In this episode, Meagan and Julie tackle hot topics like the VBAC calculator, epidurals, and uterine rupture. What does the evidence actually say? And why do providers give such drastically different statistics from one practice to the next? 

When you know the facts, you are equipped to take charge of your VBAC journey!

VBAC Calculator

ACOG: Deciding Between a VBAC and a Repeat Cesarean

VBAC Calculator Online Library

Epidural Side Effects

VBA2C PubMed Article

Evidence Based BirthⓇ: The Evidence on VBAC

Uterine Rupture

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Julie: Welcome, welcome. You are listening to The VBAC Link Podcast, and guess what? We have a special guest for you today, and that is me. It’s Julie Francom. I am here today with Meagan, and I am joining her for a really cool information-packed episode debunking some common misunderstandings about VBAC and showing you what the evidence is and where you can find more evidence-based information about VBAC. 

Without further ado, your host, Meagan. How was that?

Meagan: Oh my gosh. Thanks Julie for the amazing welcome. Oh, so fun. It’s so fun. Yes. I am so excited for this episode because it’s one of the last episodes with you and I. No, it’s not one of the last episodes. It is the last episode of you and I of the year which is so crazy. It is so crazy. 

Julie: This year has flown. Time is wild. Time is wild. 

Meagan: It’s so strange to me, but that’s okay. We will welcome in 2025, and we will say goodbye to 2024. We want to say goodbye to it with, like she said just a really great evidence-based packed episode for you guys.

I feel like all year we have gotten messages like, “I had a C-section. I’m being told I can’t ever have a vaginal birth. Is this true? Is VBAC safe or possible?”

We’ve had, “I’ve had one and two C-sections. I’ve had three C-sections. Is VBAC possible? My provider gave me a 20% chance to VBAC. Is that true? Can I VBAC? Do I really have that low of a chance?”

How about this one? This one was more recent that I’ve heard from our last recording. “You have a 60% chance of uterine rupture if you choose to VBAC.” Ugh. Seriously, so many things that we have heard along the way where it’s just–

Julie: Lies, lies, lies, lies. It’s lies. Let’s just call it what it is. 

Meagan: Aggravating. 

Julie: For the most part, I do not think providers mean to spread lies or misinformation. I do think that there is a lot of information related to birth in general, but especially VBAC about how this is the way we’ve always done it. They are just regurgitating information that they have heard from some unreliable source somewhere and aren’t really taking the time to keep up with the actual facts about VBAC, about birth, and about anything in general. 

Also, our system is not set up for continuing educating all of the providers in all of the things. Our hospital providers, I feel like in some capacity we have to give them some grace because they are incredibly overworked. They work crazy hours. They see lots of things and deal with a lot. The medical system is that way. 

But I also feel like who’s responsibility is it to make sure that you are providing the best care? But how can you when the system is working against not only the parents but also the providers and the nurses and everybody. It’s really hard because it puts the responsibility on you, the parent, in order to really dig and discover what your options are so that you can make the right choices that benefit you because the system is not set up to support you in any other way besides their hospital policies and following their rules, etc. 

So, yeah. I don’t want this to turn into a provider-bashing episode. I don’t think it will either. Sometimes, I think with me talking especially with me being more salty now, it can come across that we are anti-provider or whatever which we are not, but the system is just really frustrating. 

It takes everybody’s efforts to try and change it, everybody’s efforts. Not one part of the system can be passive if we want to change it and we want to influence it for better.

Meagan: I agree so much. Like you said, we don’t want to ever shame the hospital system or providers, but a lot of times, the things we are saying definitely does happen. But it’s because there is a lot of fault. There is a lot of fault in these areas. 

Like you were saying, a lot of these things are lies. The biggest and hardest thing that I found when I was going through my VBAC journey. Julie, I wanted to speak for you and probably say that is the same for you, and that’s why we created The VBAC Link: How to Prep VBAC Course is because we didn’t know what was right and what wasn’t. We just didn’t know, and there were so many avenues on Google that you could go down, and you could actually find truth on both sides sometimes even. 

Julie: And trying to figure out which is true and credible and which is not sometimes is really tricky.

Meagan: It’s really, really tricky. We want to talk more about that today. We recently talked about hospital policies and what that means and how to go about those, but along with hospital policies come a lot of other things that providers do or suggest or say, so we’ve got this random policy that was created over here, then we’ve got all of these random things that are being said over here. We want to know our options. 

We know hospital policies are what they are. If you haven’t listened to the episode, go listen. It’s back in November, last month. Go look for it. But today, we are going to be talking about what is the evidence. What are the facts?

Let’s talk about the VBAC calculator. Let’s just start right there because this is where a lot of providers actually begin to determine someone’s ability or qualifications if they can VBAC. They’ll pull out this list, this calculator, that is online. You can actually get it online. If you want to play around with it, I’ll try and make sure to put the link in our show notes because I actually find it very interesting to play around with. We used to do that when we would do in-person courses. We would have everyone pull out their phones, type in the calculator, and type in different scenarios. It was pretty mind-blowing to see how much it could change based off of the answer that you give this computer. 

You want a VBAC. You have determined that a VBAC is something you want to explore. You want to learn what you can do to have a VBAC. You go to your provider and you go, “Hey, I’ve had a C-section. I don’t want that experience this time. I want a different experience. I would like to have a VBAC,” or what they would call a TOLAC, a trial of labor after a Cesarean. And they’re like, “Great. That’s wonderful.” Then they’re like, “Let’s talk about it.” 

They pull up their calculator and they ask you questions like what, Julie?

Julie: They ask you questions like, hold on. I was just digging into the history of the VBAC calculator a little bit more because I was curious about it. They ask you what was the reason for your previous Cesarean? How much do you weigh? It used to ask what your ethnicity was then they docked you if you were black or Hispanic. 

It also asks, let’s see. 

Meagan: It asks if there was an arrest of descent. 

Arrest of descent is if you needed a Cesarean because your baby didn’t come down. It asks about your history as in have you had a vaginal birth before? Have you had a VBAC? What was the reason for your previous Cesarean? 

It even asks if you’ve been treated for hypertension. Interesting. 

Julie: Interesting. 

Meagan: Yeah. So height, weight–

Julie: Oh, because the chronic hypertension requiring treatment is what replaced the race. When they replaced the race questio