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Today on the podcast, Sarah joins us from Minnesota. Sarah got COVID-19 very early on in her first pregnancy during the height of the pandemic. The protocol at her practice was to recommend a precautionary 39-week induction. Sarah trusted her doctor and consented to the induction along with other interventions that were suggested. Her birth ended in a Cesarean under general anesthesia. During recovery, Sarah’s knees would buckle to the point where she needed assistance walking and fell until the problem slowly resolved. When she achieved her VBAC, Sarah was able to immediately walk unassisted. She wasn’t groggy from just having had anesthesia. Her throat didn’t hurt. She got the immediate skin-to-skin she missed the first time.Sarah is such an amazing example of how powerful a VBAC birth can be, especially with the right prep and the right team. We just love how hands-off and supportive her doctor was. Sarah went into her birth mentally and physically strong. She labored hard, stayed calm, and pushed her baby boy out in 20 minutes!Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsMeagan: Welcome to The VBAC Link. We have a story for you today coming from Minnesota. We have our friend, Sarah. And Sarah, tell me. Did you have your babies both in Minnesota or have you moved since then? Sarah: Yes, both in Minnesota. Meagan: Both in Minnesota. All right, so Minnesota parents, listen up. This is a wonderful episode in your area. Review of the WeekAs always, we have a Review of the week but first I want to talk a little bit about COVID-19. Sarah and I were just talking about how we have seen so many COVID-19 stories coming through. They had their C-section through COVID-19 or even had their VBAC during COVID-19 and then now they have gone on to VBAC. There is definitely a trend of situations that we are seeing so I’m just so curious today. Go comment on today’s episode and let us know if you have any relation, but a lot of providers are wanting to induce if you have the virus, COVID-19. Sarah, that was kind of the case with you, right? They wanted to induce because you had COVID-19. Sarah: Yes. That was kind of the standard of care at that point. Meagan: Yes, which is kind of interesting to think about the new standard of care. I really am curious to see one day what the Cesarean rates did during COVID-19. You know, there is some evidence here and there on it, but I’m really curious to see what the Cesarean rate did because we do have a lot of people saying that they were induced because they had COVID and then they ended in a Cesarean. So we’re going to talk a little bit. She’s going to share her birth and her induction story that then led to her VBAC. But of course, we have that review. It is by Raving Abbeh and the title is “Confidence.” It says, “I found this podcast at 34 weeks pregnant and it helped me gain the confidence to fight for my chance and get a VBAC. I hope to submit a success story in a few weeks.” And guess what? This was also during 2020, so Raving Abbeh, if you haven’t submitted your story, we would love you to and as always, you guys, we’re always accepting stories. We definitely record in chunks, so know that if it takes time, that doesn’t mean you haven’t been chosen or you will never be chosen, but if you want to submit your story, go to thevbaclink.com/share. Sarah’s StoriesMeagan: Okay, Sarah. Welcome to the show. Sarah: I’m so excited. Meagan: I’m so excited. I’m so, so excited. Well, tell us more about this 39-week induction and why they were saying it was the new norm. It was the protocol, right? Sarah: Yes. So at this time, I was working full-time in the hospital where I gave birth as a radiographer– an X-ray tech. I was kind of in the world a little bit. It was definitely not a fun time to work in the hospital. I actually tested positive when I was 8 weeks pregnant, so very newly pregnant. I was seeing family med for my provider and what they were doing at that time, they said, “Okay. This is what’s going to be different. You’re going to meet with a high-risk OB who specialized in COVID.” I would have growth ultrasounds every 4 weeks and then also, they were recommending this induction at 39 weeks. When I asked about that, what she said was that they had seen issues with the placenta. That was the reason that they had. I actually looked back on it now and I think in the study, they really only had 16 pregnant people so that was what they were basing this all off on. Meagan: Which is really nothing to start making a protocol so wide-ranged. Sarah: Right. Right. And actually, right now, my sister-in-law had COVID and she’s pregnant. She had COVID at the same time I did at 8 weeks, but now it’s 2023 and her doctor is not doing the growth ultrasounds. They’re not recommending induction. There actually is nothing different with her current, right-now pregnancy which I find interesting. Meagan: Interesting, right? Right? Sarah: But again, it can range. Meagan: In 2020, it’s interesting because they were like, “Oh, we’re going to have you with this provider who specializes in COVID pregnancies,” but how does someone specialize that fast? Sarah: Right. The person that was the specialized person was the highest-up person in the department of OB. Meagan: Okay, so definitely a specialized OB. Okay. Sarah: Right. I actually only ended up meeting up with her one time because if there was anything abnormal, that’s when I would go to her but my pregnancy was completely normal. I had no issues related to COVID or related to anything else which was obviously a blessing, but kind of also a bummer because now, I’m going to have this completely unnecessary induction at 39 weeks.Meagan: Yeah. Sarah: She did mention at the time that if I wanted to go past 39 weeks, I could definitely make that choice but she would do NSTs. Now after learning so much and being where I am now, I would have been like, “Okay. Let’s go longer and do NSTs,” but at the time as a first-time parent, I was like, “That sounds kind of weird. Let’s just do what you think.” Meagan: It sounds intense with all of these extra visits. It’s a lot. It sounds like a lot. Sarah: Yeah. Otherwise, about that pregnancy, being a first-time parent and having this medical background, it’s no surprise probably that my attitudes towards the doctors were that I completely trusted their knowledge with the COVID stuff because it was so new. Meagan: Oh yeah, and scary. Sarah: Yeah, definitely, but I was completely unaware that there was such a wide range of ways to treat pregnancies and so many different attitudes on how to birth babies. I was just clueless to the whole thing about the cascade of interventions and why do inductions have an increased risk of C-section? I was completely clueless to it. I am just used to with a doctor, you have a certain condition and there are ways to treat it. It was very narrow. But with birth, there are midwives. There are doulas. There are so many different ways to treat someone’s birth and pregnancy that was just over my head. When people would ask me, “Oh, why are you having an induction?” and tell me that maybe I shouldn’t do that, I was like, “Oh, well why wouldn’t I when they say that is the best thing to do for this COVID situation?” For me, it was like, “Well, they know better than me.” Meagan: Right, yeah. Sarah: I think you say all the time that you don’t know what you don’t know. Meagan: You don’t know what you don’t know and you can’t judge yourself for not knowing what you don’t know. Sarah: Yes. I definitely had to work through forgiving myself for sure. Meagan: Yeah. You have to take the information. I think I talked about this too. My husband had said this. We took the information we were given and made the best choice that we felt we had with the information provided. Sarah: Yes. Meagan: Right? And that’s what you did. Sarah: Right. Honestly, it’s funny now. Even just preparing for birth in general, take away the COVID part, it’s kind of funny how I did basically nothing to prepare for birth. I just focused on my registry and other things like that after the baby got there. It was kind of because I had this, “Oh if I go with the flow, I’ll have the best outcome. I don’t want to put too many expectations on myself. I don’t want to pressure myself. I’m just going to go with the flow. I don’t know how my body is going to handle it,” which does have a place. There is a goodness to that, but I think I was a little too extreme where I was like, “My mom had C-sections. I know if that happens, it happens.” It was just very, “Whatever happens, happens.” Now, I look back and I’m like, “Well, now all I did was have no tools in my toolbox to deal with pain, labor, or resources to help make those hard decisions that I was going to have to make.” I had nothing in the background to help me with that. Meagan: No tools in your toolbox. Sarah: Exactly. That’s why it was very different for my second birth but at that time, I was like, “Okay, whatever happens, happens. I don’t know what’s going to happen to me or how my body is going to take it, so we’ll just see what happens.” I was scheduled at 39 weeks on a Monday and actually, that Friday before, they called me and said, “Hey, do you want to come in early? We have a lot of people scheduled on Monday.” I was like, “Oh, I’m excited to meet my baby. I’ll go in even earlier,” which is like, oh. Okay. That weekend, we were actually moving into our new house an hour away. Meagan: Oh my gosh. Sarah: We actually spent one night at our new house and the next day we drove back to Rochester to have our baby but we were so excited. Meagan: Yeah. Absolutely. Sarah: I wasn’t even thinking about anything else. We were scheduled for a 7:00 PM Saturday appointment then. When I got there, I was completely 0% dilated. Closed. 0, 0, 0, -3 station. Furthest from ready. Meagan: Not ready to have a baby, yeah. Sarah: No. So they started me with Cytotec overnight and in the morning, they placed the Cook catheter then they started Pitocin right after. I faintly remember watching Beauty and the Beast bouncing on a ball, but that was the extent of any movement in my labor. Like I said, I didn’t prepare for anything. I just was like, “Oh, bounce on a ball. Everyone says that’s good.” I didn’t do much. But what did start happening was the baby was having decels, not liking the Pitocin, so I had to get moved from side to side. I was lying on the bed– not the best position to have the baby not be so high up. Meagan: Right. Sarah: But then by 10:00 AM, they took out the Cook catheter. I was 4 centimeters dilated. Things were moving along. But then at 11:00, they had to turn down the Pitocin because again, the baby was still not tolerating it very well. Then I felt a big pop in my belly and I was like, “Oh, is this what it feels like when your water breaks?” I was excited. I’m like, “Oh, that sounded like a balloon popping.” So they came in and they were like, “No, we don’t see anything. Your water didn’t break.” I was like, “Oh, okay sure.” Meagan: I felt something. Sarah: So then a half hour later, they came back in because they had to actually turn off the Pitocin because the baby still wasn’t happy. They checked me and they’re like, “Oh, there’s all your water,” and it gushed out on them. So I was like, “Okay, well at least I know that I can trust my intuition even though you didn’t quite believe me.” Meagan: Yes. Sarah: But I’m not crazy. It did break. The contractions were getting really intense at this point. I tried laughing gas. It didn’t really work. At that point, I decided, “Okay. I’m ready for an epidural. I feel like I’ve gotten as far as I can with what I prepared,” which was nothing. I actually found out this after the fact, but at this point, they actually gave me medicine to stop my contractions. Meagan: Like terbutaline or something?Sarah: Yes, exactly. They gave me that at this point. I actually have no recollection of this, but I was able to look at my records after the fact and I was like, “Oh, I never knew they even gave me that.” Apparently, they gave me that to stop things or slow them down or whatever. I was about 5 centimeters dilated at this point and they placed the epidural. Everything went smoothly with that and then an hour later, they were like, “Oh, we’re going to start the Pitocin again.” I was like, “Okay.” I was 5 centimeters at that point and then 40 minutes later, they checked me and I was 9 centimeters. Meagan: Whoa, so your body went into total relaxation mode and dilated. Sarah: Yes. Yes. I was like, “Cool. That was fast.” They had just sent away the doctor. They had to call her back. Shortly after that, I was at 10 centimeters, ready to go. This is when they had me start pushing. One important part that I know now is that I don’t remember ever feeling pressure or the urge to push or anything like that. They were just like, “Okay. It’s time to push.” I’m like, “Okay.”I did end up pushing for about 3 hours. They did let me try a few different positions. They tried to turn down my epidural to help too, but she never really progressed past that zero station. So nothing was happening. I was mostly on my back for all of it.I remember them saying that they would let me push for the most at 4 hours, but at the 3-hour mark, I was exhausted. I felt like we had made no progress. I was just like, “Nothing’s going to change in another hour at this point for me. I don’t know what I’m doing. You try to tell me how to push. I still don’t know.” Meagan: Yeah. You’re just like, “I’m tired.” Sarah: Exactly. The contractions were beginning to be really painful. Again, I didn’t really have a way to cope with them. The pushing wasn’t working so I consented to the C-section. I just remember feeling so defeated and just crying, being wheeled into the OR. My doctor stayed right by my head and talked to me until my husband was supposed to come in because I kept saying, “Hey, I feel these contractions. They are strong.” They were trying to give me all of the medicine to numb me enough. They were doing the prick test to make sure that I couldn’t feel it and I just remember it was really hard because my nose was plugged up from crying. I felt like I couldn’t breathe anyway. I wasn’t sure about the pokes. I was like, “They are sharp to me. I feel them. They don’t feel like pressure. They feel sharp.” They were like, “Okay. Well, we’re going to have to put you under.” They put the mask on me. I breathed in and went to sleep. Meagan: And you were gone. Sarah: Yep. Then I was gone. Meagan: Your husband probably never came in then? Sarah: So he did get to go into the OR. She was born. They let him go in so he was all gowned up. He was in the OR. He kind of tells it like, “Yeah, it was so weird. I looked over and there you were on the table.” He wasn’t so close to me. Meagan: Sleeping. Sarah: But yeah. I was sleeping. He did get to do skin-to-skin. They let him do that in the OR which was really nice. They got a bunch of pictures of her getting weighed and him cutting the cord in there so it was nice to have some of those pictures that I can look back on. Meagan: Right. Sarah: That’s something. Meagan: Right, yeah. It helps you relate, too, when you’re not awake. Sarah: Exactly. It was definitely a weird experience. But when I did come to, apparently, I had been awake longer but you know how that works. When you’re waking up from anesthesia, it’s kind of weird. But apparently, when I woke up, they told me that I was just like, “Where’s the baby? Where’s the baby? Where’s the baby?” They rushed me back. I don’t remember any of that, but what I do remember is when I woke up, my throat was so sore and hurt so bad. But she was on me and she latched immediately and started feeding so that was really special. Meagan: Yes. Sarah: Just how she was able to eat right away and I didn’t have any problems with that which was…
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