sweeps.” They did the ultrasound and she was like, “Did you know your baby’s breech?” I was like, “No, I did not.” Meagan: News to me. Rebecca: Yeah. Every time the OBs would very quickly, I will say, very quickly palpate me, they’d be like, “Yep. Feels like she’s head down. Everything’s good.” She was like, “Yeah. She’s breech so we’re going to go ahead and schedule a C-section for today at 4:00.” It was around 11:00 or something when this happened, so I just immediately started crying because I did not want a C-section. That wasn’t what I was planning for at all. She was like, “Well, we don’t do the (ECV)s here.” Is that what it’s called? (ECV)? Am I saying it right?Meagan: Mhmm, yeah. Rebecca: Yeah. She was like, “We don’t do that here. Your amniotic fluid is kind of low, so yeah. This is your option.” Meagan: I wonder why they don’t do it there. Rebecca: I don’t know. She just said that they don’t offer that service. I guess I didn’t really know to ask for a second opinion or to see what other– I was just like, “Well, she’s telling me that this is my only option,” so we consented to the C-section which was really disappointing. 07:25 Consenting to an unexpected C-section for breech presentationRebecca: My husband had to go home and get a hospital bag ready because we didn’t bring it with us or anything. We were like, “Oh, we will have time to go back if they are going to induce me.” I don’t know. We just weren’t prepared. Anyways, around 4:00, she was born via C-section and it was uncomplicated. It was uncomplicated. She did well. She did have some hip dysplasia because she was frank breech and they think she was probably frank breech for a long time, so her hips and the bones weren’t in the socket at all. But other than that, she was completely healthy. But yeah, I remember that night kind of laying in bed with her nursing, and my husband was asleep. I just was quietly sobbing because I felt like everything that I was looking forward to kind of got ripped away from me and I didn’t really have a choice in the matter. So I never got to experience one single contraction or any of that with her. I didn’t even really have Braxton Hicks with her. It almost felt like there was no closure to the pregnancy. It felt like I should still be pregnant. I definitely, yeah. That was a struggle. That was a struggle for a while afterward kind of trying to find closure of that whole experience because it was just like, “Okay, you’re pregnant and now you’re not pregnant.” There was no transition. That was her story. 8:53 Fertility FridaysActually, to be honest with you, shortly after her birth, I was kind of like, “Well, if we get pregnant again, I think I’m just going to do a C-section again because I know what to expect. My body’s already been through it. You know, I think I’m just going to do a C-section again.” That was kind of what I was thinking. But as I went on throughout my postpartum time, when I got my period back, I noticed throughout the year that I had some weird issues. I was spotting a lot all throughout the month and just different things were happening that I was like, “This doesn’t seem quite right.” When I went to the OB about it, they were like, “Oh, it’s fine. Your body is probably just getting back into the swing of things.”But it would be like, “Okay, well I’ve been postpartum for a while now.” This was two years down the line. I think that there’s probably something going on that needs investigating. They were kind of like, “No, it’s fine. It’s fine.” I ended up finding a podcast actually called “Fertility Fridays”. I don’t know if you’ve heard of it, but it’s really awesome. Meagan: I haven’t. Rebecca: It just teaches women about their bodies. How to track your cycle and what your cycle means, and how to know if you’re actually fertile at that time because that’s another thing. It took us a year to get pregnant with Emma Jean. I was also afraid, “Well, it took us a long time last time. Maybe something was wrong.” I just got really into body awareness and women owning their bodies and the different choices that we make and that our bodies have all of these natural processes that we don’t even really know about all of the time because we are not educated about those things. Meagan: Yeah. Rebecca; So as I educated myself on how my body worked and all of its amazing processes, I also

Happy podcast Wednesday, Women of Strength! You do NOT want to miss today’s episode. Clair shares her beautiful journey to a VBA3C. After fully dilating and pushing for hours but ultimately ending in C-sections with her first three babies, Clair finally had the vaginal birth she so badly hoped for with her fourth! Clair shows just how powerful birth can be when a woman’s intuition is combined with informed consent and an open-minded birth team. There were unfortunately some technical difficulties during this episode and part of Clair’s third birth story was not recorded. Clair graciously submitted this written account below.24:08 “With my third baby (attempted VBA2C), I dilated quickly and smoothly, baby was descending beautifully, and I started feeling like it was time to push. I pushed for a long time - a couple of hours - and he was coming down, but slowly. We tried many different positions, moving around, etc… but it was taking a while. Looking back, I was having some back labor and it’s likely that when my water broke on its own, he dropped into a posterior position. After several more hours, we could see his head! I thought a VBAC might really happen! But baby’s heart rate started having decels and having a hard time coming back up, so we decided to transfer to the hospital for monitoring. I was pretty exhausted by that point, so I was hoping that IV fluids would help me regain strength and keep going. When we got to the hospital, however, they would only let me labor in the operating room because I was a VBAC patient, so I was very limited in mobility and my options. Baby seemed stable, but they were basically prepping for surgery from the moment I walked in the door and wouldn’t tell me baby’s stats. We eventually called it, opting for a C-section on our terms so we could have delayed cord clamping and a calm environment. Baby boy was almost 10 pounds and had very healthy APGAR scores! I was disappointed I didn’t have a VBAC, but I felt respected by my midwife the whole way through. Postpartum physical recovery was difficult, but emotionally this birth was much less traumatic because I had a supportive birth team. I also took two intentional weeks to do nothing but be with the baby and rest, which I hadn’t done with my previous two births, and that made a huge difference in my mental health and bonding with my baby!”Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Time Stamp Topics01:56 Review of the Week04:30 Clair’s first pregnancy and birth 07:50 Recovering from a C-section while moving 09:24 Getting pregnant at 3 months postpartum & dual care during COVID14:39 Laboring at home to complete & hospital check-in17:49 Clair’s second Cesarean19:08 An emotional recovery23:38 Third labor with a home birth midwife24:08 Pause in story – read caption!24:20 Fourth pregnancy 28:49 Moving to Utah 35:34 Midwifery care in the hospital38:47 Active labor begins45:04 Circumvallate placenta Meagan: Hello, hello Women of Strength. We are at the end of February here and we have a story that I swear– VBAC after multiple Cesareans is very highly requested when it comes to this community so we have a story for you guys today for VBAC after three C-sections. Not only was it a VBAC after three C-sections, but it was also a pre-term VBAC after three C-sections. I think in a lot of places around the world if someone came in pre-term and they have had three C-sections, finding that support is going to be hard. It doesn’t need to be necessarily hard, but I know that it can be so I’m excited for this story from our guest, Clair, today because it’s a story that just shows that it is possible even if you have certain things stacked against you that the medical world looks at in a negative way. 01:56 Review of the WeekSo we are going to be sharing that story here in just a few minutes, but of course, we have a Review of the Week and this was shared on Apple Podcasts. It’s by brittleesmith. It says, “Highly recommend for both VBAC mamas and mamas in general.” It says, “In 2019, after 30 hours of labor, I ended up birthing my son via unplanned C-section. I was devastated and knew my future birth had to be different. I immediately started digging into VBAC resources and came upon your podcast. I listened to every single episode before I even became pregnant with my second baby. The knowledge I gained from both of you as well as your many guests is truly invaluable. This resource is great for any expectant parent, not just VBAC moms and I wish I had discovered you all before my first child. “I am thrilled to announce that I got my VBAC this past February and I owe a lot of thanks to y’all. Keep it up, ladies.” Oh, I love that. I love when people say, “We found you. We learned and then we got our VBAC,” or “We found you. We learned and I didn’t get my VBAC but I had a better experience.” This is what this podcast is here for to help people have a better experience, to learn the information, to feel more empowered to make the best choice for you, and even sometimes when the experience doesn’t go exactly as we planned, to still have a better experience because we know what our options are. As usual, if you guys have not left a review, we would love them. They actually help Women of Strength find this podcast. They help people find the information and the empowerment for their births, do drop us a review. You can leave it at Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there or wherever you listen to your podcasts, drop a review. 04:30 Clair’s first pregnancy and birth Meagan: Okay, cute Clair. It’s been so fun. I just was scanning over your stuff and I was just excited because of all of the people you had at your birth, I know personally because you are also here in Utah. I’m so excited to hear your whole story and your journey. I just want to tell you congrats in advance because it is so amazing. So amazing. Clair: Thank you so much. Yeah. We didn’t expect to be in Utah, but it turned out to be a really great place to birth so we are really grateful to be here. My story actually starts on the East Coast thousands of miles away and I was due with my first in May 2019. I didn’t really know much about birth in general. I’m the oldest child and kind of a rule follower. I was like, “Well, if I just do everything the way I’m supposed to, then birth will just happen.” Yeah. I had a really supportive OB. He has several children of his own. His wife was a friend of mine. He was a really great doctor. But at around 32 weeks, I was flying at the last possible second I was allowed to fly and running through an airport. I kind of felt the baby kind of settled in a weird spot after that. I started having prodromal labor at 39 weeks or something. That went on for about two weeks. What I didn’t realize was that these were all signs that maybe he was posterior and not in a great position. My OB, even though he was really wonderful, wasn’t trained to determine where the baby is, just that the baby is head down. Meagan: Right. Clair: So at 41+1, early in the morning, I was over a week past my due date. I was losing my mucus plug. “Hey hon, we’re going to have a baby today.” I was so excited. We ended up laboring all day at home. We went to the hospital. I had really, really bad back labor so I ended up with a lot of IV fluids. I had a couple more interventions. They broke my water eventually and basically, what ended up happening was that 41+2, so 9 days after my due date, I had dilated to complete, but the baby wasn’t dropping at all. He wasn’t engaged. He was still really, really high and after a while, his heart rate wasn’t tolerating labor well anymore and they recommended a C-section. Meagan: Did they have you push? Clair: I didn’t push. Yeah. They said he was still too high. They didn’t recommend that. Meagan: Interesting. Isn’t that how we get babies down? Clair: Yeah. I’m not really sure. Meagan: Yeah. Yeah. Clair: It definitely was a situation he was not used to or prepared for. He was kind of surprised and honestly very sad that I didn’t have the birth experience that I wanted. He came to visit the next day and just spent a few minutes with us. His wife came to visit who I was friends with. It was really hard and pretty traumatic, but it also could have been much worse. His bedside manner, I was really well taken care of. 07:50 Recovering from a C-section while moving So that was really hard. It was a challenging physical recovery because I had 48 hours of labor and most of it was without an epidural. It was really intense. The hardest part of that birth was that the first time I saw my son, I saw a picture of him that the nurses showed me because they took him away to be measured right away. So that was really hard. He was 9 pounds, just that plus not being in a great position and being with a provider that didn’t have a lot of options of what to do if baby is not descending properly. That was a difficult adjustment to motherhood especially because that baby was born in Louisiana. We were moving back to Virginia where we have a lot of family and friends. We were planning on moving two weeks after the baby was born, but because he came late, we actually left the hospital and started driving north. I would not recommend this. Don’t do it. Meagan: That’s a lot. That’s a lot. Clair: It’s a really bad idea. Meagan: Oh my gosh. Clair: His first night out of the hospital was in a hotel in Birmingham, Alabama. Yeah, don’t do it. So yeah, that was just hard because we were moving and I’m trying to physically recover. So it was pretty wild. 09:24 Getting pregnant at 3 months postpartum & dual care during COVIDClair: That was my first. My second– we surprise got pregnant three months after that baby was born. Meagan: Okay. Clair: He was a cycle zero pregnancy. I had no idea. I just felt off and was like, “Maybe I should take a test,” and I was so shocked that I

We are following up on last week’s informative episode on gestational diabetes with a gestational diabetes VBAC story! Samantha’s first labor ended in a traumatic Cesarean with her first baby, but she didn’t find out many details of what happened to her until she requested her operative report months later. Samantha found out that she had a lateral scar extension. Despite this and other odds that felt stacked against her (i.e. her gestational diabetes diagnosis!), Samantha was determined to do absolutely everything in her power to put her in the best position to achieve her VBAC. And she DID!Additional LinksLeslee Flannery’s InstagramNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Timestamp Topics2:18 Review of the Week6:32 Samantha’s first birth story  9:37 Scheduled induction13:04 Complete dilation, pushing, and stalling15:49 C-section22:15 Official reason for C-section25:15 Recovery26:57 Second pregnancy42:46 Labor52:34 Feeling pushy55:42 “You’re not going to need a C-section today.” 1:02:39 Finding supportive providers1:05:53 Prep tips for listenersMeagan: Hello, hello you guys. It is likely a cold winter morning or afternoon. At least here in Utah, it’s February and I don’t know. It’s not something that was intentional, but it seems like this month we are talking about gestational diabetes. We talked about it last week and coincidentally enough, the story today that we are recording talks about gestational diabetes today. So I’m excited to dive more into that and talk a little bit more about that. We were talking about this just before we started recording. It’s becoming more common but it’s not talked about enough so it’s probably fitting that we are doing two episodes this month on gestational diabetes. We have a really great story for you today. We have a C-section that was begun with an induction then she got a double-whammy with an asynclitic and a posterior baby. I’m really excited to hear what your diagnosis was on that, Samantha, because I always get so curious when we know we had fetal positioning if we get that CPD diagnosis and things like that. 2:18 Review of the Week But of course, we have a Review of the Week so I’m going to share this and then we will dive right into Samantha’s story. This was by lindseybrynneohara. Shoot. I always butcher names. It says, “An invaluable resource. I found The VBAC Link shortly after my first daughter was born via Cesarean after a planned birth center birth. My second turned home-birth Cesarean as well. I have found a home in a CBAC (Cesarean Birth After Cesarean).” You guys, for everyone that doesn’t know this, if you’ve had a Cesarean birth after a Cesarean, please know that we have a group for you too. We know that sometimes after not having a vaginal birth, it can be hard to be in a VBAC group, so we have created this Cesarean birth after Cesarean group and it’s amazing. She says, “I’ve found a home in the CBAC group these ladies put together. It helped me through some dark days of postpartum and processing my unplanned repeat Cesarean. You can find VBAC groups all over the place now, but a group for those mamas who are grieving the loss of their VBAC, they can’t find. Not so much. This is a very special group where I feel completely supported, heard, and respected for a birth I sometimes struggle to call mine and my baby’s. I am now diving into all of the VBAC after two Cesarean and VBAC after multiple Cesarean content from over the years and I am finding so much comfort and hope in these brave women who have come before me. I just have this strong feeling I will get to be one of them.” Ooh, that just gave me the chills. “I hope to share my story with you when that day comes. I’m learning so much about birth and myself as a birthing woman. I thought I was informed for the first time, but there are so many layers of understanding past births and planning for future births especially when C-section is involved. Thank you for the well-researched evidence-based content and special stories.” Wow. That review literally gave me chills and made me emotional. You guys, when Julie and I– Samantha can see my eyes. No one else can, but really, they are tearing up. When Julie and I created this group and this podcast and this course, this is why we did it– to help people feel exactly how she was describing. To feel loved, to feel heard, to find a place of education, and to understand that you’re not alone because sometimes it can feel so lonely. Just so lonely. So thank you for that review. I am literally crying. Thank you for that review from the bottom of my heart. As you can see and as you know, we love reviews. They truly make everything that we do. It warms our hearts. It helps people just like you find this podcast. It helps people find the course so they can find the information and it helps people find that Facebook group. You can leave it on Google. You can leave it on Apple Podcasts. You can leave it on social media. You can leave it on Facebook. Message us. Wherever. If you love The VBAC Link and you have something to share, please let us know because we absolutely from the bottom of our hearts love it. 6:32 Samantha’s first birth story Meagan: Okay, Samantha. Now that I’m trying to soak back up the tears that wanted to flow, I mean, I don’t know. Yeah. Sorry for being so vulnerable here. Samantha: No. Meagan: Wow. That just touched my heart. But now that I can see the screen again, I would just love to turn the time over to you. And also, thank you for being here with us. Samantha: Thank you so much for having me. I’m so excited. This is my second goal after getting a VBAC. I need to be on The VBAC Link’s podcast. Meagan: Oh. Samantha: But same thing as the review was saying, it’s an invaluable resource. I had no clue what I didn’t know going into my first birth, 100%. My story starts in 2020, I guess. I found out I was pregnant in August on my birthday, actually, I found out. Meagan: Happy birthday to you!Samantha: That was so exciting. My pregnancy went super well. I had a bit of leg pain at some point, but I was seeing a pelvic floor physio. She fixed me up really well and everything was perfect. I had an anterior placenta so I learned a little bit about that, but it shouldn’t have been a problem so it was fine. I was due May 7. That was the due date that they gave me. I don’t think it was necessarily accurate. I think I was due a little bit later. I think the 11th or 12th. I was tracking ovulation and stuff like that. So at 39+5, I had my doctor’s appointment. He sent me for a growth ultrasound. Had I known what I know now, I would have said, “Nope. No, thank you.” 8:19 Blurry vision and feeling offBut he was estimated at being 7 pounds, 10 ounces. Then the week after, Tuesday night, I had this weird episode I want to call it. I was sitting on the couch and all of a sudden, my vision got blurry. I ended up with a headache and I was waiting to see if I should go in or not. I felt off. In the end, I went into labor and delivery because it was the height of COVID. I didn’t want to go to the emergency room and all of my symptoms had subsided by then. They thought it was an optical migraine. He said, “Look. We can’t do anything for you. You’re having some contractions. Nothing crazy.” I wasn’t feeling anything, so they were like, “Look. You have your doctor’s appointment tomorrow. Just talk with them.” Meagan: Talk to them there. Samantha: Yeah. So the next day I went in and he was like, “Oh, it was probably just an optical migraine. You’re fine now, so whatever.” Meagan: I’ve actually never heard of that. Samantha: Right? Meagan: Optimal– Samantha: Optical, like in your eyes. Meagan: Optical. Interesting. Samantha: Strange. But it put me a little bit on edge so that’s why I’m telling that part of the story. Meagan: Yeah, set the story. Samantha: He told me, “You’re almost 41 weeks. It means you’re overdue.” I’m like, “Okay.” He’s like, ”The rate of stillbirth goes way up now.” I was like, “Oh, jeez.” Of course, that puts fear right into your heart.9:37 Scheduled inductionHe’s like, “We’re going to schedule the induction. It’s going to go great. It’s going to be amazing. You’re going to have your baby in the next few days.” He’s like, “Look. We’re really booked next week so I’ll set you for Thursday. Thursday, first thing in the morning, come in.” They call me. They were like, “We are ready for you.” I got there at 9:00 AM. The plan was to put a Foley bulb in, but the doctor who was on rotation at that time came in and said, “You’re already 2 centimeters. It’s not worth doing the Foley bulb at this point. We’re just going to start you on some Pitocin if that’s okay with you.” I was like, “Okay. Whatever you say. I trust you. You are a doctor.” Had I known. Anyway, we stayed in that room until 5:00 PM that night because they didn’t have a room to start Pit yet. So from 9:00 AM until 5:00 PM, I was just sitting there having random contractions that I never felt and wishing. I had a gut feeling. I told my husband, “We shouldn’t be here. I shouldn’t be induced. This is not what I want to do.” Meagan: Oh really? Samantha: But I didn’t know I could leave. I didn’t know that it was a thing. Meagan: Women of Strength, it’s a thing. It’s a thing. You do not have to be there. Samantha: There was nothing abnormal about the baby’s heartrate. There was nothing going on. They did a mini ultrasound just to check his position. He was head down. That’s all I knew really. I was at a -2 station. I was 60% effaced, 2 centimeters. Everything was fine. My body was fine. He was fine. We started Pit at 5:00 PM, but they were ramping it up quite quickly. I wasn’t feeling anything at this point. Meagan: They took forever and then ramped it up. Samantha: Yeah, they were like, “Hello, welcome.” Finally, they broke my waters the next morning at 6:00 AM. Meagan: Do you know what dilation or what station you were at that point? Saman

We have an incredibly special episode for you today with the one and only Lily Nichols! She is a registered dietitian nutritionist and the author of two books (soon to be three!)-- Real Food for Pregnancy and Real Food for Gestational Diabetes. Lily is truly a pregnancy nutrition expert providing women with access to the most current evidence-based information regarding food. Lily specializes in helping women with gestational diabetes feel empowered with options to help their blood sugar stay diet-controlled. This important work is helping women with gestational diabetes have healthier pregnancies and more birthing options when so much of the conversation around it becomes limiting and fear-based. Whether you have gestational diabetes in your pregnancy, are pregnant, preparing to be pregnant, or just want more nutrition education, this episode is for you!!Additional LinksLily’s WebsiteReal Food for Gestational DiabetesReal Food for PregnancyHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Timestamp Topics09:28 What is gestational diabetes? 11:15 Are there preexisting signs and ways to prevent it?13:59 What can we do? 17:00 How much protein you should get in pregnancy19:11 Best sources of protein22:04 Getting enough protein on a meatless diet26:17 Fats & Gestational Diabetes31:14 Do we have to have a baby at 38 weeks with gestational diabetes?32:28 The problem with the standard gestational diabetes guidelines40:20 PCOS and gestational diabetesMeagan: Hello, hello everybody. This is The VBAC Link and we have a very special episode for you today. This is a topic that if I were to show you in the inbox, you would be like, “Whoa. I didn’t realize so many people have this question.” The question is– I mean, there are lots of questions– but the topic is gestational diabetes. So if you have any questions about gestational diabetes, this is your episode for sure. And then actually, right before we started recording, I learned there are even other things that make us at high risk or are a known risk for gestational diabetes. Even if you haven’t ever had gestational diabetes, you’re going to want to listen because there are things that we can do preventatively before pregnancy or during pregnancy to avoid it. But you guys, we have the one and only Lily Nichols on today with us talking about this extraordinarily common topic. Lily Nichols is a registered dietitian nutritionist and certified in diabetes education. She is a researcher and an author with a passion for evidence-based prenatal nutrition. Drawing from the current scientific literature with the wisdom of traditional cultures,  her work is known for being research-focused, thorough, and sensible. Her best-selling book is Real Food for Gestational Diabetes. I absolutely love that the start of this is “Real Food”. Real food is something that I don’t feel like we focus on enough in our every day– not even during pregnancy– lives. We live busy lives, so it’s hard to focus on real food. But Real Food for Gestational Diabetes and you guys, she has an online course with the same name so Real Food for Gestational Diabetes Online Course. She is absolutely amazing and has even written two books and now what I learned today is going on the third, so Real Food for Pregnancy and Lily, what is the title of your new book?Lily: The forthcoming book is Real Food for Fertility. Meagan: For fertility. Oh my gosh, you guys. She is evidence-based. It’s amazing and you know here how much we respect evidence-based information and getting this to you guys so you can know the true facts and go on and make decisions that are best for you. So Lily, thank you so much for being here with us today and talking about this topic because like I said, it is one of the most common questions we get in our inbox. Lily: Yeah, absolutely. I’ve spent a lot of work working on gestational diabetes so I’m happy to speak about it with you today. Meagan: Yes. Can you tell us a little bit more about your course? I’m going to start there because you have an online course. I think this is a great thing for anyone who has either had gestational diabetes or has it to really learn more about it. Lily: Yeah, absolutely. The course is really designed for women with gestational diabetes not necessarily healthcare professionals and it kind of expands upon the information that is in the Real Food for Gestational Diabetes book so additional, practical resources that support the same principles that you learned in the course but takes it to another level so there are additional meal plans. There are three weeks worth of meal plans and several different carbohydrate levels so you can customize them. There is more information on lowering your fasting blood sugar naturally with the hopes that we can reduce or minimize your risk for medication or insulin which, depending on where you are and who your provider is can limit your birthing options. Also, I generally disagree with it, that is often a policy. We really often try to use food and lifestyle as much as possible to enhance our ability to keep our blood sugar under control. Probably some of the biggest benefits, though, of the course is that we do have a private Facebook community just for course participants and I do host weekly office hours. People will share what’s going on with their blood sugar. “Hey, I’m struggling with this with my fasting blood sugar. I’ve tried x, y, and z and it still hasn’t worked. Do you have any tips for me?” We have a really active community in there. Once you are a member, you are always a member. We have some moms who are on their third pregnancies and still in the course that can offer feedback but I also answer questions every single week. I’ve been told that arguably the biggest benefit is you can get my eyes on it and get a second opinion. Since I don’t have a whole lot of availability for one-on-one clients, it’s really the main way you can get my feedback on what’s going on. That’s helpful, I think because there really isn’t a one-size-fits-all intervention for gestational diabetes. Obviously, there are some general truths that work food and lifestyle-wise, but individual tinkering is something where you really need individualized attention versus, “Here is this snack that works for every single woman.” There really is no such thing. I wish there was. It would make my life way easier. It would make everybody’s lives easier. It would make the diagnosis less frustrating. But oftentimes, it’s like, “Okay. I need to get my blood sugar under control in two weeks otherwise they’re going to put me on medication.” People really need that kind of information right away at a really important time point in their pregnancy. Meagan: I love that you say that. We have private groups too and I feel like these groups are just money. Lily: Oh yeah. Meagan: Even just seeing things that other people are asking and you’re like, “Oh, actually I have that same question,” then maybe you reply to them and it just filters down. Those groups are so awesome. I love that you have created that and created a space for people because I don’t feel like in the medical world– and this is not to shame the medical world– they just don’t have time to do exactly what you were saying. “Okay, you’ve got this diagnosis. Let’s break it down for you as an individual.” It’s, “Here’s a sheet of paper,” that you can pull off of Google. It doesn’t mean that it applies to you. You have the diagnosis so it could help you but it doesn’t mean that it’s going to be the best thing for you as an individual. Lily: And moreso than that, sometimes you don’t have a provider that is well-informed on the updated research so I get a lot of women in the course who are like, “Okay, I don’t know if I really need this course, but I figured it would be a good idea,” then they jump in and they are like, “I have my meeting with the dietitian this week,” then they come back in the group and they are like, “What the dietitian said that what I’m doing is wrong and that I need to eat this way, so I’m going to try it,” then they come back three days later and they are like, “My blood sugar was terrible. This advice didn’t work. I feel awful. I need to go back to the original.” It’s just the ongoing thread of community members who have been through the same thing. Ultimately, that’s why I do the work that I do and write the books that I do because the standard of care just doesn’t often work or it’s 20 years outdated. Meagan: Oh, I can so relate to that one when it comes to VBAC. It’s the same thing when we’ve got one provider saying this and then another provider is saying this. It’s a very similar situation. You’re like, “Well, what is it? What does the evidence really say?” 9:28 What is Gestational Diabetes? Lily: Right. Meagan: Oh, well okay, so I think I would like to just even start off with what is gestational diabetes. What does that mean? If you get this diagnosis, what does that mean? Lily: Yeah. So at its simplest definition, it is blood sugar that is elevated during pregnancy beyond a certain threshold. The whole diabetes during pregnancy, I think, confuses people a little bit because it is like, “How can I develop diabetes during pregnancy but only during pregnancy?” Really, it’s that your blood sugar is elevated beyond a certain threshold. There are other definitions like insulin resistance during pregnancy or carbohydrate intolerance during pregnancy. They are all speaking to the same thing. Your body has a more limited ability to bring your blood sugar down within the normal range for whatever reason. There can be a number of different reasons. Sometimes there are pre-existing issues before pregnancy that we didn’t know about and during pregnancy, we test for things so there are a whole lot of the population that is walking around essentially with pre-diabetes and has no idea. Then during pregnancy, we screen blood sugar levels to rule out gestational

I don’t know who needs to hear this, but…You do NOT have to be induced at 39 weeks to have a vaginal birth. You CAN have an induced VBAC. Your cervix DOESN’T have to dilate by 40 weeks.Home birth is just as SAFE as hospital birth, even for VBAC.Your pelvis is PERFECT. You are capable of doing MORE than you even know.Tune in to today’s hot episode to hear Meagan and Julie dive deeper into these topics and many, many more!Additional LinksThe ARRIVE Trial and What it Means for VBACHome Birth and VBACBrittany Sharpe McCollum - Pelvic BiodynamicsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello everybody. We are already a month into 2024 and we are ending the month off with a nice, spicy episode. I think it will be a little spicy. Julie is with me today. Hey, Julie. Julie: The bringer of the spice. Meagan: The bringer of the spice. You know, ever since you stopped doing doula work as well, you have picked it up a notch in your spice. Julie: Because I’m tired of watching people get railroaded by the system. Meagan: I know. Julie: I have picked it up a little bit, yeah. Meagan: I know. Julie: You have to deal with the backlash by yourself if there is some backlash. Meagan: Seriously. No, this episode is going to be a good one. Women of Strength, I think that this episode is going to be very empowering. Yes, it is going to be spicy. We are going to have passion because if you haven’t noticed over all of the years of Julie and I recording, we have passion. When it comes to like Julie was saying, people not being railroaded by the system or not taken advantage of and really knowing what information is true and not, we are pretty passionate about it. So today, we have an episode for you that is going to be amazing. It’s titled, “I Don’t Know Who Needs to Hear This, But…” We are going to be telling you all of the amazing things. Review of the WeekWe have a Review of the Week so we are going to get to that and then we are going to kick it up a notch. Julie: Perfect. All right, yeah. I’m really excited about this episode inspired by all of you really, all of us, and everybody in the birth community around the whole entire world. Anyways, this review is from Apple Podcasts and it’s titled “Highly Recommend.” It says, “Thank you, Meagan and Julie, for creating this podcast. It holds space for mothers with so many different birth stories and as we know, representation matters. After an unexpected emergency Cesarean with my first daughter, I found myself seeking stories similar to my own. I literally binged your show. It  helped me process my own trauma and was incredibly healing. I have since become a labor and delivery nurse and I find myself recommending this podcast to my patients regularly.” What? That’s awesome. “I’m happy to say that this podcast gave me the courage and confidence to TOLAC and I had the most empowering and beautiful VBAC in November. Thank you a million.” That is incredible. I love it. Meagan: That is incredible. I love hearing when labor and delivery nurses or providers will hear the podcast and recommend it to their patients and their friends and their family. That makes me so happy. If you are like our reviewer and you would recommend the podcast, if you wouldn’t mind doing us a solid, pause right now but come back because it’s going to be great. Pause right now and leave us a review. Go to wherever you are– Apple Podcasts, Spotify, or if you are just listening on our website which you can at thevbaclink.com. You can even just Google “The VBAC Link” and leave us a review and recommend us there because your recommendations and your reviews are what help other Women of Strength find this and find these amazing stories and find the information like what we’re giving today. Meagan & JulieMeagan: Okay, Julie, I am so excited. I am so excited. This idea is amazing. We were talking about this before. This is kind of like a viral reel. This reel went viral. “I don’t know who needs to hear this…”, but Julie said this. Boom. That is what we are going to do. This is amazing. This episode is going to be so fun. We have actually scrolled The VBAC Link Community which by the way, if you are not in The VBAC Link Community on Facebook, we have a private Facebook group that is very safe and very welcoming to all Women of Strength no matter what type of birth they are wanting, vaginal or Cesarean. You can find us at The VBAC Link Community on Facebook. Answer the questions. You do have to answer the questions to get in because we are very, very strict with that and then we’ll get you in. If for some reason, you have a weird decline because sometimes Facebook is declining them on their own, I do not know why, just message us at thevbaclink.com or on Instagram or wherever and just let us know, “Hey, I’m trying to get in,” because we have definitely been having issues. Julie: Weird. Meagan: I know, right? People are writing us like, “We’ve been trying four times and it’s just declining.” But okay, you guys. Julie, do you want to kick it off? “I Don’t Know Who Needs to Hear This, But…”Julie: Yeah, let’s kick it off. Okay, so I don’t know who needs to hear this, but you do not have to be induced at 39 weeks to have a vaginal birth. Meagan: Correct. You do not. Julie: It makes me so mad. It lights my fire. I have a friend who lives in Maryland. He is a major researcher. He researches everything and every topic– politics, home school versus public school, anything. He can give you a one-hour speech on demand because he is on a top-notch level. His head is in the papers. He is just there. But for some reason, we as a culture don’t like to do that amount of research when it comes to having our babies. Right? Why is that? Anyway, so when his wife had their first pregnancy, it was right after the ARRIVE trial came out, and of course, she got induced at 39 weeks. They’ve had two other kids since then. They got induced at 39 weeks every time. Lucky for them, it was super great. They had pretty uncomplicated, straightforward deliveries and everything was fine, but I wanted to scream at him and say, “Friend! You research the heck out of everything. Why are you guys not looking into this for your own babies and your own children and your family, the most important thing in your life?” It’s always been interesting to me for that. So we know by now that everybody is hungry to induce at 39 weeks. We also know by now– I mean, we knew early on, but the rest of the world is catching up now showing that the results of the ARRIVE trial are incredibly flawed. If you don’t know what the ARRIVE trial is, just Google “The ARRIVE Trial, VBAC” and our article on the ARRIVE trial will pop up, but basically it says that induction at 39 weeks lowers Cesarean rates and other complications for mother and baby but there are so many things wrong with that study. There are so many things wrong with that study. I’m not going to get into it because we have a short amount of time, but go look into it. We know now that there have been several research articles from major universities doing research on giant, enormous population groups showing that it actually increases complications and risks associated with induction and it increases the risks of having a Cesarean for mothers. So, guess what though? I hate how fast the ARRIVE trial took on. Everybody is like, “Woohoo! Induction at 39 weeks, let’s do this,” but guess what? Now that we are showing that it is actually harmful to families, everybody is looking away. It’s going to take 10-20 years for this trend to stop. Meagan: But yet it took overnight for it to start. That’s what is frustrating to me. Julie: Because it is more convenient. It is more money. It is easier to manage. Meagan: I have so many feelings. You guys, we have a blog on the ARRIVE trial. We actually have an updated episode on the updates of the ARRIVE trial as well so if you are wanting to learn more about the ARRIVE trial or if you are being told that you need to be induced at 39 weeks in order to have a baby, go check out Episode 247 because we are going to talk more about that topic. Julie: Yeah, absolutely. There’s lots to go into it, but I just want you to know. We want you to know that it’s okay to go past 39, 40, and 41 weeks and wait for your body to go into spontaneous labor. That is really your best chance of having a vaginal birth. Now, there are reasons and times when a medical need for an induction arises that are true and are actually real. Having an induction doesn’t mean you are going to have a C-section, so if you need to go that route for whatever reason that is medically safe for you and your baby, it is safe to do that. “I Don’t Know Who Needs to Hear This, But…”Meagan: So on that topic, I don’t know who needs to hear this, but induction is okay for a VBAC and it is possible to have a VBAC with an induction. So yes, it’s more ideal to have spontaneous labor and for things to happen on their own and not to be intervened. But, if medically, there is a reason for an induction, it is okay. You do not have to just have a C-section because there is a medical reason to have a baby. You can be induced. “I Don’t Know Who Needs to Hear This, But…”And then sort of on the same topic, but I don’t know who needs to hear this, but your cervix doesn’t have to dilate by 40 weeks. It doesn’t have to. It can dilate after. It doesn’t mean it’s not going to. If you are not dilated or effaced by 40 weeks, it doesn’t mean it won’t, right? Julie: Yep. I hate when people say, “I just left my 37-week check-up and I’m not dilated at all. My provider thinks I needed to schedule a C-section.” I’m like, “Your cervix is doing exactly what it needs to do before it’s time to let the baby out which is stay closed, stay tight, and keep that baby in.” Meagan: Yeah. Yeah. I don’t love that because if a provider is checking at 37 weeks and someone’s not dilated, they’re placing doubt tha