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    Kids & Family

    The VBAC Link

    Here at The VBAC Link, our mission is to make birth after cesarean better by providing education, support, and a community of like-minded people. Welcome to our circle, we are so glad you are here!

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    Latest Episodes:
    Episode 314 Amanda's Joyful VBAC + Building a Team with The VBAC Link's Resources Jul 03, 2024
    Show notes

    “It was just such a redemptive, wonderful experience. I am so grateful to The VBAC Link for seeing me through it, for giving me the information, and just the inspiration to even take this on because if I had never found you, I don’t know for sure if I ever would have gone through with it. So, thank you so much for that.”Amanda’s episode will warm your heart, give you chills, and bring tears to your eyes. Her birth stories include a rough induction at 36 weeks due to preeclampsia with an 11-day NICU stay and not getting to hold her baby for 32 hours. When she found The VBAC Link, Amanda was given hope that she could have another baby and that her experience could be very different. Equipped with information and drive, she was able to do just that. Amanda’s VBAC birth was spiritual and powerful!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Episode Topics:Review of the WeekAmanda’s storiesMonitoring for preeclampsiaCervadil, Magnesium, and CytotecConsenting to a CesareanThrowing up during the C-sectionWaiting 32 hours to hold her babyFinding The VBAC LinkPraying for a babyScared or scarredSigns of wavering provider supportPhysical and mental preparationContractions beginAdvocating during laborThe night nurse“It is done.” Importance of lactation supportMeagan: Hello, everybody. How are you doing? I hope you are doing great. Right now, I can just tell you that my face is already hurting from smiling just from talking to our guest for 5 seconds. We have our friend, Amanda. Hello, Amanda. Amanda: Hello. Meagan: Oh my goodness. She has just been the sweetest thing just pouring on the sugar and sweetening me up. I mean really, she is saying just the nicest things about The VBAC Link and it has just been so fun to hear how The VBAC Link was part of her life. You guys, I love this so much. Thank you for supporting this podcast. Thank you for supporting us on Instagram and Facebook and all of the places. I truly from the bottom of my heart love you. I know I haven’t always met you but I love you and I love this community and I love what we are doing here. I am so grateful for the opportunity. I just wanted to say that it really wouldn’t happen without all of you so really from the bottom of my heart, thank you. Review of the WeekMeagan: We do have a Review of the Week so I want to jump into that and then we are going to get into Amanda’s stories and maybe even some other things. We will see what this episode transpires to. Okay, so this is from Liz Judd and it doesn’t say where it was from, but it says, “Empowering”. It says, “I found this podcast around week 30 of my second pregnancy by searching for ‘VBAC’. I had a traumatic C-section in 2019 and I knew I did not want to go through that again. It was helpful for me to learn the evidence on VBAC, how to advocate for myself, and healing to listen to other’s stories. I just had my second child by VBAC and I thank you for the role you played in that.” Seriously, it warms my heart and you just said the same thing. You carried me through my whole pregnancy, and then this was back when Julie and I took a big 10-month break and you were like, “Oh no, they’re gone!” But here we are. We are back and I hope that we are carrying someone else or many other people through their pregnancy journeys as well. Amanda: I’m sure that you are and that review could not have related more to my story so I can’t wait to get started for you. Amanda’s storiesMeagan: Okay, well without further ado, let’s do it. Let’s get started.Amanda: Here we go. My husband I met in 2004 which yes, was 20 years ago. We got married in 2009 and we were just living our best lives. We were traveling, doing all of the things. I had lost 129 pounds and I said, “I want to run a marathon and have a baby.” Meagan: Dang, yeah. Amanda: I was even a group exercise instructor at the time. Life was good. I ran the Marine Corps Marathon in 2015 in October and in 2015 December, I got pregnant. What was really special about that was we got engaged on Christmas Eve so on the 10th anniversary of our engagement, I got to share the news with my husband that we were expecting. Meagan: Yay! That’s so awesome. Amanda: It was really special but other than that, I really had no knowledge at all about pregnancy and birth. I just knew that I wanted an unmedicated birth. Where I came up with that, I’m not sure, but I just was going to trust my doctor. That’s where my brain was at. I went to my normal OB who I had always gone to and it was a very small practice. There were three doctors and a nurse practitioner and up until this point, I had always seen the nurse practitioner. She confirmed my pregnancy and she advised that I limit my exercise from what I was currently doing and to only maybe just walk and do some light cycling. Meagan: Oh my gosh. My OB said the same thing. I was wanting to run a half marathon and he was like, “Oh no, you’re having too much round ligament pain. Just go for a walk.” I was like, “What? Okay,” so I stopped working out. Amanda: Right. That’s exactly what happened to me. Now I know that was the first red flag of this practice, but I didn’t know at the time. I was just like, Okay. Listen to what the doctor says. So I just kept going to my appointments and I generally felt okay but at my appointment check-ins, my blood pressure started to be high. They would put me into the room and I would lay down on my left side and they would have me do the whole appointment that way and then they would check my blood pressure at the end and it would be okay so they would have me come back in a couple of days for a re-check and it would be okay. We just continued on that way until I circled through all of the doctors and back to the nurse practitioner. She was really the only one who seemed a little more concerned than everybody else about what was going on. Monitoring for preeclampsiaAmanda: I got back to her and she sent me to the hospital for a blood pressure monitor. It wasn’t super high so they sent me home, but they told me to do a 24-hour urine collection. I did that and my protein in that came back at 299 and she said, “Well, 300 is preeclampsia so we are just going to keep monitoring it.” Meagan: Mhmm, okay. Amanda: Okay. That’s exactly what I said. Meanwhile, I’m not exercising. I’m just taking my prenatal and going to these appointments. I didn’t have any preeclampsia symptoms either. I had no headaches, no spots, no swelling. I just felt yucky. I just chalked it up to pregnancy. I thought, Okay, I’m pregnant. This is what I should feel like. Meanwhile, people around me are pregnant and they are like, “I feel fabulous. I love this.” I was like, I don’t love this. This is not great. I’m excited to have a baby but I don’t love it. I also got carpal tunnel. Meagan: That is a thing by the way during pregnancy that people don’t talk about. Amanda: They don’t and I didn’t know about it. My doctors were just like, “It’ll go away when the baby is born. It will go away when the baby is born.” I’m like, “But I’m really in pain. My poor husband has to cut my food. I can’t function here.” Finally, one of the doctors said, “Well, if it hurts that badly then you can go to a hand and wrist doctor.” Okay, so I did and I ended up getting a cortisone shot because it was unmanageable. I had the braces. I was doing night braces and day braces so that did help a lot. A high blood pressure and getting admitted to the hospitalAmanda: In the meantime though, we moved from an apartment to a house. I was the matron of honor in a wedding and then we moved into our house on July 17th. I had a surprise baby shower on August 6th and August 8th which was my 36th week, I had a non-stress test at the hospital. I went into the hospital for the non-stress test. They took my blood pressure. The nurse didn’t say anything. She was like, “I’m just going to take it when it’s over,” which is something I had heard the entire time. I do the non-stress test. She takes my blood pressure again. She says, “You know, the doctor wants to talk to you.” I was like, “Okay. That’s fine.” I go into this little room and the doctor starts saying things like, “Not going home” and “Going into triage” and “Keep you pregnant as long as possible”, so I was like, What? I just couldn’t even process those things. Meagan: And there wasn’t any extra talk of, this is why. Amanda: No. Meagan: Yeah, okay. Amanda: No. I called my husband. I was like, “Listen, you might want to come be with me because I’m not sure what’s going on.” So I go over to triage which was right around the corner and I’m waiting in that waiting room for over an hour. I’m still not thinking there is any type of emergency. They take me into triage and they take my blood pressure which was 214/111. Meagan: Okay. Amanda: Yeah. Meagan: Okay, well that’s high. Amanda: Yeah, so then everyone starts going a little bit crazy. They start giving me medicine. They have me only lay down. I’m not allowed to get out of the bed and they start talking. I start hearing words like, “Possible seizure” and I’m like, “What is happening here?” A nurse finally comes over and says, “We are going to admit you. We just don’t know yet if it’s to labor and delivery or high-risk OB.” I looked at my husband. I was like, “Are we having a baby right now? Are we having a baby?” Then at that point though, that’s when all of the things started happening to me and I was not a part of any of these decisions. Cervadil, Magnesium, and CytotecAmanda: I realize that that was a very high blood pressure and I didn’t really check it after that, but they do take me up to labor and delivery where the doctor starts with Cervadil. This is on a Monday night. She inserts the Cervadil but I had zero dilation. They also put me on magnesium and when they did the magnesium, they also wanted to give me a catheter because they didn’t want me to move. I said, “I don’t really want that.” At this point, I still felt fine and nobody was really explaining to me–Meagan: The severity of things and what was really happening, yeah. Amanda: Right, right, right. So then they were giving me the saline. It was just so much fluid so I had to use the bathroom a lot. They were just letting me use the bedpan and teh nurses were so irritated by me. They would just stand there and watch me. I just felt horrible. It just was a very uncomfortable experience. Then there was the magnesium which–Meagan: Bleh. Thumbs down. Amanda: Yes. It was awful. I just felt terrible. They also gave me a shot for lung development because I was only 36 weeks. Yeah. My water broke on its own but that is the only part of labor that I experienced at all with him. After my water broke, they gave me a dose of Cytotec, and literally nothing happened. Not one thing. My blood pressure was still unstable. The magnesium made me feel awful and then I felt decreased movements. I just kept telling the nurses, “I can’t feel the baby moving. I can’t feel the baby moving.” I was scared. At one point, we knew nothing was happening. My husband and I actually called the doctor and said, “Should we have a C-section? Is this what is going to be happening?” They said, “No. Let’s just see how this plays out.”Looking back, I’m shocked that that was the answer they gave me because of everything else that was going on. They just kept doing cervical checks and they were very uncomfortable because I had zero dilation and I didn’t know I could say no. In fact, one doctor came in. This was actually the doctor who ended up delivering him. She said, “Do you want an epidural?” I said, “No. I don’t even have any pain.” She said, “Well then, you need to let me check you.” Meagan: Wait, because you didn’t want an epidural then you had to let her– what?Amanda: Right. I think she was saying this because I was acting like it was uncomfortable. I mean, it was uncomfortable. I wasn’t acting. Then they gave me another dose of Cytotec. Nothing is happening. Now this is late Tuesday night. My blood pressure is all over the place. They keep giving me different doses of medication. I was on fire from the magnesium. I just kept saying, “This room is so hot.” They said, “But it’s the coldest room in the wing.” “I don’t care. I’m burning up.” Meagan: You’re like, “My skin feels like it’s on fire.” Amanda: So they gave me a fan. That was their accommodation for that. Consenting to a CesareanAmanda: It was around 12:45 so now this is Wednesday morning at 12:45 AM. The doctor comes in and she is just sitting on the end of my bed. I was in and out of awareness. I remember having her be there, but the magnesium is terrible. They just kept taking my blood pressure and she just kept giving me medication. All of a sudden, she stands up and she says, “We need to do a C-section right now.” I still don’t know to this day if it was a decel. I don’t know if it was his heart. I don’t know if it was my blood pressure. I don’t know what happened that made her stand up, but I just remember watching that happen and the look on her face. They were laying me down. They were giving my husband scrubs. I’m signing all kinds of consent forms laying down and then they gave me this awful drink for nausea and wheeled me into the OR. Because I had the magnesium, they were lifting me. I wasn’t allowed to do anything by myself and I forgot to mention that since I wasn’t exercising or doing anything, I gained 90 pounds during this pregnancy which was terrible but I didn’t know. I wasn’t small and they were moving me around. I get a spinal. As soon as I got the spinal, I said, “Oh my goodness. I’m going to be sick.” I just felt so nauseous and I remember the anesthesiologist behind me saying, “It’s okay. We’re ready,” and other people saying, “Lay her down. Lay her down.” They immediately lay me down and then I vomit into the bucket. Meagan: Oh yeah, that’s the most miserable feeling. Amanda: It was terrible. He was ready. He did have a bucket. He wasn’t lying, but then they squirted something on my stomach and I just remember saying, “I can feel that. I can feel that.” The doctor says, “Yeah, but is it cold?” I said, “No.” She says, “Starting incision.” She just is going. Throwing up during the C-sectionAmanda: Literally every time they pushed on my stomach, I was throwing up. Every single push and shove they did, it was awful. It was awful. But at 1:38 AM, our first son was born and there was one squeaky little cry and then he stopped and the NICU team got to work on him. They were about to take him up to the NICU and God bless my husband. He stops in front of the door and says, “Can she at least give him a kiss first?” They brought him over really quickly. I got a kiss and then they took him away. All was quiet. I was still nauseous and I just remember the anesthesiologist saying, “They’re just putting you back together. Why don’t you try to take a nap?” I was like, “Um–”Meagan: Okay. Amanda: Right. Needless to say, the bedside manner all the way through was not great. Meagan: Not great, no.Amanda: But once I got into recovery, I was just holding onto the fact that they said I could see my baby in 24 hours. I was like, Okay. I just have to make it 24 hours and they will take me to see him. I set an alarm on my phone. I am pumping. They gave me the pump. I am pumping. Any colostrum I am getting, I am sending up to the NICU. My blood pressure is still not settling down. Waiting 32 hours to hold her babyAmanda: 24 hours goes by. I call the nurse. I’m like, “It’s 24 hours. Take me up to see my baby. Please take me up to see my baby.” She’s like, “Well first, we have to take your blood pressure.” It was not good. She was like, “Wait 2 more hours and then we will check.” I was like, “I just waited 24 hours and now I have to wait 2 more.” They take my blood pressure again and it was fine. I was like, “Yes. I’m going to go see my baby.” They were like, “Well actually, you have to walk and go sit in this chair first and…

    Full show notes at the publisher

    Episode 313 Happy Birthday to Meagan’s VBA2C Babe + Walking Down Memory Lane with her Husband, Ric Jul 01, 2024
    Show notes

    “Trust your partner. Trust the mom. They know things better than you do.”Meagan’s husband, Ric, joins the podcast today as they celebrate their VBA2C baby’s 8th birthday! Ric gives the perspective from the partner’s side of things as they both share details of Webster’s birth story. He talks about some not-so-proud moments and is the first to admit how little he knew about how to support a VBA2C labor– especially one that went over 40 hours! But through it all, Ric came to understand the importance of doulas and how magical it can be to have not one but five doulas! He agrees that the births of each of their children ultimately was a special journey and brought the two of them closer together. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:17 Review of the Week04:10 Deciding to birth out of the hospital06:35 Agreeing on a birth center10:57 PROM for the third time15:05 Laboring loudly20:23 Relying on the doulas28:33 Navigating doubt and transition on the toilet34:25 Pushing Webb out in three pushes37:08 Passing out after birth40:37 It takes a village42:45 Ric’s advice to other dadsMeagan: Today is my VBAC baby’s birthday. I cannot believe that it has been 8 years since that little boy joined our family and today I wanted to share or reshare his story. I know I’ve done it in the past, but I invited my husband, Ric, to share the story again for you and maybe I might just give him a couple of questions and see how he felt about it from his perspective. When we were going through pregnancy and preparing for me, it was just like, This is what I want to do. This is what I want to do. I would always go and say, “Hey, these are my thoughts”, and to be honest, I don’t know if I even gave him a ton of opportunity to share his exact thoughts because I was so driven and just wanted to get this.We are going to dive more into his thoughts and his perspective on the birth because we know so many dads out there are also a little hesitant when it comes to the idea of VBAC because the world as we know it talks about VBAC in a very poor manner and it can be a very scary thought. So we will be diving into that today in just one moment.01:17 Review of the WeekMeagan: We have a Review of the Week so I wanted to get to that before we get into Webster’s birth story. This is from Katiewarren11. It says, “I wish I would have found this sooner.” It says, “I love the show. I wish I would have heard these before my last baby. I was planning for a VBAC 7 years after my first baby and just thought it would happen. I didn’t realize I might have to fight for it.” That just gave me the chills. It says, “I got to the week of my due date and my body didn’t seem at all ready. Then they were estimating her to be 9 pounds, 12 ounces, and the doctor told me, ‘No option. You are getting a C-section.’ After listening to these stories, I now know that there were other options.”Thank you, Katiewarren11, for sharing your review. I want you to know that you are not alone. There are so many of us who get to the point at the end of our due date. We are being told that our babies are too big or our bodies aren’t working because they are not dilated yet or whatever it may be. There are lots of scenarios that people are told, but there are options. You have options and that is definitely what this podcast is about is helping you learn and grow and know your options. So thank you, Kate, again, and as always, if you have one moment, we would love to hear your review of the show. It really does help the show grow. It helps other Women of Strength find these stories and help them know their options as well. You can do that on Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there or if you would like, you can email us a review and let us know what your thoughts are. We always throw those into our spreadsheet as well. Thank you so much. 04:10 Deciding to birth out of the hospitalMeagan: Okay, you guys. As I mentioned, I have my husband, Ric. Hey, hon. Ric: Hello, everyone. Meagan: I’m sure he is just so excited that he is here. But really, I wanted to go through the experience from your perspective on VBAC and not only just the birth but also before and us deciding to birth out of the hospital. I was already kind of a crazy pants when we were trying to conceive because we really wanted a boy so I was really dialed into that. Then once we found out we were pregnant, I really, really just wanted to find someone to help me through the journey of VBAC. I interviewed many, many, many providers in fact, even before I was pregnant. We know on the show, I have talked about it, that it is really important to interview and look for providers before you are pregnant if you can but I ended up finding a provider actually just right after I found out I was pregnant or right before I found out I was pregnant. We went in and it seemed like a really great fit. Ric, you seemed like you were pretty on board with the provider shift at that point. ric: Yeah, I mean those who know Meagan know that when she is passionate about something, it is very unlikely that she will be turned away. Meagan: Convinced otherwise. Ric: Convinced otherwise so I just kind of went with the flow. But yeah, the provider seemed great. You seemed happy which was most important. Meagan: Yeah. And just kind of a quick little back summary, how did you feel about the C-sections? Did they bug you at all? Did they affect you at all? Did they just seem normal?Ric: Yeah, I mean, I didn’t know anything other than the C-sections so it was normal. It was just that you were very unhappy with them which was hard for me. It was hard because I was stoked that we had the babies and you were upset with yourself, with the provider, and I didn’t share those feelings because I didn’t know. Meagan: Yeah, It was hard because like you said, we were so happy that we had our baby but I was in this cloud of doom and just and unsettled cloud. Ric: Dissatisfied. Meagan: Yeah, I was dissatisfied. 06:35 Agreeing on a birth centerMeagan: Okay, so we found this provider and everything is going really great. This provider at the time was the VBAC provider in Utah. Everybody went to him and he was amazing. He flat-out said after reviewing my op-reports that my pelvis was too small and my baby would probably never come out of my pelvis and that my body didn’t know how to dilate, he really agreed that I probably just wasn’t given a fair chance and he didn’t understand why we wouldn’t be able to go forward.But at 24 weeks, I attended a birth just before that with a midwife out of the hospital that blew me away. I immediately knew that I wanted to go talk to her which was kind of interesting because we never really discussed birthing outside of the hospital, but I went and met with her and I told you, “Hey, I want to birth out of the hospital.” Now, you knew nothing but C-sections. You were okay with me finding a provider, but how did you feel about the idea of birthing outside of the hospital?Ric: I don’t think I was that excited about it. I was okay switching providers, but not being in the hospital was worrisome. I actually think, didn’t you broach the subject on birthing from home? Meagan: I think I did. Ric: I immediately put the kibosh on that. Meagan: You were like, “No.” Ric: So I think when you initially discussed birthing outside of a hospital, you gave a couple of options of a birth center or a birth from home so I completely– that was too big of a jump for me from hospital to home so we went and did we go to multiple birth centers or just one? Meagan: We just went to one and we interviewed with a different provider than the one I met, but it was at the same birth center that the provider I met would have birthed at so we met with another midwife at the birth center. Ric: Right. It was awesome. Meagan: It was awesome.Ric: No, the midwife was cool too. She was great. Meagan: Yeah, she was really awesome. Yeah. So as we were there, did you feel like, Oh, okay. Once you saw it, did you feel more comfortable? Ric: Yeah, because it seemed more medical. I don’t know the word for it, but it just seemed like, Oh, hey. Things looked sterile which was a big deal for me and it just made it seem like, Yeah, it’s not the hospital, but– can I swear on the podcast? Meagan: Yeah, sure. Ric: –if shit hit the fan, then we were in a better circumstance than trying to find gauze and stuff at our home. Meagan: At our home, yeah. Which for those who are birthing at home, typically your midwives would bring all of that to the birth but we didn’t even get there for me to explain that. Ric: I don’t need to know if I would have even let you. Meagan: Get to that point? Ric: Yeah. Meagan: Okay, so then fast forward. Labor begins. Actually, we hired a doula. Ric: A doula? Meagan: Multiple doulas.Ric: You had these two mentors in the doula community here and you said, “I definitely want to hire them,” so we did. Those two mentors were in a group of three. Not only that, your really good buddy who became a doula at about the same time and had gone through the doula course with you wanted to attend, and then your cousin who is about as much of a doula as you can be without being a doula– Meagan: Seriously, yeah. Ric: Also had to attend the birth. Plus the midwife–Meagan: And the assistant. Ric: And the assistant. There were a lot of people in the room. Meagan: There were a lot of people in the room.Ric: Initially when you said, “Hey, look. We are going to hire a doula,” because you were doing the stuff, I was totally on board. I had no idea how many doulas would actually show up. Meagan: Yeah. Ric: But they did and it was fine. Meagan: It was great. And rewinding back, remember back with Lyla when I asked you if we could hire a doula or bridge that, you weren’t super keen on that idea. Ric: I don’t remember that conversation.Meagan: You don’t. Ric: But I remember our nurse being a doula. Meagan: Yes. Ric: And she was awesome. Meagan: She was fantastic. Ric: And that solidified your desire to be a doula. Yeah. Meagan: Absolutely. 10:57 PROM for the third timeMeagan: Okay, so with all three of our kids, I for some reason have PROM. If you don’t know what PROM means, that’s the premature rupture of membranes. My water broke with each kiddo and my body took its sweet old time to kick into labor. They say only 10% of women will experience that, but we are 3 for 3. Ric: Do they know the story about where I was when your water broke with Lyla? Meagan: No, I don’t know. That was another reason why I wish we had a doula. So going back to Lyla’s birth, my second C-section–Ric: Kind of just showing the progress of where Meagan began as a, “Hey, look. I trust my doctors. I’m going to do everything that they say on the first birth.” The second birth opened my eyes as to how Meagan was going to control the situation as much as she possibly could. So yeah, tell them where I was when your water broke. Meagan: So you were in Texas when my water broke with Lyla. As he mentioned, my cousin is pretty much a doula without the doula training and she just is so loving and caring. She was really excited because we wanted this VBAC. I wanted this VBAC really, really badly. So yeah. Ric was out of town and my water broke. I was like, “Uh, you should probably come home.” Nothing was really happening at all really. I was just leaking. Yeah. You got home probably 6-7 hours later. Ric: No, it was about 10. Meagan: Was it about 10? Ric: Yes and I assumed you were going to go to the hospital. Meagan: Yeah, you were not happy when I was not at the hospital when you got home. Ric: I walked in and you were sitting there naked in the bathtub and I’m like, “What in the world are you doing? You are supposed to be in the hospital. Your water broke.” Because for me, your water breaks, you go to the hospital. For Meagan, that’s not necessarily the case. Meagan: Well, yeah. I think going back to what you were saying, a lot of providers actually say, “If your water breaks, come right in,” even if labor is not going on. Through my research with Lyla and the VBAC, I realized that I didn’t necessarily need to just run right into the hospital. I checked my vitals. All was well. Everything was good, so we stayed and labored at home. Plus, I was waiting for you to get in town. Ric: Yeah, but it kind of prepped me for what the next birth was going to look like. Obviously, that birth ended up in another C-section and you were really disappointed after that one. You worked really, really hard. Meagan: I was, yeah. Ric: Then with the next one, when you were going through options of birth centers, doulas, and midwives, that instance where I flew home in an emergency fashion as quickly as I could and came home to find you in the bathtub realizing, Meagan is going to do what Meagan wants to do. Meagan: Yeah, so when I told you, “Hey, let’s birth out of the hospital”, did you feel like, She is going to do whatever she wants to do anyway? Or were you more comfortable with the birth centers? Were you okay with that? Ric: Yeah. It’s hard to tell you no, but when we went to the birth center, I did feel significantly better about having a birth there. Meagan: Yeah. What had you heard about or had you heard anything about VBAC just in general? Ric: Nothing. Meagan: So you didn’t really hear a ton. Ric: Other than what I heard from you. Meagan: So you didn’t hear anything scary. Ric: No. Meagan: Okay, because a lot of dads out there do hear when they say, “Oh, my wife wants to VBAC,” people are like, “Oh my gosh. It’s so scary.” I think that can be really hard especially if their partner is saying, “Hey. I want to birth out of hospital.”15:05 Laboring loudlyMeagan: Okay, so my water broke with Webb at 3:00 AM or something like that. Yeah, what do you remember about that? My water broke in the middle of the night. I don’t even think I told you until I woke up. Do you remember anything about that?Ric: With Web, that was where you labored forever, right?Meagan: Yeah, 42 hours. Ric: I don’t remember that first morning. I remember the next night. Meagan: Yeah. Ric: Didn’t Hillary– Hillary is her cousin, everyone. Hillary showed up at 6:00 in the morning and you guys went out and walked around the neighborhood. Meagan: Yeah, so the night–Ric: The first night?Meagan: No, that was the second morning, yes. My water broke and again, I had PROM so I was so frustrated. I was 40 weeks and 3 days or 4 days. I had him at 40 weeks and 5 days. We had a visit with Danielle and my water had broken. I was sort of contracting a little bit here and there. I asked if you would come up to Park City with me. We went up to Park City and I went in and I did my regular visit and then she said, “You’re going to Christine.” Christine, at the time, was my chiropractor so we went to the chiropractor. You got me a Jamba and we drove back down the mountain and came home. My body just really wasn’t going into labor. It was taking its time so I went and I took a nap which is really hard to do when you are in labor because your mind is so excited and you just want to have a baby, but I needed to nap so I went in and I napped. It’s weird. I can even picture exactly how our room was set up that day. I took a snooze and woke up and I was sort of starting to contract. I actually went out into the driveway and threw a tantrum. Do you remember me throwing a tantrum in the driveway?Ric: No. Was I working? Was I at home?Meagan: You were at home. I threw a tantrum that my water broke. I was triggered. I was like, “This is going to be the same. I’m going to have another C-section.” I was just so upset. I remember our next-door neighbor had this big pine tree and they were watching me throw this insane tantrum in our driveway. But yeah, so then that night, that’s when you said you started remembering. My cousin came over for a little bit and actually, my doula came over and was d…

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    Episode 312 VBAC Basics with Meagan & Julie Jun 26, 2024
    Show notes

    This episode goes back to the basics and is a great place to start on your VBAC journey! Julie joins Meagan today as they talk about many common questions beginning with reasons why providers tell women they can’t go for a VBAC. Topics today include: Nuchal cordsBig babiesSmall pelvisesArrest of descentThird-trimester ultrasounds Cervical dilationInductionDue datesThe ARRIVE TrialWhy there is so much contradicting VBAC infoPregnancy intervals EpiduralsMeagan and Julie also reflect on how their perspective toward each of these topics have changed over the years. Allowing for nuance is so necessary when approaching birth. Know that you always have options and never feel pressured to make a decision that doesn’t feel right for you.The VBAC Link Blog: Pregnancy IntervalsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:24 Review of the Week07:48 Intro to the basics09:53 Nuchal cords13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds17:08 How will this change my care?18:47 Cervical dilation25:54 Due dates28:18 Vulnerability and the ARRIVE trial30:44 Inducing a VBAC36:15 Julie’s social media story38:29 Contradicting information41:36 Pregnancy intervals46:38 Epidurals54:13 Allowing for nuanceMeagan: What’s up, everybody? This is Meagan. We have Ms. Julie with us today and we are going to be talking to you about what we need you to know about VBAC. We obviously like to talk about different topics but Julie and I decided this morning as we were getting ready to record that we need to do an episode on just the basics again. Don’t you feel like it’s the basics? It’s not to shame anyone for not knowing the information. It’s honestly to– I don’t even want to say the word shame– but providers are not educating their patients. They are just not. We see it time and time and time again where people just don’t know. We saw a post, I don’t know, maybe a month or so ago. I think maybe Julie sent it to me. It was just saying, “Hey, so can you have a VBAC no matter what reason the C-section was for?” Someone said, “Well, it depends because if it’s something like a cord wrapped around the baby’s neck, if that was the reason you had your previous C-section and if your last baby had its cord wrapped around their neck and was having struggle, yes. You have you have a C-section.” Julie: I am getting a little salty. I feel like maybe salty is not the right word, but direct. I jumped in and I’m like, “That’s actually not true. The cord wrapped around a baby’s neck preventing them from descending is a perfect VBAC candidate because it’s not anything to do with the pelvis or labor stalling or anything like that.” Anyways. Meagan: Even with that said, even with that said– Julie: People still argued with me. Meagan: Well, but even if it was due to someone being told that their pelvis was too small or their baby didn’t descend– Julie: That’s also false. Meagan: That’s also false. Julie: I mean with actual pelvis trauma where it’s actual CPD and is legitimately diagnosed and that type of thing. Honestly, most people are good candidates for VBAC but we are going to talk about that. Meagan: Yeah, we’re going to talk about that today because it’s obviously something that we are really passionate about and it’s something that we want you guys to know so let’s talk about it. 04:24 Review of the WeekMeagan: We do have a Review of the Week. You guys, it’s a really long one and I might have specifically been waiting for Julie to come on with me so she can read it because she’s a lot better at reading long reviews sometimes. I’m just going to pass the time over to Julie to read this amazing review. Julie: Now I feel pressure, man. Meagan: Don’t mess up. Julie: The pressure’s on. Are you ready for this? This review says, “This is such a tremendous resource for VBAC mamas.” See? There I go. I knew it. I’m going to start BBAC mamas. Try and translate that, Paige. Anyway, okay. It’s fine. I’m going to circle back around. “This is such a tremendous resource for VBAC mamas. I sadly only discovered your podcast after my VBAC in April 2022 but having caught the birth bug during my prep for that birth, I still listened to each episode as if I’m preparing for my VBAC all over again. I think having a special place for this very unique scenario helps those planning and hoping for a successful VBAC feel less alone, more supported, and very well-informed. “The balance of evidence-based information with the age-old practice of sharing birth stories makes this one of the best birth resources out there. I only wish I had this when I was planning my VBAC but maybe someday I’ll get to share my own story and help inspire a fellow Woman of Strength. “Prepping for and achieving the unmedicated birth of my daughter absolutely flipped a switch in me and I feel determined to become a birth worker one day.” I feel like all of us go through that, right? “Knowing that this podcast team also has a course for prospective doulas like me thrills me to my core. I want to be there for other anxious, hopeful VBAC mamas like me and the amazing work that you are doing is changing birth and lives everywhere. Keep it up. It is so needed and appreciated. Adrianne.” I love that so much. I feel like that’s all of us like you and me. We all go through this journey like, Hey, I had a really bad birth experience or I had a really bad one and then an empowering one and I want to be part of this change so that other people don’t have to suffer like I did. I love that and I feel like almost all birth workers’ stories start like that. I know mine did and yours too, Meagan. We all are there at some point. Meagan: We are. Yeah. I couldn’t agree more. I definitely have been there. 07:48 Intro to the basicsMeagan: Okay, all right. Let’s talk about the basics. What basic do you want to talk about first? We were talking about just a second ago where we were like, Hey, this was being told to you and you are being told you may not get to have a VBAC. So maybe we just start with reasons people are told that they have to have a C-section and they can’t have a VBAC. Julie: My gosh. I want to speak to a couple of different points in that direction. I have a couple of different ideas in my head. First of all, I feel like it’s important to acknowledge that we are all ignorant to things at some point. Right? We all have to learn that VBAC is an option at some point or maybe we always knew. For me, I feel like I never was like, Oh, I can have a vaginal birth? I just always thought I could have one, but I also feel like the age-old “once a C-section, always a C-section” thing is so ingrained in some parts of our culture that you really do have to have that awakening that, Oh, I can do this. It is safe.So I just want to acknowledge that. Sometimes, even for me, I’m scrolling through Facebook and I see this post about something or the ARRIVE trial with induction at 39 weeks is safer and it’s really easy to eye roll or it’s really easy to be like, Oh my gosh, how come you don’t know this? But I feel like let’s circle back when I see these things and remember that we all start somewhere. Not all of us have access to supportive providers, supportive hospital systems, supportive families, supportive providers. We don’t all have access to those things. If you’re advanced in your VBAC thoughts or thinking or whatever, I encourage you to still stay on the episode because you never know when you’re going to learn something new. You never know when something is going to click right for you and you never know when you’re going to gain the perspective that you need. If you are a seasoned VBAC pro, please also stick along with us. 09:53 Nuchal cordsJulie: I feel like I hear a new reason why someone is told they can’t have a vaginal birth every day. Not every day, that’s a little dramatic. Meagan: But a lot. Julie: It still surprises me. I’ve been a doula in the birth scene for 9 years now and I still get that cord prolapse one. I have never heard that as a reason why someone would have a repeat C-section. I mean, I had a VBAC client. She was trying for a VBAC at home and it ended up in a hospital transfer. The baby’s cord was wrapped around her neck four times. They had to cut the cord in four places to get the baby out via C-section. Meagan: I remember you saying that. Julie: Yeah, that baby was stuck so tightly in there. In those circumstances, that C-section was necessary. That baby was not coming out, but that doesn’t mean she can’t try for another VBAC. I think she is done having kids, but that is completely circumstantial and specific to that pregnancy. So I feel like that’s a really important thing to note is that most things are circumstantial. Even stalled labor or arrest of dilation or failure to progress or a big baby or whatever these things are circumstantial. The cord around the neck preventing baby from coming down– totally circumstantial. I feel like even the American Pregnancy Association– did I say that right?-- says that 90% of women who have had C-sections are good candidates for VBAC. I think that’s important to note is that if you’re being told that you are not a good candidate for a VBAC, I would really question why because most of the time, you are a good candidate. Big baby, sure. That’s one. We can throw these around. People say, “Oh, your baby is too big. You have to have a C-section.” That is not evidence-based. Even ACOG says that big babies are not a reason for either induction or automatic C-sections. Meagan: Suspected big babies. julie; Right, suspected big babies. Meagan: Let’s just say that they’re not always big. Julie: They are not always big and we know this is something we automatically know like, everybody knows this but not everybody does. Your ultrasound measurements can be off by 1-2 pounds in either direction. They can measure small or big. The only accurate way to determine how big your baby is is to weigh it after it is born. Meagan: To birth your baby. Right, to birth your baby. Julie: Not only that, but big babies come through petite pelvises all the time. Babies’ heads mold and squish through pelvises that flex and open and move to work together. The baby and the pelvis are this really cool diad where they have this great relationship of working together and the pelvis opens and the baby’s head smooshes together. Anyway, I feel like that’s probably the biggest thing that I’m hearing lately, “My baby’s too big and my provider won’t let me.” Or there was a post in the community today that Meagan shared with me and she said, “Is it really possible to have a VBAC after a C-section? Because I feel like you always have to have C-sections. Is it really possible to have a vaginal birth after a C-section?” We need to remember that we live in a country and in a world where many people still have this way of thought. Many people don’t question their options and many people, most people go in and just automatically schedule a C-section because that’s what their provider says, that’s what’s most convenient, and they don’t take the initiative to learn and ask questions. 13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasoundsJulie: it’s a failure in the system. We were just talking about this before. Meagan, go ahead. Meagan: Yeah, I was just going to circle back around with the size thing. What I’m seeing more is people doubting their ability because we have people saying, “Well, your baby is this size,” but the reason why they are even saying that is because I’m seeing an increase in third-trimester ultrasounds. Julie: Yes. Third-trimester ultrasounds are trouble. Meagan: They are trouble. Julie: Just routine to check on baby’s size and check fluids– no. Just say no to third-trimester ultrasounds unless there is a valid concern for baby. Meagan: Yeah. Yeah. It is getting me. It is getting me that I’m seeing it so often. It’s just getting me irked a little bit. Julie: Gosh, Meagan, I swear though. The reason you are getting irked is because we have seen these things go south so many times. Guess what happens? They go in for a third-trimester ultrasound and there are no published statistics for this. I don’t know. I haven’t looked. But I feel like people go in and they get their third-trimester ultrasound and then they are like, “Well, my baby is measuring big,” and then they start to get worried like, “I don’t know if I can have a big baby,” because their provider is like, “Oh, your provider is measuring big.” Their provider is saying it like that. It casts doubt. It casts that doubt in their mind and that little seed of doubt gets planted. That little seed of doubt gets nourished like, “We will let you try for a VBAC but your baby is kind of big so we will just have to see how it goes,” and then these parents get set up for wanting to have an earlier induction for big baby because they don’t want their baby to get too big or just scheduling a repeat Cesarean because they are terrified of a bigger baby and the problems that a big baby could have which are not actually that many. The risk of shoulder dystocia I feel like doesn’t increase significantly more with big babies. We just think it does. Smaller babies get shoulder dystocia just like bigger babies do. Or, “Oh, my fluids are too big or too little,” and those ultrasound measurements are just so inaccurate first of all, but most of what they find isn’t evidence-based either. You’re walking into a situation where your provider will cast doubt on you whether intentionally or not. I don’t want to villainize providers because most providers I don’t think have ill intentions. They are just doing what they know and doing what they are comfortable with. But that happens nonetheless. So if your provider is recommending a third-trimester ultrasound, here is something that I encourage people. Ask them, first of all, why. If they will be like, “Oh, just to check on baby and check the size.” I feel like you can politely decline unless you want to. It’s fun to see your baby and things like that, but what would change? This is what you can ask your provider. “What will change in my plan of care based on what we find in the ultrasound?” What will change? What direction would shift? What answers are we looking for? What will change in my care based on what we find in the ultrasound? If your provider says, “Well, we just want to make sure that your baby is not too big,” that’s a red flag. Right? Meagan: Yes. Julie: “We want to make sure your waters are okay,” which could be a legitimate reason. If you are measuring more than 10 weeks ahead or behind, it’s probably a good idea to get your fluids checked by ultrasound but if you are only measuring 3 or 4 weeks ahead or behind, that’s not necessarily an evidence-based reason to do that. I would just ask that. I mean, that’s a good question to ask for any type of intervention or checks or whatever.17:08 How will this change my care?Julie: “You want a cervical check at 36 weeks? Okay. What would change in my care? What are we looking for? What would change in my care plan if this happens and if that happens?” because most of the time, cervical checks before labor– actually cervical checks during labor too– don’t tell us anything. They don’t tell us anything. I just missed a birth a month ago or about three weeks ago because a first-time mom went from 3 centimeters– she was at 3 centimeters for 12 hours and went from 3 centimeters to baby in less than an hour and a half. Cervical checks tell us nothing. Anyway, before I get off on a little more of a soapbox there. Sorry, I’ve been rambling. Meagan: You’re just fine. I absolutely love that you pointed that out and that you specifically said that it can really apply to anything in your care. What does this thing do or how does it change my care? I just think everybody should take that nugget from this episode right now and just hold onto it tight…

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    Episode 311 Sami's VBAC After an Unexpected Breech Cesarean Jun 24, 2024
    Show notes

    Upon arriving at the hospital during her first labor, Sami was told that her baby’s heart rate wasn’t stable, Pitocin was necessary, and a C-section was most likely going to be the safest mode of delivery. After laboring for a while, she was wheeled to the OR but the anesthesiologist was running behind schedule. Sami was checked and discovered she was complete! She pushed like her life depended on it and with the assistance of a vacuum and forceps, was able to vaginally deliver her baby in the OR. Sami was thankful to have had a vaginal delivery, but it wasn’t the empowering experience she hoped for and she knew she wanted something different the next time around. But when her second baby flipped breech during labor, Sami unexpectedly consented to a Cesarean. During her third pregnancy, Sami did everything in her power to set herself up for a VBAC. She found out her baby was breech and exhausted all options to try to flip her. A few weeks after a successful ECV, Sami had a precipitous VBAC, pushing her baby out within one hour of arriving at the hospital!Sami's Fitness AccountHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:23 Review of the Week04:26 Sami’s first pregnancy06:41 A vaginal birth in the OR07:55 Second pregnancy and switching providers11:00 Flipping breech during labor13:10 Sami’s C-section and feeling invalidated16:50 Third pregnancy24:19 A successful ECV29:38 Going into labor32:38 Pushing her baby out within one hour of arriving at the hospitalMeagan: Hey, hey everybody. We have another VBAC story for you today from our friend, Sami. She is actually local to me here in Utah. Hi, how are you?Sami: Hi, I’m good. I’m so excited to be here. Meagan: So excited to share these stories. I was going over your story and it’s just crazy to think how things can twist and turn and the unexpected can happen. I love that about stories sometimes and then I don’t love that it happens but I also love the uniqueness of that. Does that make sense? Sami: Yeah. Yeah. I feel like literally and figuratively, my babies twist and turns happen. Meagan: Yes. It’s important to know that going into birth even though we are planning one way, sometimes twists and turns can happen and then it’s up to us to figure out how to navigate through that space and it’s not always easy. It’s okay to not always have it be easy and then sometimes it is easy. That’s another thing I wanted to talk about too is pointing out that to some, a twist and a turn might be no big deal to someone and then to some, it rocks their world. We are all in different spaces here and you definitely like you said both figuratively and actually have some twists and turns. 01:23 Review of the WeekMeagan: We’re going to share her story in just a minute but of course, we do have a Review of the Week and I just wanted to quickly share it. This is by– okay, I’m probably going to butcher this. It is mitaywa. I’m so sorry if you are listening and you are like, You are telling this so wrong. It says, “I hope this plays over the speaker in every OB/GYN office.” I love that. That’s a cool subject. It says, “I cannot even begin to describe what encouragement these podcasts have been for me. I have completely binged on these the past few weeks and they have grown my confidence for my up-and-coming VBAC baby. I cannot stop sharing everything I’m learning and even help encourage first-time moms to educate themselves on how to avoid a Cesarean in the first place. Thank you so much for this no B.S., truth-declaring and empowering platform that I know has encouraged so many more than just myself. Keep being amazing. I can’t wait to share our story in just a few short months. All of my love.” Aw, that’s such a great review. I love that so much. I hope that you got your VBAC and that all went well. I’m so excited to hear that this podcast is doing exactly what we intended it to do– empower, educate, inform, and inspire people to know their options for birth after a Cesarean and like you said, how to avoid a Cesarean in the first place. 04:26 Sami’s first pregnancyMeagan: Okay, cute Sami. I’m excited to hear these stories. Thank you for joining us today. Sami: Yeah, thank you so much for having me. It’s a really cool full-circle moment to be here after binging on the podcast for months and months and months so I’m excited to be here. Meagan: All right, well every birth story starts with baby number one, and your first baby actually wasn’t a C-section, right?Sami: Yeah, with my first baby, I got pregnant in 2017 and had him in 2018. I feel like as so many other people on the podcast, I felt like I was pretty informed going into the birth. I mean, I read two books. To me, I’m like, I am so informed. I took a HypnoBirthing class but I had a provider who had just been my OB/GYN for a long time so I decided to stay with her. Even though I didn’t have a C-section with that first delivery and pregnancy, it definitely wasn’t what I was hoping to get out of it. I went to 40 weeks and thought that I would have my baby right then and there. I didn’t have a doula. I hadn’t talked to a lot of people but I was planning on going unmedicated in my delivery and then the days kept going on. I got to 40 and 5 and finally started to go into labor. I was really excited because my OB had scheduled an induction for me I think the next day actually. I got to the hospital and everything changed. We got there. We were excited and fresh-faced. We were having our baby today. The minute we got there, they were picking up a lot of heart decels. They didn’t feel like the baby’s heart rate was doing well. They told me that I needed to get on Pitocin immediately and that I would be really lucky to not have a C-section so my hopes for an unmedicated delivery went out the window immediately. My OB came in and told me, “I really do think that a C-section is going to be the best course of action for us but let’s give you a couple of hours and see how things do with Pitocin, get you an epidural just in case,” and after a few hours, came in and said, “I really think we need to go to the OR right now. We need to get your baby out for his safety.” 06:41 A vaginal birth in the ORSami: We scrubbed up, my husband and I. She took us back to the OR. I was a wreck. I was crying and just so upset because no one had prepared me for that. In my HypnoBirthing class, all of the stories that were shared were really positive. We didn’t really talk about what would happen in this type of situation. Like I said, I didn’t have a doula. We got to the OR and the anesthesiologist was actually running behind. He was doing another C-section and they didn’t have another one on call I guess. She was like, “You’re dilated to a 10 so if you can get this baby out right now, I’ll let you push and try.” So I pushed like my life depended on it trying to get this baby out. He was sunny-side up so she did end up using forceps and a vacuum. We got him out in that timeframe. It was so cool honestly after having this experience that felt really scary and just not what I was wanting, I was riding the high of my life to have still been able to deliver him. So I didn’t get my unmedicated delivery, but I was just really happy to have him there with me. Meagan: Yeah, yeah. 07:55 Second pregnancy and switching providersSami: So fast forward to my second pregnancy, I got pregnant in 2019 and had him during the pandemic in 2020. I decided to switch providers just because I felt like after going through that experience with her, it wasn’t a bad experience, it just wasn’t what I was wanting. To get there and have her immediately pushing a C-section– Meagan: That’s kind of unique. Did she ever tell you exactly? It was just the heart rate? “You’re heart rate is wonky. Let’s put you on Pitocin.” Those two things often don’t match. And then it’s like, “Oh, you’ll probably end up there anyway but we’ll let you keep going.”Sami: It was so bizarre. Looking back at it for me, I do feel like there were signs that she just wasn’t going to be a supportive provider of an unmedicated delivery all along. I told her I didn’t want to have an epidural and she said, “Well, good luck. You’ll probably change your mind, but I support you doing whatever you want to do.” We found out after he was delivered that the cord was wrapped around his neck twice. That was what was causing the decels to happen, but that was what was hard for us to understand too. We were like, “If it’s emergent, why aren’t we being taken back right now?” Yeah. It just felt like she wanted to get the baby out. I was over 40 weeks. I felt like even though I had a great experience postpartum and I was fine, I couldn’t trust her anymore. I didn’t feel like she was a safe person or someone who would honor my wishes during birth. Meagan: Right. Sami: I had heard of a doctor locally. A few of my friends had just raved about him. He is pretty popular in my neighborhood. I feel like a lot of different people go to him, but it’s Dr. Thackeray and INC. Meagan: Oh yeah. Sami: Yeah, so I switched over to him for that second pregnancy and immediately just really liked him. He was warm. He took a lot of time talking over everything, getting to know us in a way that most OBs don’t in the hospital setting and I let go of my hopes of having an unmedicated delivery. It just felt like with my first birth and postpartum, everything that could have happened did happen. I had this plan. I had the birth plan. I wanted to have that unmedicated labor and it all went out the window the minute that we got there. I felt like, What’s the point in even trying to go unmedicated? There are so many unexpected things that can come up in birth. I went forward with that pregnancy. It was a pretty normal pregnancy. Honestly, I felt great. I’m one of those weird people who enjoys being pregnant. I just soaked up the time with my oldest son. We were having another boy, but when the pandemic really started to get serious, we were terrified. We were being told every week that things were changing. You could have people come with you and support you. You couldn’t. My birth partner may not be able to be there with me. We were a little nervous about that. 11:00 Flipping breech during laborSami: I got to 40 weeks exactly and went into labor again. I was so excited. It’s really funny because my husband and I took pictures outside of the hospital. We were both really excited to hopefully have a more normal experience of being able to deliver in the delivery room without all of those interventions. We got checked into the hospital. They checked the baby’s position and they told me that he was head-down. Then shortly after that, my water actually broke. They called my OB to come in and just check on how things were progressing. When he came in, he checked me and he was like, “I don’t think that I’m feeling the baby’s head. I think I’m feeling the baby’s bum.”They did an ultrasound. Meagan: So breech? Sami: He was breech but he wasn’t even just complete breech. Meagan: Like sideways? Sami: Yeah. He was transverse. It brought up a lot of anxiety and emotions from that first delivery. I’m like, “No. I avoided a C-section. I really don’t want to go back to the OR. I don’t want to have forceps. I don’t want to have all of these things happen.” They tried to perform an ECV. They actually tried for 45 minutes to get him to flip but because– Meagan: Which is also impressive just to say for a provider to do that during labor. That’s impressive. Sami: Yeah, he was. He brought in one of his partners. I could tell that they were trying really, really hard but he would not budge. They told us that because my water had broken, it was just likely that there wasn’t enough fluid in there to get him to flip back. Meagan: Rotate. Sami: Yeah. We don’t know at this point. The nurses who checked us in told me that he was head down, but we don’t know if he flipped when my water broke or if he had been sitting breech for a long time. In any case, he wasn’t flipping. My husband and I asked for some time just to think about our options, but his foot became prolapsed and they told us, “This is an emergent situation. We need to get him out right now. If the cord prolapses, it could be pretty risky.” 13:10 Sami’s C-section and feeling invalidatedSami: They rolled us back to the OR. It was kind of like Dejavu from my first delivery. I’m sobbing. I’m like, Oh, I don’t want to have a C-section. I’ve got a baby at home to think about this time around. I told him I’d be back in two days. Just a lot of emotions were brought up. They took us to the OR and kept having to give me medication after medication. They lay you down obviously. So many people listening to this story are going to be able to relate to what it’s like in there, but it’s freezing cold. They laid me down and strapped me onto the bed. I was shaking. I felt like I was going to vomit. They just kept giving me all of these medications. They finally started to perform the C-section and I just had tears rolling down my face. The anesthesiologist bent down and was like, “Don’t worry. My wife had to have C-sections with all of our babies and she’s fine.” It was just the weirdest situation. Meagan: Yeah, probably out of the goodness of his heart of, “You’re going to be okay. My wife was okay,” but it’s not really what you say to someone in that moment either. Sami: Yeah. It just felt kind of invalidating that I was having a hard moment. Meagan: Yeah.Sami: Ultimately, they got my son out. They took him and cleaned him off and when they brought him over to me, I can barely remember what it was like but I couldn’t hold him. I was shaking. It was a really hard moment to not be able to have that immediate connection with him. We got back to the recovery room and things went fine for the most part. I did have a pretty bad hemorrhage and they kept having to come in. They were going to open me back up at one point, but all in all, it was fine. My son was healthy and I was really grateful for that. I think the hardest part for me was just like I said with the anesthesiologist just feeling really invalidated in how hard the situation was. I wanted to get back to see my son. I’m pretty into fitness and health like I talked about and hadn’t really wanted to have this really long recovery from all of that. People just kept saying, “Well, your baby is healthy. That’s what matters. At least your baby is healthy.” I think that’s a really hard thing sometimes for moms to hear because as the mom of the baby, I want them to be healthy more than anyone. Meagan: It’s a no-duh situation. Sami: Yeah, that’s my number one goal. Funny enough, I found The VBAC Link in the hospital while I was lying in my hospital bed those three days just feeding him and spending time with my baby and I started listening to the podcast then. I just thought, If I ever go down this road again and have another baby, I really want to have a different experience from these first two deliveries. I want to be able to hold my baby the minute that they are born, not be so drugged up that I’m having to come out of being groggy and things. To make a really long story a little bit shorter, my postpartum situation with my son– the recovery was okay but it was really hard. It brought up a lot of postpartum anxiety for me, a lot of different things with the pandemic. We weren’t able to have visitors, not be able to be outside or move around the way I wanted to immediately. The podcast really helped me get through a lot of that. 16:50 Third pregnancySami: Fast forward to 2023 and I got pregnant for a third time, I was just excited to hopefully do things differently this go-around. We had two boys and found out that we were expecting a girl. I’m a pretty type-A person so I devoured all of the information that I could about VBAC and realized that I really hadn’t known that much going into my first birth. I thought that HypnoBirthing cl…

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    Episode 310 Kristen's Healing VBAC with a Special Scar Jun 19, 2024
    Show notes

    Every pregnancy and birth experience is different. That is true for everyone, but especially for Kristen. Kristen joins us from Provo, Utah, and shares her experiences with an initial vaginal birth, a diagnosis of omphacele with a Cesarean and infant loss with her second that left her with a special scar, an induced, medicated hospital VBAC with her third, and she is currently expecting twins!Kristen’s journey has not been easy, but she has learned and grown so much. She talks about how a safe and supportive birth team truly makes all the difference. Your intuition will help guide you to the best provider for you. When you know, you know!Meagan concludes the episode by touching on some myths and facts about doulas. The VBAC Link Blog: Myths and Facts About DoulasThe VBAC Link Blog: Special ScarsSpecial Scars, Special HopeNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:50 Review of the Week04:02 Kristen’s first vaginal birth09:41 Coping with grief and hospital communication issues15:17 A low transverse incision with a J extension19:59 Finding VBAC support in Salt Lake23:10 Foley induction at 41.5 weeks29:29 Changing plans30:37 Myths about doulas38:55 Facts about doulas41:05 Kristen’s advice to other women with special scars43:26 Listening to your intuition when choosing a providerMeagan: Hello, Women of Strength. Thank you for joining us for another amazing episode here at The VBAC Link. Today’s story is from someone who is local to me which I think is always kind of fun to have someone who when they are telling the story, I know the birthing place, I know the provider, and here I even know the doula so that is super exciting. Welcome, Kristen to the show. Kristen: Thank you, Meagan. Meagan: Thank you so much for being here and I’m excited for you to share your stories. I would like to get into a review really quickly so then we can do that. Kristen: Sure. 01:50 Review of the WeekMeagan: Okay, we have a reviewer from Apple Podcasts and it says louuuuuhuuuu. I think that’s how it is and it says, “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 like being flat-out told no at my 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 HBAC” which is home birth after two Cesareans, actually HBA2C, “and I definitely don’t think I would have had the courage or believed it was possible without the podcast. Thank you, Meagan, for all of the work that you do to provide this information.” And thank you, louuuuuhuuuu. I don’t know how to say it. I’m just butchering your name. If you are still listening, thank you so much for your review, and as always, we love your reviews. They really do help the podcast. They help Women of Strength find these incredible stories and information just like she was able to receive. You can drop that review at Apple Podcasts or Google or wherever you listen to your podcasts. 04:02 Kristen’s first vaginal birth, Cesarean, and infant loss experienceMeagan: Okay, Kristen. Thank you again so much for joining us. I would love to turn the time over to you to share your stories. Kristen: Well, thank you. It’s hard to know where to start. There are a lot of details to mine. We had our first little boy in April of 2018. That was its own experience. That was a vaginal birth honestly. That was as hard as it was as a first-time mom and a first-time pregnancy/birth. It had its own set of interesting details to go along with that but we soon found ourselves unexpectedly pregnant with our second one just four months later after he was born. Meagan: Really soon. Kristen: Yeah, they would have been 11 months apart. I say would have been because my daughter who I had via Cesarean ended up passing away a few hours after she was born. She had a few congenital defects and when we got our first ultrasound, we found out she had a condition called omphalocele which means she had some of her organs on the outside of her body in a little protective sac. It was mostly her liver. I saw the ultrasound. I looked at it and I was like, That doesn’t look normal. It was one of those moments where the ultrasound tech was like, “I’m going to get the doctor.” Your heart sinks and your heart drops. At the time, it wasn’t a big deal after the doctor came to us and talked to us and said, “She’ll be fine. You can deliver safely. It would most likely be a scheduled C-section.” I was expecting that from the very beginning because it wasn’t just, “Oh, this is going to be a big baby. This is going to be a big baby with a large–”Meagan: 100% necessary Cesarean. Kristen: Exactly. 100% necessary. Meagan: Yes. Kristen: That was to be expected even though I was like, Darn. I don’t want that, but obviously, I wanted her to be her in the best and safest way possible because this is just such a crazy anomaly. That was around 18 weeks and then around 24 weeks, we were at Maternal-Fetal Medicine at our local hospital down here where I live in Provo, Utah and they discovered something else which is a lot more serious. She had a diaphragmatic hernia which means her diaphragm didn’t really develop all of the way and allowed some of her other internal organs to be pushed up into her chest cavity. Meagan: Oh wow. Kristen: Whatever was left in her abdomen was pushed up. I think some of her spleen was in there and pushed. They essentially squished her lungs so they couldn’t develop all of the way which is essentially what happened at the end of her life. That’s not something– we’ve grieved and healed a lot from that but it’s also something that I consider one of those things that now I can be there for somebody else now who has gone through infant loss in whatever way that means. I can be a sounding board for anybody else who has been there. Meagan: Yeah. It’s crazy how sometimes we have some of the most unfortunate or horrific experiences that we could ever imagine going through and life-jarring and after we get through them, we are still super there but we are also stronger in a weird way where you can be that support for other people and you can relate. It’s just this weird but most amazing thing that there are people like you who are like, I went through this really not great experience, but now I’m here and I want to support those who need it. Kristen: Yeah, totally. It took a long time to get there. Meagan: I’m sure. Kristen: She was born on March 25, 2019 and so she would have turned 5 this year. We celebrate her birthday as a family every year. Meagan: Good, yes. Kristen: My 6-year-old is excited because we always release a balloon up for her and he said, “I’m so excited. My sister’s going to get this balloon.” It’s still very innocent and sweet. We love being able to do that as a family because she is very much still to us a part of our family. Meagan: Absolutely. That just gave me the chills thinking about your little boy doing that. That’s so awesome. Kristen: He’s very tender-hearted and sweet. It’s one of those things that means a lot to him. Even though he was barely one when this happened, he wouldn’t have remembered her at all. Anyway, with those things going on, her outlook from the very beginning was bleak. That was a hard piece of the puzzle to deal with, but it also plays into what happens later. Although this was a scheduled Cesarean and absolutely necessary, we wanted to give her every possible chance just in case she could beat the odds or whatever. Me as mom, I’m like, There is still a 20% chance this could be okay. That’s something. It’s not nothing. Meagan: Exactly, yeah. Kristen: You’ve got to hold onto something and that’s what I did. 09:41 Coping with grief and hospital communication issuesKristen: The Cesarean itself was fine. The process in the hospital for me, nothing went overly wrong with me physically. But afterward, that was where it gets a little complicated. We had to leave the hospital with just my husband and myself which was obviously very hard but we also had a few different things that left me baffled and confused but really frustrated. Anyway, the first thing was that after our daughter had passed and while I was recovering, the hospital staff didn’t seem to be on the same page with a lot of things. First being their communication. I remember it was the anesthesiologist who came in the day after my daughter had passed and they asked, “Oh, how are you? How is your baby?” Did you not read the notes? Is there not a sign on the door that says she’s not with us anymore? I had to clarify. Of course, he was very apologetic. “I’m so sorry.” Okay. That seemed like one of those things where it’s like, okay. You should have been informed. I don’t know why. After that, we had the resident doctor and the doctors in training at the time. He comes in and says, “We had to do a mid-transverse incision on your uterus and so you should plan on Cesareans from here on out. It’s not safe and don’t plan on having a vaginal birth.” It’s like, “Okay, no one told me that was happening.” I felt like there was again that lack of communication and just that misstep between doctors and the other providers and stuff. I was told that in the hospital as I was recovering so that was another blow of course because I was very much expecting, Okay, I know I can have a vaginal birth after a Cesarean. That’s totally a possibility. I go in with that strand of hope again for myself thinking that I could totally do this later. I’ve heard it’s possible. I’ve just got to find somebody who can help me with it. I’m fine, then someone tells you like your reviewer today. I hate it when someone tells me no. Don’t tell me no. Don’t do it because I will literally make it my life’s work to prove you wrong. That was really hard to hear, of course, in that setting and in that moment. It’s really deflating to hear that. But I was like, Okay. If that’s what they think, that’s fine. I’m going to prove them wrong later. Whatever. I’ll do it.Then we ended up going home. I ended up calling back the doctor’s office saying, “Okay. You said mid-transverse. What does that actually mean?” I was trying to clarify things. Meagan: It’s higher up. Kristen: Yeah. The nurse who answered said, “Well, we had to do a mid-transverse incision. We had to make more room for your baby to get out.” I was kind of expecting that they might have to do that. They did forewarn us that it may be a possibility but no one ever said that was what happened in the hospital when we were delivering her. Anyway, they never told us that happened until I called back and said, “Hey, what actually happened?” She said, the nurse I remember was like– it still makes me baffled why you would say something like this– but she goes, “We had to show a mid-transverse incision with a double-J extension,” so one on either side. Meagan: On each side? Wow. Kristen: Yeah. That’s what she told me. She said, “Think of it like a smiley face on your uterus.” It’s like, why would I ever think of it like that? It was just the weirdest verbiage. Why would you say that to somebody? I don’t know. I was like, Okay. That was weird. Why would you say that to me? Then it gets even better. You can request your op-notes. Meagan: Yes. Kristen: I did that. I requested them. I feel like people are just going to be doing the facepalm like, Oh my gosh, seriously? What were these people thinking? On my op-notes, they have little bullet points. The first one says, “Uterine incision”. The uterine incision they told me they had on there said “classical”. Meagan: Oh. Kristen: Which is wrong, totally wrong. Immediately beneath that, it says, “Detailed C-section notes”. Then it says, “Mid-transverse incision. Patient should not labor in the future.” That was the note. First it says classical. Then it says mid-transverse incision. Then they tell me I have a mid-transverse incision with a J extension or double J’s. What do I have? What did you do? Meagan: Yeah. Yeah. 15:17 A low transverse incision with a J extensionMeagan: That’s frustrating. Kristen: Yeah, so fast forward to when I have my new provider. We’re pregnant with our third now or we were at the time. He was a wonderful, wonderful guy and a wonderful provider. He said, “Do you know what? I’m going to go off of the actual written notes from the person who says they were watching the procedure.” It’s like, oh that’s really smart. They said I have a low transverse incision with a single J extension to my right side. Meagan: Wait, so different again? Kristen: Different again. So I was like, Oh my goodness. Where does this end? It stopped there, thank goodness. Yeah, he said, “I’m trusting more the person who was basically looking and saying, I was here in the moment taking physical notes and this is what was done. I’m trusting this more than somebody’s bullet points.” Meagan: Everybody’s bullet points, yeah. Kristen: Exactly. Meagan: And the nurses who are just randomly saying what they did. Okay. Kristen: Yeah, exactly. Exactly. Meagan: Wow. Kristen: So I was like, “Thank goodness I have you to translate for me,” because I was like, What did they do to me? I have no idea. Probably any other doctor who wasn’t super VBAC-friendly would be like, “Well, this is too risky. I don’t want to take any chances.” Meagan: So technically you have a special scar. Kristen: I do. I have a special scar. Meagan: Low-transverse with a J. Kristen: With a J. In those op-notes, I actually did notice just the other day when I was reading them again, it said that they extended it bi-laterally which in my mind, I didn’t call and ask obviously, but in my mind, that would translate to making the low transverse incision just a little bit longer. Again, I don’t know. But at least at the bare minimum, I have a low transverse incision with a J extension. So yes, I have a special scar. It was one of those crazy things like, Oh, now I’ve got to look this up. Again, I’m gung-ho at this point about, I can do this with a special scar. I’ve listened to the podcast. So many women have done it. I can do it too. I’ve just got to find somebody who is willing to meet me in the middle. Meagan: Support you. Kristen: Yeah and like I said, luckily I did up in Salt Lake where it’s not too far of a drive from where we are from. It was definitely worth it. He said, “It shouldn’t be a problem from what I’m reading. We’ll just go with it and if anything changes, I’ll keep you posted.” He was just supportive from day one which was super awesome. Meagan: He’s wonderful. Kristen: Anyway, so yeah. That’s the complication from my fun story. Hope that all makes sense. Hope we are all able to piece that together. Sorry. Meagan: Well, that’s so hard because it’s like, I’m being told this and this and this so what is it? All of these things impact my decision or maybe it doesn’t. But you want to take all things into consideration so it’s frustrating to not know what you have. Kristen: Right, totally because yeah, like you said, it could totally impact somebody’s decision. Meagan: It could affect somebody’s decision, yeah. 19:59 Finding VBAC support in Salt LakeMeagan: Okay, so you found out it was a low transverse extension J special scar. You found a provider up here in Salt Lake that was like, “Yep, okay. We’re going to do this.” How did that go? Kristen: That was really good. Honestly, it was one of those things where you start looking online first and then go from there. I just found his name. At the time, unfortunately he doesn’t practice that anymore, but he had his own little personal video posted about that. I was like, I feel this. I’m getting really good vibes from this guy and I really like it. So I called his office. I scheduled myself in. Great. Okay. Then yeah, it was really comfortable from day one. I told him. I said, “I’ve got some weird things going but at the same…

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    Episode 309 How to Tell if the VBAC/HBAC Information You See is Real or Fake Jun 17, 2024
    Show notes

    Julie Francom joins Meagan on the podcast to talk about checking the validity of the information you see surrounding VBAC. There is so much information out there and so much misinformation that we want to help you figure out what is actually evidence-based! Julie and Meagan draw on their personal experiences with making corrections to information they understood and have shared. They talk about how the structure, size, and date of a study can influence the statistics. Julie shares why Cochrane reviews are her favorite.The VBAC Link is committed to helping you have the most evidence-based and truthful information as you make your birthing decisions. We promise to update you with all of the new information as we receive it!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:30 Checking the validity of social media posts08:01 Our corrected post about VBA2C12:56 The production behind a statistic or article18:37 Cochrane reviews19:06 Checking the dates of studies and emailing us for verification23:29 Nuchal cords25:21 Julie’s sleep training story29:45 Information at your fingertipsMeagan: Hey, hey everybody. Guess what? We have Julie today on the podcast. Julie: Hey. Meagan: Hey. We’re going to be doing a short but sweet, maybe also a little sassy because as Julie has said, she likes to get sassy these days. We’re going to do a short but sweet episode on how to tell if VBAC or HBAC or really just anything–Julie: Any. Meagan: Yeah, any information you see online is real or fake. Now, if you’re following along on our social media, you likely have seen a lot of our myth and fact posts. I think we share them probably once a week honestly because there really are so many things out there that are myths and things that are facts, but on a whole other side and a whole addition to myth and fact is really what should we be believing? What should we be resharing? Right, Julie? I think that this definitely is something that is close to our hearts at least I’m going to say is close to my heart. I think it’s close to Julie’s heart. Julie: Oh, for sure. Meagan: We want to protect this community and we want this community to find the real information, and not the false information. We know. You can Google anything. Julie: So much false information. Meagan: You can Google anything and find the real and false information but when it comes to VBAC, like she said, so much false information. We’re not even going to do a Review of the Week. We are going to jump right in in just a second after the intro. 03:30 Checking the validity of social media postsMeagan: All right, Julie. Are you ready to get spicy?Julie: Yeah, I think maybe the biggest reason we decided to do this episode and at least for me anyway why I brought it up is because there is so much information out there that looks good, right? You can be like, Oh my gosh, yes. This is amazing. We’re passionate. We as in me and Meagan, but we as in you too who is listening. Clearly, you’re passionate. But we really need to be careful what we’re sharing both from our business accounts and what we’re resharing from other people because sometimes if you share this information and it’s incorrect and wrong and it goes viral which there is a recent post that has and sparked this thing, and we’re not going to call anybody out, but when you share misinformation and it goes big and people start believing this incorrect information, it can really do damage to the efforts that we’re trying to make here which is increasing access to VBAC for everybody. If you have this entire group of people who think that their chances of having a VBAC at a hospital let’s say are 30% or something like that when really your chances of having a successful VBAC if you get to try– get to try I’m using very loosely– are really between 60-80%. Those are the numbers. But there was a post recently that went viral that said it was around 32% in the hospital and that is just simply not true. The post went viral and everybody is jumping on board like, Look how much better home birth is than hospital birth, but those statistics were very flawed from a flawed study that was super small from Germany 20 years ago. Meagan: Less than 2000 people. Julie: Yeah. Yeah. It could give you some pretty conclusive. Some, but it’s not big. It’s not a meta-analysis. It’s definitely not something to be definitive. It’s from Germany and there are a lot of flaws in the study as well. But everybody saw this thing, Oh, HBAC success is 87% and hospital VBAC success is 32%, or whatever the number was. People are like, Look how much better it is at home, and spreading this information which don’t get me wrong, having three HBACs myself, I love home birth. I love home birth after Cesarean for whoever feels it is appropriate for them, but I also know that those numbers are just wrong and if you share that information and these people believe it, they might be choosing HBAC out of fear. Meagan: Well, yeah. Absolutely. Julie: Instead of having the right information and making the right choice for them. I don’t know. That’s what we want to do here. We want to help you spot misinformation easier and learn to question the things that you see on the internet which sounds so silly. For me, I’m like, Okay. Let’s challenge everything. But I saw that post and my first thought was, Heck yeah. That’s crazy. I’m all for home birth but then I was like, Wait a minute. These numbers don’t feel right to me. Meagan: It doesn’t make sense. Julie: So then I dug a little bit deeper into it. We just want to equip you with knowledge so you are doing your best to get the most accurate information and spot the information that is not necessarily true. I think we are all guilty of it. I’m just going to keep talking, Meagan::. Meagan: I know. I was going to say really quickly. Just like what you said, you were like, Heck yeah, as someone who is passionate about birth or maybe someone who may have trauma. I’m talking about this specific post but really in any general post, someone who may have trauma surrounding the opposite of what that post is supporting, it’s so easy to just be like, Boom. Share. You know?Julie: Yeah, you’d be like, Oh my gosh, yes. I love HBAC. Let’s share this. Let’s increase VBAC. Everyone needs to hear this. This is important information. We get excited, right? Meagan: Right, but we need to do exactly what Julie said and take a step back and I mean, this goes for anything. It might be sharing the correct age of a child being out of a car seat. I mean, just random and you’re like, Yeah, that looks good. Boom. Share. Make sure that you are sharing the right stuff. 08:01 Our corrected post about VBA2CMeagan: So let’s talk about this. Keep going, Julie. I know you were on a tangent going into it. Let’s talk about how to understand if it’s real. Julie: Well, first of all, I think before we do that, I want to admit that we have been guilty of sharing, I don’t want to say misinformation because I guess it kind of was. A few years ago, we misquoted an ACOG bulletin about VBAC. Meagan: Yeah. Julie: It was me. I did it. It was me. I’m the problem, Taylor Swift fans. What had happened was that ACOG, in their bulletin about VBAC after two C-sections, cited two studies. One study that they cite– first of all, they say that VBAC after two Cesareans is a safe and reasonable option for parents to attempt and the decision should be patient-based. Anyways, so they cite two studies. One study that they cited about VBAC after two Cesareans shows no increase in rupture rates with VBAC after two Cesareans compared to one. The second study that they cited showed risk of almost double the rupture rate for VBAC after two Cesareans compared to one. It’s really interesting because they cite these two studies that are equally credible that had drastically different results. So when I made the post, I paraphrased the bulletin that said something to the effect of, “VBAC after two Cesareans shows no increase of rupture risk.” Now, that was only really kind of half true because I saw the study and I was like, Oh my gosh, like Meagan:: said, This is exciting! Everyone needs to know this. I made the post then we started getting some kickback on it and so we looked again because I was like, Oh, well I will show you where in the ACOG bulletin it says this, and then I went and I was just like, Oh yeah, it doesn’t say exactly that. I unknowingly spread this misinformation so what we did is we updated the post and we posted an additional post that was a correction because here at The VBAC Link, we want to make sure we are giving you 100% accurate information all of the time. The reality is that we are humans. We are going to make mistakes sometimes but as soon as we realize that we make these mistakes as long as they are actual mistakes and not just people wanting to talk crap, we’re going to correct ourselves. That’s the biggest thing. I want to say that it’s okay to not be perfect all of the time, but I think it’s also important that when you realize you’ve made a mistake that you correct it in the same space that you made it. Anyway, I just wanted to say that. Meagan: Yes, not wanting to shame anyone for being excited and making these posts. Julie: You should be excited. We’re excited. Meagan: Yeah. We were really excited to even see that post earlier and then we had to take a step back. It’s not to even shame that person. They are probably really excited to share that information but again, as a poster, one, take a step back before you share, and two, take a step back before you post. If you post and there is question which unfortunately there were a lot of questions on this post, change it. It’s okay. It’s okay to be like, Oh, I actually misunderstood this. Julie: Update it. I didn’t see this. Yes. Meagan: Or, I didn’t realize this wasn’t as credible as it felt. Julie: Or seemed. Right. Meagan: One of the best ways to find out of the research or the study or what you are looking at is really, really credible is if it’s peer-reviewed honestly. Right? Julie: Right. I think before you even go into that is if you see data or information like this post shared and it doesn’t seem quite right or even if it does seem right and you don’t see a source cited, ask for a source. Meagan: Ask for it. Julie: Mhmm, especially if they are throwing out numbers like, Home birth has an 87% success rate for VBAC and hospital birth only has 32%, everybody wants to get on board with those numbers, but there were no studies posted. There was no anything so I actually went on and made a comment. I asked about it and she posted four different studies. I was like, Three of these studies aren’t even relevant at all and this one where you are getting numbers from is incredibly flawed. I think it’s really cool to get on board with something that shows these fancy numbers, but it’s really important to at least see a source cited I would say. Bare minimum, see a source. Ask for a source and then go through and verify the source. Meagan, yeah. Let’s talk about what makes a source credible. 12:56 The production behind a statistic or articleMeagan: Yeah. Julie: These are just some things. Not all of these things are going to be true all of the time for a credible source, but these are things to look for and why they are important. Sorry, go ahead. Meagan: No, yeah. I think one is looking at who even produced it. Who produced this stat or this article or whatever? A lot of the time, someone who produced the article may not be the person who produces the stat or the evidence. That’s something to also keep in mind just because if Sally Jane at whatever company shared an article, it doesn’t mean that she’s not a credible person but I think sometimes when we are digging deep into what is credible and the real original source, it will take us to the original source which then we need to look at. ACOG, right? We pay attention to ACOG. Midwifery groups and things like this, we want to look. Who wrote it? I think one of the things is what is the full purpose? Julie: Yes. Meagan: One of those articles that I was reading actually wasn’t in relation to what the post was about. Julie: Exactly. Meagan: I don’t know if you saw that. Julie: Three of them. Meagan: The purpose of this article and the goal of why they are one writing it in general and what’s their ultimate goal in giving you the information. Julie: Right. Meagan: I mean, when I was reading one of them, I was like, Wait, what? Julie: And when she shared these four links and I called her out, I said, “These three are about this, that, and the other thing. They are not related to the other things that you posted,” she deleted all of the other information that she shared and just kept the one outdated German study up. I felt really salty then. I still feel a teeny bit salty about that. But yeah, I feel like asking the author and the poster. I know that at The VBAC Link, when I was there, I tried to really make sure that we did this and I feel like you still do but whenever we post anything with stats or numbers or anything like that, we try to post a source with that every time. Meagan: Yeah, for sure. Exactly. Julie: It’s in the course like that. Sorry. I feel like we are going in different directions there so circle back. Meagan: Yes. I think you really need to break it down and look at the ultimate study. If it is saying that you have a whatever success chance of having a VBAC in the hospital or having a VBAC in general and you’re looking at the stats, if you’re looking at a review that has 9,000 people and then there is another one that has 400,000 people involved in that study, to me, automatically I’m going to be looking at the difference there because to me, 9,000 is a lot but this one was less than 2,000 specifically. Julie: Right. Meagan: So when we’re looking at big studies, if you have a very small control group, it’s just not as credible as some other sources. Julie: Right. 18:37 Cochrane reviewsJulie: What I really love is when I can find a Cochrane review of something. Cochrane reviews in my opinion is the most credible place because what Cochrane reviews are is they are a meta-analyses of a bunch of different studies. What they do is they find a whole bunch of different studies or research papers or evidence or just huge collections of data. They go through and pick them all apart and find out which ones are credible or which ones are not credible and then they compile the results in those studies to have a bigger meta-analysis which is a collection of a whole bunch of credible studies pulled apart and data presented. I love if I can find a solid Cochrane review because I know that is just about as credible as you can get. Also realize that most studies have flaws and limitations like Meagan:: was talking about. Who is behind the study? Who funded the study? Who contributed to the study? What were the study controls? How many variables were there? Because if you have a study with more than one variable, then your numbers are going to be skewed anyway because these different variables may influence each other. If you have, for example, the ARRIVE trial. The ARRIVE trial we know had flaws. I’m not going to go over all of them but they were funded by a doctor at a hospital whose goal was to show that induction provides the same or better outcomes than waiting for spontaneous labor. That was the intention of the study. When you go in trying to prove something, you’re already introducing bias into the study and you could bring protocols or procedures into the study that might not be realistic in the real world that could influence the results of the study which is one of the things that actually happened in the ARRIVE trial. A lot of studies I feel like could be picked apart and torn apart which is why I really love Cochrane reviews and meta-analyses is because you can compile all of these and get more accurate…

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    Episode 308 Shannon's VBA3C + Doubt From Her Delivery Team Jun 12, 2024
    Show notes

    “I did it. They said I couldn’t, but I did it.”When planning for her VBA3C, Shannon got just about as much kickback as someone can get. She was ambushed. She was coerced. She was given the scariest information. Shannon joins us from England today and talks about how each of her four births brought her to where she is today. By the time she was pregnant with her fourth, she was ready to advocate. She was ready to fight for something she had never gotten to experience. Though none of her providers were supportive, Shannon stayed grounded. She made her desires known and stood by them. Shannon labored unmedicated for just over 14 hours. Then to everyone’s surprise, she pushed her fourth baby girl out vaginally in 14 minutes!The VBAC Link Blog: Is VBA3C Right for You?The VBAC Link Blog: VBAMCHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:04 First pregnancy and birth08:31 Second pregnancy and scheduled repeat Cesarean10:56 Third pregnancy14:04 A heartbreaking third Cesarean17:42 Postpartum during COVID19:55 Fourth pregnancy24:37 Getting ambushed28:40 Shannon’s VBA3C birth36:32 “We are all so proud.”38:30 VBAC after three CesareansMeagan: Hello, hello. You are listening to The VBAC Link. We have our friend, Shannon. Are you from England? Where are you?Shannon: England, yeah. New Cambridge. Meagan: Okay, see? I’m so glad my mind is remembering. You are in England and you guys, she is recording. It is quite late there. She is such a gem to stay up and record and share her VBAC after three C-sections. Shannon: Three. Meagan: Yes. Her fourth was a vaginal birth. Uno, dos, tres. I can’t even say. I can’t even pretend that I know Spanish. Let’s be honest. So three, you guys. After three Cesareans and we know in our community that this is definitely something that people want to hear. People want to hear these stories because it is harder to find the support. They want to hear what people are doing, how they are navigating through, where they are finding support, and what they are doing to have their vaginal birth after multiple Cesareans. We are excited, Shannon, for you to share your stories today. 01:07 Review of the WeekMeagan: We do have a Review of the Week so we’re going to get into that and then we’ll dive right in. Okay, so this is from morgane and it says, “I’m Not Alone.” I love that title because Women of Strength, you are not alone. This community is so incredible and we’re all here for you. It says, “This podcast has provided so much comfort for me in coping with my unplanned Cesarean and now planning for VBAC in March. The transition to motherhood has been somewhat lonely for me since most of my friends are not mothers and hello? Pandemic.” So this is a little bit ago, right? It says, “I am also an aspiring doula and spurred on by these ladies and their work. So thankful I stumbled across this group.” Oh my gosh. It says, “Us women really are strong.” I love that. Us women really are strong. I could not agree more. You guys, you are strong. You are capable and you have options. If that is not anything and everything that we talk about on this podcast, then I’m doing it wrong and you need to let me know on your next review. As just a constant reminder, if you wouldn’t mind leaving us a review, that would be so great. You can leave it on Apple Podcasts, Google, or you can even email us. 04:04 First pregnancy and birthMeagan: Okay, Shannon. Uno, dos, tres– three. I’m saying it correctly now. After three Cesareans, you have had quite the different journey with each birth. Shannon: Yeah. I think each one taught me a little bit more and I probably wasn’t ready for a vaginal birth with my first three. I think that while looking back on my journey it’s difficult, I think it led me to where I am today. Meagan: Me too. I’m right there. Amen. Same. I love birth and I’ve always loved birth, but I do not think that I would be here right now with you today if it weren’t for my experiences. Shannon: Yeah. I think the same. I’ll get into where I am now when we’re after my fourth, but had it not happened the way it did, I wouldn’t be where I am now. Meagan: Who you are today. We grow and we learn and we inspire and here you are sharing your story. So let’s talk about baby numer one.Shannon: Okay, so I was 19 when I had him. I just assumed that he was going to come out that way, that he was going to come out vaginally. It was going to go well. There were going to be no complications and it didn’t turn out like that. I was due in the end of May and I think I was about a week over due. I went into the day unit here. It would be just where you would go if you had concerns that were slightly more than you would go to your midwife for but not enough that you would need to go to the labor ward for. Meagan: Kind of in between? Shannon: Yeah. Here, you have a midwife who is assigned to your GP surgery, your doctors, and they are usually who you see throughout. It’s supposed to be a continous midwife, but it can chop and change. You don’t see that midwife usually in the hospital so you deliver with someone completely different. Meagan: Oh, okay. Shannon: Yeah, so you don’t get that continuity of care in labor. So I went to the day unit because I was having some hip pain. It was really difficult to walk and because I was overdue and I was already booked in for an induction purely because I was overdue, they brought my induction forward. I think I was 8 days overdue when I went in. I was induced. I had the pessary induction and it worked pretty quickly. It worked within about an hour, an hour and a half. Meagan: Oh wow. Shannon: They didn’t believe me. They told me that it couldn’t happen that quickly. Meagan: That’s not super normal but it can happen. Shannon: They sent my husband home and left me on my own for three hours before they summoned me. I was 5 centimeters which is when they take you over to labor ward. I was wheeled over. I called my mum and my husband. Then it’s kind of a bit fuzzy. I don’t remember a lot from his birth. I remember that they broke my waters and there was meconium. They put the monitoring clip on his head. Meagan: The FSC, the fetal scalp electrode? Shannon: Yes. They put that on him and I was managing fine on the gas and air. Meagan: Was it nitrious? Shannon: Yes, yeah. Meagan: Okay. Shannon: Yes, the gas and air. It was about 3:00 in the morning and they told me that the anesthetist was going home and if I wanted an epidural then that was my last chance. I felt pressured so I got the epidural. All stalled from there. I didn’t move off the bed. I think I got to 10 centimeters at 10:00 the next morning so I’m now 9 days overdue. I pushed. Nothing happened. They wheeled me to theatre. I think I started pushing at 11:00 and he was born at half 12:00 so lunchtime. He was a big baby. He was 9 pounds, 13. Meagan: Okay. 08:31 Second pregnancy and scheduled repeat CesareanShannon: That was that. I recovered and didn’t think anything of it. 18 months later, we decided to have our second. I fell pregnant I think within the first month. It happened quite quickly. I did my research. I wanted a VBAC. I actually got signed off for an HBAC.Meagan: Home birth? Shannon: Yep. It was all going fine. Then I got to 32 weeks and I panicked because my mom is our only childcare and she lives about an hour. I didn’t know how quickly I would labor because I had never labored spontaneously. I didn’t know what was going to happen. So I booked a routine section. That was booked for 39 weeks. At 38 weeks and 3 days, I went into again, the day unit because I had reduced movements. They put me on the monitors and his heart rate was quite erratic. It wasn’t settling. It was either quite high or quite low. There was no middle ground. I think they put me on there for about 4 hours and they just weren’t happy so they brought my section forward to the next day. Meagan: When I read your note, I’m like, I don’t know why, but that got me. If baby’s heart rate is that erratic and they are that concerned, it would be that day and then. Shannon: Yep, but they were happy for me to go home and come back the next day. Meagan: Yeah. Yeah. It’s just convenience. It seems, I am not going to say, but it seems like it was more of like, Well, it’s already going to happen so we will make it for tomorrow. We’ll give you this as a good reason why to validate it. Shannon: Yeah, no I agree now. At the time, I don’t think I thought about it like that. Meagan: Of course not, no. Shannon: Yeah, because with my fourth, with my VBAC, I went through a lot of what happened before. I definitely think it was a case of they didn’t want me to come back with more reduced movements and just sit there so because the section was going to happen anyway, they just thought– Meagan: Mhmm, let’s do it. Let’s move it up. Shannon: Yes. He was born at 38 and 4. He was 10 days early and he weighed 8 pounds, 11 ounces. Again, he was quite a good size. Meagan: At 38 weeks, yeah. 10:56 Third pregnancyShannon: So then we decided to have a third. It took us a long time to get pregnant with her. It took us 14 months which was our longest conception. Our first one was four months and then a month so it took a while. She was due the 11th of April, 2020. I got to, I think it was about 30 weeks when talk of the pandemic was rolling in. We were like, Oh, it’s fine. We don’t need to worry about it. And then it all blew up. I had to go to midwife appointments alone, the hospital scans alone because I had to have growth scans because my babies are big. Everything was fine. I did want a home birth again with her, but they kept me waiting. I wasn’t signed off until 37 weeks. They kept me waiting a long time to sign me off for that, but it was all signed off and we were good to go. I was feeling good despite the pandemic because we were in lockdown by the time she was due. I think the lockdown was called a month before she was born. Lockdown here for the first time was called on the 23rd of March and she was born on the 23rd of April. I remember I went into hospital and I had a growth scan at 40 weeks. She was absolutely fine, no issues. She was measuring fine. The water levels were fine. The placenta looked good. They gave me a sweep and sent me on my way and said, “I don’t think I’ll see you next week. You’ll have this baby by the weekend.” It didn’t happen. I got to 41 weeks and I went back for another routine growth scan. I remember going in the car on my own obviously and I felt good. I thought that they were going to say that everything was fine again and that they were quite happy for me to just carry on. It didn’t go like that. I should probably mention that my hospital’s policy is that if you haven’t had your baby by 41 and 4, so 41 weeks and 4 days, they either induce you or they give you a section. That’s their policy. I had this growth scan at 41+3. I went in, had this growth scan, and I was on my own. I didn’t have any support. It was about 3:00 in the afternoon. She scanned me. In a week, my placenta had aged. It calcified and it was failing. Those were the reasons she gave me that she needed to get my baby out the next day. She gave me the pre-op swabs. She took my blood and she basically told me to come back the next day at 11:00. I had no time to prepare. I had no time to research. I had no time to ask questions. It was, “This is what’s happening. You’re going to do it.” Meagan: See you tomorrow. Shannon: Yep, basically. Meagan: Was baby’s heart rate struggling? Shannon: No, she was fine. Meagan: She was fine. Shannon: She was fine. There was no reason at all. Meagan: That’s interesting. Okay. 14:04 A heartbreaking third CesareanShannon: Then it was a mad dash too because I am the only driver in my house. My husband doesn’t drive. Obviously, having a section means we can’t go anywhere. Meagan: Yeah, and during the pandemic on top of all of it. Shannon: Yeah. It was a mad dash that night to get enough food in. House deliveries were like unicorn dust so to get enough food in, I had to arrange childcare with my mom. Otherwise, I was delivering alone. Again, she still lives an hour away in a different county. We were sure what the rules were because here, you weren’t allowed to cross county lines. Meagan: Oh no way. Shannon: Yep. It was difficult. She did come up and she did look after the boys. I did see her before I went into delivery, but I didn’t see her again until baby was 6 weeks old. She had gone home by the time I came home so that was difficult. I went in. I think I got to the hospital at 11:00. I was pulled down to theatre at 2:00 and baby was born at 3 minutes past 3:00 in the afternoon. She weighed 9 pounds, 4 ounces, so again, she was a good size. I got back to the recovery ward. My husband stayed with us for an hour and then he left. He wasn’t allowed to come back. I still had my catheter in. I was still numb. My phone was dead and I was just left because I couldn’t get anything. Every time you had to call a midwife in, they had to put in new PPE on and it just took so much longer. I didn’t get wheeled around to the actual recovery ward until about 1:00 in the morning. They admitted to me that they had forgotten about me. I was just in this room on my own. Meagan: I’m so sorry. Shannon: Yeah. They wheeled me into recovery. I still had the catheter in. That didn’t come out until 7:00 the next morning so I was bed-bound with this new baby. They came around and took my observations. My temperature was raised which is normal after a section, but I was told that I might have COVID, that my baby might have COVID. I would need to be separated from my baby and we wouldn’t be able to leave the hospital for 3 days. Meagan: Stop it. Shannon: No, honestly. Meagan: I am feeling very frustrated for you right now and very saddened. Yeah. I feel a little enraged because this shouldn’t have happened. These things didn’t need to happen to people. Shannon: I know and the more that I talk to other people who have had babies during the pandemic, it’s not unusual either. Meagan: No, it’s not. It’s maddening. Shannon: It is. It’s strange now to talk about it without either filling up or actually crying because it has taken me a long time to get to this point. Meagan: To process. Shannon: Yeah. She said she would come back in an hour. I remember, obviously, I had my catheter in so I didn’t have to get up and go to the toilet. I was just downing water trying to get my temperature down. She came back at 4:00 and I did get my temperature down because I didn’t have COVID. It was a strange experience. There were six beds in this ward, but I was on the end bed and there was a woman diagonally to me and there was a woman two beds over and that was it. There was no one else there. It was eerie. It got to the point where I couldn’t do it anymore so 26 hours after my baby was born, I discharged myself and I went home. I was not staying in there any longer. 17:42 Postpartum during COVIDShannon: Even after that, I got home and I spent the first week in tears. Motherhood wasn’t new to me. She was my third baby, but giving birth during a pandemic was a completely different experience. I don’t know what it’s like over there, but here you have a midwife check in at day 3 and day 5 and then you get signed off at day 10 by the midwife then you get sent to a health visitor who then looks after you until your baby is about 5 then they go to school. Meagan: Wow, I like that. We do not have that. We are just told, “We’ll see you in 6-8 weeks. See ya.” Shannon: Oh. Meagan: Then you just go home. Yeah. It’s very different for a lot of home-birth people, but that’s how the hospital is. It’s like, “We’ll see you in 6-8 weeks and we’ll see you then.” That’s really it. Shannon: That’s interesting. I didn’t know that. Meagan: Yeah. It’s not great. Shannon: No. So on day 3 and day 5, I had to go to a clinic. They usually go to your house especially if you’ve had a sec…

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    Episode 307 Dr. Christina Pinnock + High-Risk Situations & What They Mean for TOLAC Jun 10, 2024
    Show notes

    Dr. Christina Pinnock is a Maternal Fetal Medicine Specialist/Perinatologist based in California and creator of the ZerotoFour Podcast. She is here to help us tackle topics like what constitutes a high-risk pregnancy, lupus, preeclampsia, HELLP syndrome, gestational diabetes, fibroids, and bicornuate uteruses and how they relate to VBAC. The overarching theme of this episode is that all pregnancies are individual experiences. If you are hoping to achieve a VBAC and you have pregnancy complications, find a provider whose goals align with yours. By ensuring that your comfort levels are a good match, you are on your way to a safe and empowering birth experience!Dr. Pinnock’s Website and PodcastNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 00:58 Review of the Week03:13 Dr. Christina Pinnock03:56 Importance of a VBAC-supportive provider06:36 High-risk pregnancies11:02 Lupus and TOLAC14:31 Preeclampsia 17:19 Varying ranges of preeclampsia20:46 HELLP Syndrome 26:36 Other High-risk situations 27:54 Gestational Diabetes35:00 Inductions with gestational diabetes42:25 Fibroids 46:33 Do fibroids tend to grow during pregnancy? 51:20 Bicornuate UterusMeagan: Have you ever been told that you were high risk, so you’ll be unable to TOLAC? Or maybe you can totally TOLAC assuming nothing high-risk comes into play? What does high risk mean? We often get questions in our inbox asking if having your previous cesarean makes them high risk. Or questions about topics like preeclampsiaclampsia, gestational diabetes, bicornuate uterus, fibroids, and more. I am so excited to have board-certified OB/GYN Dr. Christina Pinnock on the show today. She is a high-risk pregnancy doctor passionate about educating women along their pregnancy journeys so they can be more informed and comfortable during their pregnancy. She is located in California and has a podcast of her own called “ZerotoFour” where she talks about topics that will help first-time moms prepare for, thrive, and recover from pregnancy as well as shares evidence-based information and answers everyday questions like we are going to discuss today. 00:58 Review of the WeekMeagan: We do have a Review of the Week, so I'm going to jump into that and then we can dive in to get into these fantastic questions from Dr. Christina Pinnock. Today’s reviewer's name is Obsessed!!!! It says, “The best VBAC and birth podcast. I am grateful to have discovered Meagan and this podcast. I definitely believe listening to stories of these amazing women and their parent’s course helped me achieve my two VBACs. Thank you for all you do The VBAC Link.”Oh, thank you so much Obsessed!!!!! And as always if you wouldn’t mind, drop us a review leave us a comment and you never know, it may be read on the next podcast. 03:13 Dr. Christina PinnockMeagan: Okay, Women of Strength. I am seriously so, so excited to have our guest here with us today! Dr. Christina, is it Pinnock? How do you say it? Dr. Pinnock: Yes that’s perfect.Meagan: Ok, just wanted to make sure I was saying it correctly. Welcome to the show! You guys, she is amazing and has been so gracious to accept our invitation here to today to talk about high-risk pregnancy and what it means. Hopefully, we’ll talk a little bit about gestational diabetes because that's a big one when it comes to VBAC. And if we have time, so much more. So welcome to the show and thank you again for being here.Dr. Pinnock: Thank you so much for having me, I'm excited to be here and chat with you and your audience about these great topics, so thank you.03:56 Importance of a VBAC-supportive providerMeagan: Yes! Okay well, this isn’t a question we had talked about, but I’m curious. Being in California, do you find it hard to find support for VBAC or do you find it easy? I mean, California is so big and you’re in Mountain View. So I don’t know exactly where that is. You said the Bay Area, right? So how is it in your area? How is VBAC viewed in the provider world in your area?Dr. Pinnock: Yeah, that’s a good question. I actually did most of my training on the East Coast, so it’s been a good experience seeing the differences in coastal practices. I think where I did my training we were pretty open to VBACs and supported them. In California, I’ve had a similar experience and I think it really depends on where you are. I’m in the San Francisco Bay Area and I work at an institution where we support TOLACs and want our moms to VBAC as long as it’s safe and it’s what they desire. But I really think the opportunity to TOLAC depends on your individual OB provider that you have and their comfort in offering that. And importantly, the hospital resources that you have available in your area. California’s huge and depending on where you live it can be a very, very different infrastructure both geographically and specifically within the hospital. And so I really think that differences in that offering is based around those resources rather than maybe patient desire or even sometimes provider desire. So it really just depends on those things. Meagan: That’s so good to know. I mean, we tell our community all the time that provider is a really, really big key when it comes to being supported. But also I love that you were talking about the actual hospital because for me with my second– I had a VBAC after 2 C-sections and with my second, my provider was 100% gung-ho and super supportive. But in the end, I ended up switching because the hospital was going to end up restricting my provider in supporting me in the way he wanted to support me, right? So it’s also really important to vet your location and your hospital.Dr. Pinnock: Yes, absolutely. Sometimes, someone may live in a location where they don’t have that choice, unfortunately. If you do have that choice and you can choose hospitals and providers that can support it, by all means if you have that ability. 06:36 High-risk pregnanciesMeagan: Absolutely. Ok well, let's dive in more to high-risk. So a lot of the time, I'd love to see what you think about this. A lot of the time, providers will tell moms because they’ve had a previous Cesarean, not even a special scar or anything like that, that they are automatically grouped into the high-risk category. So I don’t know what your thoughts are on that in general, but let’s talk more about high-risk pregnancy. What does it mean? What does it look like for TOLAC? How is it usually treated? And are there often restrictions given for those moms? Dr. Pinnock: Yeah, no. That’s a really good question. One thing about pregnancy, there’s some level of risk in all pregnancies. No matter if you're completely healthy, no medical problems, or you're trying to TOLAC, or you have other medical conditions that exist before pregnancy, all pregnancies carry some level of risk but not all the risks are equal. There are some conditions that the mother can have before pregnancy that can put her pregnancy at a higher risk of developing some complications. There are some conditions that can actually develop during pregnancy that can cause the pregnancy to be at a higher risk of developing complications. Lastly, there are some conditions specific to the placenta, the baby, how the baby developed, or even the genetic makeup of the baby that can contribute to a high risk of having complications. All of these three categories can impact the status of your pregnancy being considered high-risk. So typically, if you have a condition that falls in one of those three boats, then your pregnancy could be considered a higher risk. Usually having a previous C-section or even two previous C-sections by itself is not really something that I would use to classify someone as having a high-risk pregnancy. I do think that definitely talking with your provider about your desire for delivery earlier on can help both people to be on the same page, but if you otherwise have nothing else going on in the pregnancy and you have one previous C-section or even two previous C-sections, I think the pregnancy itself, I wouldn’t consider it a high-risk pregnancy. Meagan: That’s good to know. Dr. Pinnock: Yeah no, absolutely. And when you think about the delivery, I think about it a little bit differently than the pregnancy. I think for the delivery if you are interested in having a TOLAC and you have a previous C-Section or two, then the management of your delivery and the risk of your delivery isn’t the same as someone who hasn’t had a C-section. I think about them as like two different boats. But overall, conditions that are related to maternal health can be high blood pressure, diabetes, and autoimmune conditions like lupus. Those things can cause your pregnancy to be considered high-risk. A good example of a few things that can develop in pregnancy that can make your pregnancy high-risk include things like preeclampsia which is high blood pressures of pregnancy. Having twins or having triplets can make your pregnancy a higher risk. In some instances, even gestational diabetes depending on what’s going on and where you are can be considered a pregnancy with some high-risk features. And then genetic conditions for baby whether that’s a difference in how one of your babies’ organs developed, or a genetic condition that’s discovered from testing; any of those things can really impact that high-risk status and how your pregnancy will be monitored and managed after that. Meagan: Ah these are all such great topics and actually things that we get in our inbox. Like, “Hey, I have lupus,” or we’ll have one of our VBAC doulas say, “Hey, I have a client who has lupus. She really wants to TOLAC and have a VBAC. What does that mean for her?” Obviously, all of these conditions are going to be treated differently throughout the pregnancy and probably even during the labor and delivery portion. 11:02 Lupus and TOLAC Meagan: I don't know if we can touch on a couple of those like lupus. What does that look like for someone? If I have lupus coming in, I’m doing okay right now. I have it. What does that look like for someone wanting to TOLAC and to have a VBAC?Dr Pinnock: Yeah. I think it’s similar to your first question about whether a C-section would make your pregnancy considered high-risk. So the lupus diagnosis would increase the risk of certain medical conditions happening in pregnancy relating to both mom and baby. Your doctor may get some extra blood work to monitor how your lupus is progressing in pregnancy. Your doctor may get some extra ultrasounds to make sure that baby isn’t too small and add some extra monitoring to make sure that baby is staying safe and that if there is a risk for baby to be in distress that that is picked up. And so the actual monitoring and management of the pregnancy is usually done with the help of a high-risk pregnancy doctor like myself with an OB provider. That is really specific to what is going on with that person. If everything goes smoothly and lupus stays under control and we get to the moment where we’re thinking about how we’re going to deliver baby, that’s sort of a separate boat. In an ideal world, everything goes well in terms of the lupus and pregnancy and if you’re interested in having a TOLAC, having a diagnosis of lupus should not restrict you from that option. You can still have that as an option but it really just depends on the specifics of how your pregnancy has unfolded. Have you developed any other conditions like high blood pressures in pregnancy or preeclampsiaclampsia where your doctor is maybe thinking you may need to deliver earlier? Are there things going on with your baby where we think baby is under more stress where we would really need to be very intentional about how we deliver baby? It’s a really nuanced thing and it’s based on the specifics on that person’s condition. I think an overarching theme is whatever is going on with the pregnancy that impacts the delivery if things are not going as smoothly. But if things are going smoothly and you want to try for a TOLAC, that’s not necessarily a reason to say, “No, you absolutely can’t do this,” unless there are specific conditions that came up in your pregnancy that make it less safe for either you or baby as the mom. Meagan: Yeah. Something that I’m just hearing you say so much that’s standing out is that really is individual, depending on that individual and depending on that individual’s case. I think that’s something important for listeners to hear because someone who may have lupus that’s going really, really fine, TOLACs going to be a really great option for them. But someone who may have active symptoms and it’s going and it’s really hard, that may be a different suggestion in the end. But I like that you’re like, We’re in this boat and then we travel over to this boat into this time, and then it’s a matter of how we float that boat and how we get to our destination.Dr. Pinnock: Exactly.14:31 Preeclampsia Meagan: Would you say that the same thing goes for preeclampsia? Preeclampsia can develop at any stage of pregnancy. I mean, we've had clients in weeks 18-20 develop it and then have to be really closely watched and all of these things. Is that someone also where you would say the same thing? Where it’s like, We’re in this boat doing these things and these tests and monitoring, and then again we get into this next boat and we have to decide what the best route is?Dr. Pinnock: Yeah, no. That’s a good question. I think it’s similar but a little different with preeclampsia. It depends on the type of preeclampsia that’s going on. Preeclampsia is a spectrum and with the part of the spectrum that’s more on the severe side, we still try for a vaginal birth. It really depends on, as you’ve mentioned, how far along you are in the pregnancy.Maybe you are 28 weeks and you have such a severe form of preeclampsia that your doctor is like, “I don’t think we can get any more time with the pregnancy,” that’s a very different situation than someone who has a very non-severe form of preeclampsia at 39 weeks who wants to TOLAC and have all of those options available. It really does depend but the overall theme with preeclampsia if you do want to try for a vaginal birth and your health and baby’s health are stable in the moment, then usually we do try as much as possible to have a vaginal birth. But things like very early gestational age and really severe complications of preeclampsia make the possibility of having a vaginal birth less likely. It makes the possibility of someone who wants to TOLAC in that setting less likely. It really depends on the severity of that spectrum of preeclampsia, but we always try for a vaginal birth if we can. Meagan: Yeah. This may be too hard of a question to answer, but can we talk about that range and the severity? What does a low to moderate to severe case of preeclampsia look like in a person? What would be considered that severe, “Hey, we might need to reconsider our birth desire here,” to “Hey, you have it. It’s really low right now,” or to “We’re in choppy waters right now.”17:19 Varying ranges of preeclampsiaDr. Pinnock: That’s a good question. Pre-e is defined as elevated blood pressure in pregnancy after 20 weeks. So once you hit 20 weeks, if your blood pressures are elevated, 140/90 times multiple times and we see any evidence of preeclampsia’s impact in some organs in your body.One of the most common things that we used to use to diagnose is the presence of protein in the urine. Once we see that, we’re like, “Oh, man. I think you may have preeclampsia,” then we do an evaluation of the rest of the body to understand how severe it is. Preeclampsia is a disease that’s thought to develop from the placenta when it implanted. It can cause dysfunction or impact on the organs. It can cause severe headaches. It can cause changes in your vision and problems with your blood cells, your liver, your lungs, and you…

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    Episode 306 Kelsey's Birth Center VBAC + Talk About Forceps Jun 05, 2024
    Show notes

    Our friend, Kelsey, shares with us today what giving birth is like in Canada. From moving and traveling between provinces, Kelsey had experienced different models of care and when it came time to prepare for her VBAC, she was very proactive about choosing a birth environment where she felt safest. From a scary Cesarean under general anesthesia to an empowering unmedicated VBAC in a birth center, Kelsey’s journey is entertaining, beautiful, and powerful. We love hearing the unique details of her story including giving birth at the same time as her doula just in the next room over! The personalized care she was given during her VBAC is so endearing and heartwarming. As her husband mentioned, it should be the gold standard of care and we agree! The VBAC Link Blog: Assisted DeliveryFetal Tachycardia in the Delivery RoomIs There Still a Place for Forceps in Modern Obstetrics?Forceps Delivery ComplicationsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 07:36 Review of the Week09:27 Kelsey’s stories11:47 Logistics of giving birth in Canada14:38 A normal pregnancy17:50 Arriving at the hospital21:37 Stalling at 7 centimeters26:22 Asynclitic and OP positioning29:31 Kelsey’s Cesarean under general anesthesia34:50 Second pregnancy and VBAC prep41:07 Switching to midwives46:14 Beginning of labor51:07 Driving to the birth center54:49 Pushing baby out in two pushes1:00:24 Differences in care1:02:11 Enterovirus1:08:02 Risk factors for forceps and vacuum deliveriesMeagan: Hello, Women of Strength. We have our friend, Kelsey, from Canada. Is that correct? Kelsey: Yes. Yeah. Meagan: She’s sharing her story with you guys today. Something about her first story of her C-section that stood out to me was that she had a forceps attempt that didn’t work out. Sometimes that happens. I want to talk a little bit about forceps here in just a minute before we get into her story. Kelsey, I wanted to ask you that this is something that in our doula practice we will ask our clients. If it comes down to an assisted birth with forceps or a vacuum, what would you prefer? It’s a weird thing because you’re like, Well, I’m not planning on that, but a lot of people actually answer, “I would rather not do those and go straight to a C-section.” Some people are like, “I would rather do every last-ditch effort before I go to a C-section.” Did you ever think about that before? Had it ever been discussed before as their style? That’s another thing. Some providers are really vacuum-happy. Some are really forceps-happy. I know it’s a random question, but I was just wondering, had you ever thought of that before going into birth? Kelsey: So no. I didn’t think about whether I wanted a C-section or a forceps delivery. However, I was really staunchly against having a C-section. That was primarily nothing against it, it was just that I have a really huge fear of awake surgery so with my forceps attempt, the OB who was there because it wasn’t my provider. That’s not the way Canada works. The OB who was there who was called in said, “Are you sure you want to do forceps? You could tear.” I told her, “I would rather tear than have a C-section.” That was just a personal preference for me because I was so terrified of having a C-section. Meagan: Yeah. I think that is very common and very valid to be like, “No, I would rather try this.” Kelsey: Yeah. Meagan: So I did. I wanted to go over just a little bit. I mean, I have seen a couple of forceps and they are not happening as often these days, but there was an article that said, “Is there still a place for forceps delivery in modern obstetrics?” I’m trying to say obstetricians and obstetrics. We’re just going to stop. Kelsey: We know what you mean. Meagan: You know what I mean. There was an article and I was like, That’s a really good question, because I think a lot of people think they shouldn’t be done anymore or a vacuum shouldn’t be done anymore either. It talked a little bit about the background. it says, that nowadays we are seeing a decrease in instrumental deliveries and a continuous increase of Cesarean rates. That makes me wonder if we were to increase vaginal and help instrumentally if that would decrease, but one of the things that I thought was interesting is that it says, “The prevalence of forceps delivery was 2.2% and the most common indication for a forcep delivery was fetal distress.” It is very common where it’s really, really close, baby is struggling. Baby is so low and let’s get baby out. That’s 81.6% which is crazy. It says, “Among mothers, the most frequent complication is vaginal laceration,” which means we have tearing at 41% and third and fourth-degree perineal tears were noted. It says, “Regarding neonatal APGAR scores, around 8 around the first and the fifth minute,” which is around 91.2% and 98% of newborns which is pretty great. An 8 APGAR is pretty great. I think a lot of people worry about that. It says, “8.8% experience severe birth injuries like hematomas and clavicle fractures.” Those are probably shoulder dystocias. That’s probably why they were having. It says, “Although fetal distress is the most common indication for forceps delivery, the vast majority of newborns were actually in good condition and didn’t require NICU care.” That’s something that was kind of cool. Obviously, there are a ton of more studies and deeper studies on that. This was just one, but it was kind of interesting. It was like, all right. That is a good question to ask as we are preparing for VBAC is hey, if for some reason a forceps or a vacuum is necessary, that’s something to think about. What do we want to do at that point? I love how you were like, “Yeah, I didn’t want a C-section. I feared that more than I did that.” Anyway, getting off that topic now so we can get this review and get on to your story but I think it’s a topic we don’t talk about and it’s not something that we are thinking about so as you are preparing, Women of Strength, for your VBAC, it might be something that you want to discuss and learn more about both vacuum and forceps and discuss with your provider what their tool of choice is and just have that in the back of your mind. 07:36 Review of the WeekMeagan: Okay, so onto today’s review. It is from laurenswat and it was back in 2023. It says, “Thank You.” It says, “I listened to as many episodes as possible when preparing for my VBAC. The stories on here were so encouraging to me and Meagan is so knowledgeable and reassuring. I am happy to say that I had my unmedicated hospital VBAC last week and I caught my own baby before the doctor even got in the room.” Oh my gosh, that is awesome. Seriously, catching your own baby is so amazing. I loved it personally myself as well and highly encourage it to anyone that is sort of interested because it is a really cool feeling. Thank you for your review and as always, we are looking for reviews. It is what helps people find this podcast. It helps us grow as a community. You can leave it on Apple, Google, email us, or whatever but we are so grateful for your reviews. 09:27 Kelsey’s storiesMeagan: Okay, Kelsey. Kelsey: Yeah? Hi. Meagan: Hello. Welcome to the show. Kelsey: Thank you. I’m super, super excited. Meagan: Me too. Me too. I would love to turn the time over to you. Both of your babies were born in Canada. That’s correct, right? Kelsey: Yes. Yeah. Meagan: Tell us the story. Kelsey: Yeah, so basically my husband and I got married in November 2019. Just prior to that, we had actually been living in New Brunswick. Just prior to getting married, we decided to move back because we are from Ottowa. We moved to Ottowa. We were living with his parents, his dad, at the time. We went to Mexico for our honeymoon and on our honeymoon, we decided to start trying to have a baby. We decided to start trying but not preventing it because we weren’t sure how long it was going to take and there was no indication that it could take a while but my husband is actually an IVF baby. It had taken 7 years for his parents to conceive him. Meagan: 7 years, wow. They are amazing. That’s a long time. Kelsey: He was actually their last attempt. When his mom got up to say our wedding speech, she was like my 1 in 7 or something like that and I was just bawling. So because of that, we decided to start trying and not preventing but there was nothing indicating it would take us a while. We started trying in December of 2019 and it just wasn’t happening for us so around the year mark, we had a lot of friends who started trying around the same time as us and were getting pregnant really, really quickly. I was going to so many baby showers and crocheting baby blankets that just weren’t for my baby. Actually, the year mark rolled around and I got my period the day of. My best friend gave birth the day of. I was trying so hard to be happy and stay positive and whatnot, but it was devastating. 11:47 Logistics of giving birth in CanadaKelsey: We ended up being referred to a fertility clinic. They did a full work-up on both of us and there was nothing. They didn’t come up with anything. So they said, “You could keep trying or we could start IUI.” My husband and I said, “Let’s do 3 more months of trying on our own, and then we will try for IUI.” Our fertility clinic was in Ontario and we ended up moving to Gatineau, Quebec in July 2020.The way it works in Canada is you have your healthcare which covers. You can go inter-provincially and give your card unless you are from Quebec. If you are from Quebec, it’s kind of like living in another country. If you have a RAMQ card, you actually have to pay for your care in Ontario. The Quebec government will reimburse you but only for 30%. It’s super weird. If you are from Ontario and go to Quebec, the Ontario government will cover you in Quebec. Meagan: What? So weird. This world is so weird. Kelsey: I know. It’s super bizarre. So essentially we moved to Gatineau because the housing market was a little less expensive. I was working in Gatineau at the time as a teacher. I was extremely stressed out in my job especially once COVID hit. We were sent back to the classroom before any of the other provinces were. Anyway, I was extremely stressed out in my job and I decided to switch to the Ontario side because you can go between the two. Where I lived, you cross a bridge and you can get to Ottawa so you are in Ontario. Essentially, we went through the fertility clinic. They said that nothing was going on but because the Gatineau government will cover you for IVF and any fertility treatments up to a certain price so we had to be referred back to Quebec for IUI. The month that we were referred back to Quebec for IUI, it was the day before my appointment that I found out I was pregnant. Meagan: Oh my gosh, yay! Kelsey: Yeah, on our own. It super just happened and some weird funny things happened. The day before, my husband and I went for a walk around our neighborhood. I found a quarter and was like If pennies are lucky, then quarters must be super lucky. I picked up the quarter and put it in my pocket and the day after, I found out I was pregnant. These weird things kept happening. My pregnancy made me oddly psychic too which I’ll get into after. 14:38 A normal pregnancyKelsey: I got pregnant in March. I was due November 28th. I had a super easy pregnancy. I was nauseous for the first little bit. I was working for a virtual school in Ontario so I didn’t have to go into the school which was really nice. I just got to hang out in my basement and yeah. I mainly had nausea as a symptom but I was also extremely anxious because it had taken us so long to get pregnant. It felt like it was so long. It was about 15 months. I was super anxious. I had heard so many stories of miscarriage and whatnot, but luckily, we were followed by the fertility clinic because we were with them so we had a scan at 5 weeks and we had a scan at 8 weeks and then at 12 weeks once we graduated which was really nice. It was a really, really normal pregnancy. I ended up going back into the school in September and I was working as a French teacher. I went off work at 36 weeks. It was pretty normal. The reason I say that I was psychic during my pregnancy is that I kept saying all of these things about my baby. I had this gut instinct that he was a boy and sure enough, it was a boy. Mind you, it’s because my husband’s family only really has boys but then with certain things, people would say, “When do you think he will be born?” I’d be like, “Oh, I think December 4th.” I would make off-hand comments like, “Oh, he’s going to have really dark hair.” My husband and I were both born at 5:00. I was born at 5:00 at night. He was born at 5:00 in the morning. I said, “Wouldn’t it be funny if he was born at 5:00?” I said, “He’s going to be over 9 pounds. I can just feel it. He’s going to be 9 pounds.” Then the other weird thing is that I said he would be born December 4th, but someone told me, “No, you don’t want him to be born on December 4th. He will share a birthday with your cousin.” I was like, “Okay, December 3rd.” December 3rd rolls around and I am 5 days past my due date. I wake up in the morning to go to the washroom and my water breaks. I had not been well-informed about birth. I was just going into it like, Yeah. Everything is going to be fine. I had a bunch of friends who just had babies and everything was smooth sailing. The only time I had heard of a C-section was when my aunt had two C-sections because she had a breech baby and a special scar and then they didn’t give her an option for a C-section. I was like, Oh yeah. It’s going to be fine. My provider told me, “If your water breaks, go straight to labor and delivery.” Meagan: Many do, by the way. Kelsey: Yes, I do know that. Meagan: It’s a very normal thing for people to say, but we don’t have to do that. Kelsey: Exactly. Meagan: I did the same thing, the same exact thing. 17:50 Arriving at the hospitalKelsey: Yeah, so we went into labor and delivery. Actually, we went slowly. My husband was like, “I’m going to take a shower.” I was under the impression that baby was going to be born in a couple of hours. I was like, “We’ve got to go.” He was like, “No, no. I’ve got to take a shower. First impressions are important.” I was like, “All right.” Then we went and we got Tim Horton’s because I was super hungry. I figured This will be the last time I eat.We got to labor and delivery. They monitored me for two hours and I didn’t have a contraction until 6:00 right as I was leaving and I was only a centimeter dilated. She was like, “Come back in 12 hours or sooner if your contractions get intense.” So I went home. I decided to go to sleep but I was having irregular contractions. I woke up probably around noon and I was starting to get uncomfortable. My contractions were starting to get closer together and they were more intense. I could feel them in my back and in my bum. I learned a lesson. Anyway, I’ll get into that after. I could feel them mostly in my back and in my bum. My husband was like, “You look like you’re really uncomfortable. We need to go to the hospital now.” He was afraid of getting stuck in traffic because I ended up giving birth in Ontario even though we lived in Quebec. The reason is the hospital I gave birth at actually takes your RAMQ card, the Quebec healthcare card so we weren’t going to be charged for it or anything. The Gatineau hospitals are not known for being super well-equipped for much so we preferred to give birth in Ontario. We drove to Ontario which was a 30-minute drive so not super terrible, but traffic can be bad going across the bridge sometimes. The whole way there, I had really uncomfortable contractions. We got to the hospital and the doctor had me in the waiting room for 30 minutes, not terrible. The doctor meets with us and immediately, I just was not into him. He just put me off. He made an off-hand comment about nurses. He was l…

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    Episode 305 Perinatal Fitness with Gina Conley from MamasteFit Jun 03, 2024
    Show notes

    The amazing Gina Conley from MamasteFit joins Meagan today to answer your questions all about perinatal fitness! Gina is a birth doula, perinatal fitness trainer, and founder of MamasteFit. ​​In partnership with her sister, Roxanne, who is a labor and delivery nurse and student-midwife, MamasteFit is a place for women to find education courses and fitness programs to be their strongest selves during each stage of motherhood. Gina shares her expertise on how exercise affects babies during pregnancy, labor, birth, and postpartum. She also touches on topics like when to start prenatal exercise, what to do if you didn’t exercise before pregnancy, how late into pregnancy you can exercise, weightlifting, and which movements to incorporate to create more space in the pelvis. Gina’s comprehensive prenatal fitness book, Training for Two, will be released in September 2024. It is a fantastic resource for all pregnant women!Link to Gina's Book: Training for TwoMamasteFit WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:00 Review of the Week03:59 Is it bad to exercise during pregnancy? 09:00 How will exercise affect my baby’s development? 13:40 Better pregnancies, better birth outcomes16:23 What do I do if I wasn’t active before pregnancy?19:30 Movements to incorporate20:59 Three pelvic levels 23:19 The mid-pelvis and outlet25:56 Being told that your pelvis is too small30:36 How late in pregnancy is okay to work out?32:31 When is it too late to start exercising during pregnancy?34:43 Postpartum fitness39:20 Weightlifting and pregnancy45:51 Training for TwoMeagan: Hello, everyone. Welcome to the show. We are going to be talking about prenatal fitness today with the one and only Gina Conley. Gina is the founder of MamasteFit, a prenatal fitness training company based out in North Carolina. Gina is a fitness trainer specializing in pre and post-natal fitness and a birth doula. She combines her expertise in both to prepare her clients for a strong pregnancy and birth. Fitness in general is one of my all-time favorite things to do and talk about. I do notice a difference when I’m not moving my body, but when it comes to pregnancy, there are a lot of questions surrounding fitness. Is it safe? When is it okay to start? Is it really okay to start later on? How to start? And so much more. I can’t wait to dive in on all of the amazing information that Gina is going to share after the Review of the Week. 01:00 Review of the WeekMeagan: Just a reminder, if you have not left a review, I would love for you to do so. You can leave a review on Apple Podcasts, Google, Spotify, Facebook, or wherever you listen to your podcasts. Today’s review is by Janae Rachelle. It says, “The Best There Is.” It says, “I am so happy I found this podcast. After having two prior C-sections, I was convinced I would have to have another C-section for my birth this November. I feel empowered and educated and hopeful I can do this. Thank you for all of the true facts and the safe space where we can all talk about our birth trauma and space where we don’t sound ‘crazy’ for wanting to do something God created our bodies to do.”Thank you, Janae Rachelle, for leaving that review. You are right. This is that space. This is the space where we do talk about all of the crazy things, where we talk about the trauma, where we talk about the things where in the outside world if we were to discuss them, people would and sometimes do look at us like we may be crazy. But Women of Strength, if you are wanting to pursue a VBAC, if you are wanting to learn about the evidence about VBAC, this is definitely the place. All of these stories here are going to share so much information, guidance, facts, and all of the things, and definitely leave you feeling inspired. 03:59 Is it bad to exercise during pregnancy? Meagan: Okay, it’s been so fun. We’ve actually had just a couple of returning guests from the show who have also been on 2-3 years down the road. Before we started recording, Gina was like, “I just had someone say that they listened to my episode that was on your podcast before”, which was 3 years ago. It’s fun to see that people one, are still listening all the way back to 3 years ago and then two, have you back on the show. So welcome. Gina: Absolutely. Thank you for having me. Meagan: Yes. It’s such an honor. You know that I just love you to pieces. I’m so excited to talk about fitness, prenatal, postpartum, and all of the things today because this really is a topic that as a first-time mom, I didn’t really know much about. When I was first pregnant with my daughter who is now 12, I was just determined. I was like, I’m going to run. I’m going to run a half marathon. This is going to be so great. I’m going to be one of those running through with a big belly. I was so excited to be fit and active. Let me tell you, I was the opposite of that. When I was training, I started having round ligament pains and pelvic pains. When I talked to my doctor, he actually told me to stop. He told me to stop which is kind of crazy to me looking back that it wasn’t even just like, “Maybe do less miles or don’t train for a half marathon right now, but do a 5k.” It was just like, “You should just stop. It’s too much.” I don’t know why I took that advice as, Okay, I should stop and I should eat Chinese food every day because orange chicken sounded amazing and I should really just not do anything besides be unhealthy.That’s truly how I felt like I was in my first pregnancy. I don’t think providers all over the world are telling people not to work out necessarily like mine did 12 years ago, but I think that it’s a very daunting topic and we don’t know what to do. I think a lot of people who may not be very physically active before pregnancy are unsure what they can do during pregnancy, if it’s safe, and all of the things. We have a big list of questions today to ask you and really, number one is Is it bad to work out during pregnancy? My easy answer is no, but I think it’s a real answer. Can we talk about that? Working out during pregnancy– is it bad? Is it good? Tell me all of the things. Gina: There is a lot of fear-mongering and fear involved with exercise during pregnancy. There is this really long list of things that you shouldn’t do so it gets really overwhelming to know, Well, what can I do? when the majority of the things that you see are Don’t do sit-ups. Don’t do this. Don’t do that. If you lift weights, you’ll have a miscarriage. A lot of fear that comes with fitness during pregnancy is, Is it going to affect my baby’s development and growth? Am I harming my baby by exercising? And then the second is, Is it going to affect my pregnancy length? Am I going to have a miscarriage or go into pre-term labor because I was exercising during my pregnancy? The answer to both of those is generally no. Just as a disclaimer, there are absolutely complications in which the benefits of exercising do not outweigh the risks of exercising. These are usually folks who have preexisting heart and lung conditions, if you have uncontrolled diabetes, if you are actively in pre-term labor, if your placenta is detaching, or have severe preeclampsia. There are circumstances in which exercising is not safe and your provider should be very clear in communicating that to you. You will probably already have preexisting exercise recommendations if it is a preexisting health condition. But for the majority of us who are of a normal-risk pregnancy, even some high-risk pregnancies, exercise is typically very safe to do. So a lot of research supports that it does not cause miscarriage and it does not affect the length of your pregnancy which is one of the major concerns with exercising. The risk of miscarriage is highest in the first trimester and it doesn’t differ whether you exercise or you don’t. Exercise does not cause miscarriage. It’s just something else that folks like to be blamed for when they do have a pregnancy loss. It was because I went running. It was because I lifted weights. Typically, there is nothing that you could do do prevent that pregnancy loss and it just sucks to be mourning this and then to have this additional guilt put on you like it was because you were lifting weights. There are people who are sedentary and don’t exercise at all and have miscarriages. Are we blaming them that it’s because you didn’t exercise? No, because it’s one of those things that is out of our control. 09:00 How will exercise affect my baby’s development? Gina:The second thing is, is it going to affect my baby's development? Like, is it going to make them too small? Is it going to make them too large? One of the things that can make your baby too small is the placenta. So if the placenta hasn't developed properly or there's an issue or complication with the placenta, it can make your baby too small. Well, exercise helps to improve the function of your placenta, especially if you exercise in the first half of your pregnancy, which is really cool. Your placenta will be more voluminous. It'll be larger and it'll have improved functional capacity. It's going to be able to transfer oxygen and nutrients to your baby much more effectively. It's going to help provide immune function to your baby. It's going to provide hormone function to your baby. It's also going to help remove metabolic waste more effectively. It's going to be a much more efficient organ, which is going to help to support your baby's growth. The second half is like, is it going to make my baby too big? I think most folks are not concerned about exercising and making their baby too big, but exercising could decrease the risk of developing gestational diabetes. Obviously, you can still exercise and eat super healthy and still develop gestational diabetes. It's not a foolproof method to avoid it. But exercising can help reduce your risk of developing gestational diabetes by 39% which is pretty substantial. And if you do develop it, continuing to exercise and eat well can also help to reduce the risk of you needing to get insulin or medication to manage your gestational diabetes. Those are the things that are contributing towards developing a baby that's too large. So having gestational diabetes that's controlled with insulin, uncontrolled gestational diabetes, and those two things can be mitigated with exercise. Exercise can actually help your baby grow more optimally, to have really good body composition, and be a really good size.In addition, which is really cool– and this is stuff that I was researching when I was writing my new book, Training for Two, which comes out in September. I'm really excited about it. I guess it's like the twins in my current pregnancy. Meagan: It’s awesome. Gina: But one of the things that I was researching because our editor was like, “We really need to highlight why exercise is so beneficial for baby because this is something that's going to help motivate people to move their body.” Something for me that has been helping to motivate me during my current pregnancy to move when I'm kind of like, But I don't really feel up to it is one, it helps to improve your baby's nervous system development, which is really cool. It helps to increase their blood volume as well. They have more blood reserve to respond to the stresses of labor and to postpartum after they are infants. When they're in the world, it improves their brain development. They have more cognitive function. And these are all things that are probably in response to the stimulus of exercise. So we're introducing more stimulus to them during exercise because of this controlled stress that we're introducing which is helping to build all these new neural pathways and helping them just start doing things a little bit earlier. What that translates to in the first year of life, they have more motor skill development, so their fine and gross motor skills. They're crawling earlier, they're walking earlier, they're rolling and doing things earlier. They have more cognitive function. That's responding with higher levels of IQ and improved language skills. Meagan: Wow. Gina: So there's a lot of benefit to just being active. It doesn't have to be go and lift super heavy weights. It can just be going for walks every day, doing yoga every day, and doing intentional movement throughout the day is exercise. It doesn't have to be like how I exercise. Then what happens is that even though there are all of these benefits to exercising and fairly little risk unless you have like a complication which your provider will ideally walk you through. Even though there are all these benefits, there's still a lot of fear involved with working out during pregnancy. A lot of it's just outdated guidance and folks. I think it probably relates to the fear of women lifting weights and exercising, too. Maybe it's a little bit of that as well. And then make it somebody who's pregnant and it's just like a double whammy. So we have this mentality of like, Well, it's better to be safe than sorry. And it's like, Well, actually, you can be sorry. You can actually be sorry if you don't move your body intentionally during your pregnancy because one, not that your baby would be less developed, but we're going to say no thanks to those additional development things that they're having with the nervous system and their brain development. Those are two really big deals, I think. We're going to say no to a larger, more functional placenta which really helps to decrease the risk of developing certain complications during pregnancy. We're going to say like, I'm good with increasing my risk of developing like a prenatal complication, which again, exercising does not equal no complications, but it does reduce the risk to include preeclampsia, gestational hypertension, and gestational diabetes. 13:40 Better pregnancies, better birth outcomesGina: And if we have a healthier pregnancy, it's going to serve us better during labor as well or in the preparation for labor. We develop complications. It increases the necessity of a medical induction. It increases the number of interventions that were being used during our birth. And yes, I am so thankful for medical intervention, for C-sections, and for these things that save lives. But if we can use less of them because we're healthier going into our birth, that's going to help improve birth outcomes as well. This is a VBAC podcast. So if you're wanting to have a vaginal birth after a C-section, being healthier during your pregnancy by moving your body intentionally is a really good way to help reduce the risk of needing these additional interventions. I'm thankful for them. But if you don't need them, let's go around that. Let's do that path. Meagan: Let’s avoid them if we can. Absolutely. And let me tell you, talking about my first pregnancy where I just kind of quit, I mean, I didn't even really walk. I mean, not even like a 30-minute stroll at night. I just stopped and I really didn't pay attention to my protein intake or what I was really eating. I mean, I was literally told this at the end that I was unrecognizable. Everything about my body was trying to just make a baby and it was showing in a negative way because I was struggling. I got super swollen. I gained a lot more weight. I really was not in shape. When labor came, it was harder. It was a lot harder. And then postpartum was really hard. And then having to catch up to all the things that I did to my body, but then not even to think about all the things that you just said about the baby. I mean, I was one of those people that signed up to the “no thanks”. I mean, essentially, right? It wasn'…

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