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200 Episodes with JULIE!

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Treść dostarczona przez Meagan Heaton. Cała zawartość podcastów, w tym odcinki, grafika i opisy podcastów, jest przesyłana i udostępniana bezpośrednio przez Meagan Heaton lub jego partnera na platformie podcastów. Jeśli uważasz, że ktoś wykorzystuje Twoje dzieło chronione prawem autorskim bez Twojej zgody, możesz postępować zgodnie z procedurą opisaną tutaj https://pl.player.fm/legal.

Meagan welcomes Julie back today to celebrate 200 episodes of The VBAC Link podcast! They celebrate this milestone with a special live Q&A podcast recording session joined by followers of The VBAC Link Facebook community.

Topics include: how to talk to your provider, all about Spinning Babies, adhesions, managing sciatica pain, induction, nipple stimulation to induce labor, VBAMC, C-section consent forms, and much, much more.

We can’t wait to continue sharing new episodes with you as we stay committed to our mission of making birth after Cesarean better!

Additional links

Spinning Babies website

The VBAC Link Blog: Pumping to Induce Labor

Fear Release YouTube Video

Episode 18 Leslie’s HBAC + Special Scars

Julie’s Instagram

The VBAC Link Community on Facebook

How to VBAC: The Ultimate Prep Course for Parents

Full transcript

Note: All transcripts are edited to correct grammar, false starts, and filler words.

Julie: Welcome to The VBAC Link podcast. This is our 200th episode and yes, you are listening to Julie. I’m back just for this episode and probably some more in the future at some point, but we are so excited, Meagan and I, because this is the 200th episode. We are now live in our Facebook group. Not now when you are listening to it, but right now in this moment in our timeline.

It took us way too long to get in here live, but we are doing a Facebook Live podcast episode. We have never done that before and we probably will never do it again because this was kind of traumatic.

Meagan: Yeah, this was a little rough, but that’s okay. Now that we know, now that we know, we are good. We’re good.

Julie: Now we know.

Meagan: It just took 34 minutes to figure it out.

Review of the Week

Julie: Oh my gosh. Cool. So, let’s get started first. There is a Review of the Week. Meagan, are you ready? Do you have one?

Meagan: Yep, I do. This is from blpinto and it’s from Apple Podcasts. It says, “Wonderful resources for ALL moms, not just VBACs.” It says, “I didn’t have a C-section for my first birth, but I had a traumatic experience with a forceps delivery and an induction that was not at all what I was looking for. I started listening to the podcast before I even got pregnant a second time to prepare for a better experience. Julie and Meagan were a huge part of my process and journey. I ultimately had a beautiful home birth and a 10-pound, 6-ounce baby. I felt this podcast helped me overcome my fear that I couldn’t push my baby out without help because many VBAC moms had the same feeling.”

I love that. I don’t know many first-time or second-time moms who haven’t had previous C-sections that have listened and left a review. So that was awesome. We truly believe that this is also a podcast for everybody. Just like wonderful Brian says at the beginning of this podcast, it’s for all expectant parents who want to avoid a Cesarean and want to learn their options and learn what’s happening out there. So that is so exciting that we had someone who hadn’t even had a C-section before.

If you know someone who is expecting and has fear or maybe a first-time mom who has some doubts and problems and traumatic experiences in birth, definitely share the podcast. These stories are amazing for all to listen to. I would 100% agree with her.

Julie: I love that. Do you remember years ago when we first started and we were trying to figure out how we could make something, maybe not separate, for first-time parents? We were like, “How do we get first-time parents to understand that these are things they need to know?” Because you didn’t. I didn’t. As a first-time mom, I didn’t even think about a C-section until the doctor said, “We need to do a C-section,” and we never really got very far with that because the focus of The VBAC Link is a vaginal birth after Cesarean.

Yeah, so we love that. We, I say “we”. I will always say “we” talking about The VBAC Link.

Meagan: Literally, just earlier today, I was recording a podcast and I was like, “we”. I mean, “I”, but Julie is just over here.

Julie: My spirit and presence exist in the VBAC realm.

Meagan: Yes. But it’s so much fun. It’s so fun to be here and I’m excited. If you guys haven’t had a chance or if you are watching live right now, we would love your reviews. Love, love, love your reviews. You can send us an email. You can write right here and I will copy it over and put it in the reviews. We are excited to dive in today on episode 200!

Q&A

Julie: Yeah. All right, all eight people who are watching. I guess one of those is me and maybe you, so six. Six people. Drop your questions. Nothing is off-limits. We are going to talk about everything you want to know. Everything you want to hear. We are going to get down and dirty with everything VBAC, wives, and kids. If you want to know what Meagan’s kid is doing right now in the background, we will talk about it.

Meagan: Yeah, drop your questions. I’m posting here letting people know that we actually are live now.

Julie: Oh heavens.

VBAC: Where do I start?

Meagan: Yes. It’s so funny. I keep looking on the wrong forum. Okay, who do we have in here? Who do we have? Kathryn, Jen, and AJ thank you so much for being here. Let us know your questions. I want to maybe start off just on VBAC options. We had someone write in yesterday and was like, “One, I didn’t know VBAC was an option. I didn’t even know what it was.” So that’s wonderful that they’re starting to find out that VBAC is an option, but let’s talk about how we can have a conversation about VBAC being an option with a provider. That’s just random, I know.

But what would you think, Julie, if you’re starting to discover VBAC, learning what it is, feeling like you want to feel it out, maybe you want to learn more about it and do it, how would you suggest approaching your provider?

Julie: Oh man, that’s a great question. First of all, we’ve got some good questions coming in too so I’m excited to answer these. Provider, honestly, I would just ask where their thought process is. I would approach them and say, “Hey. this is what I’m considering. What are your thoughts about it?” And I will tell you what. No matter what their response is and no matter what ultimately your birth plan is, you’re going to get a really good feeling for how your provider feels about body autonomy, informed consent, and birth in general because if they answer and say, “Oh, well I don’t think you are a great candidate. I don’t do VBAC. I don’t support them,” or anything that’s very sounds set in stone, so, “I don’t do this. We won’t let you do that. We would have to look at this and make sure your percentage is high,” or whatever.

Anything that is set in stone shows you that your provider is not as supportive of other options or your provider has a very set way of doing things and may not be a good choice for you. But if they answer and say, “Yeah. We can consider VBAC as an option. Let’s talk about some things about what your goals are. I do VBACs a lot. I love VBACs” or anything like that with a more open or a more fluid answer is going to let you know that your provider is going to not only be good with whatever outcomes that you choose but is also very open to having the parent or the mother be part of the birth process and be involved in the decisions regarding their care.

That’s really what you want to have on your side no matter what type of birth you’re having or where you are giving birth. You want to have a provider that is going to be open to your input, be a little flexible, a lot flexible based on what your needs are and the type of birth you want, and is able to accommodate that.

Meagan: Yeah, and just that’s willing to have that conversation because a lot of providers don’t honestly come out and say, “Hey, do you want to have a TOLAC?” which is a trial of labor after a Cesarean. That may be something that you have to take charge of and say, “Hey. I’m learning about this. What are your thoughts? How do you feel about it? Tell me about some experiences.”

We always talk about open-ended questions but really, truly if you can ask an open-ended question, you’re going to be able to get more information than a “yes” or a “no” or an, “Oh yeah. Sure,” versus, “Yeah. I feel really comfortable with that. We do that all of the time. This is why.” So I love that. I know it was a random question, but a lot of people are asking, “How do I even approach this topic with my provider?”

Okay, are you ready? I’m going to read some questions. We’ll bounce back and forth.

Julie: Yes, let’s do it.

What is Spinning Babies?

Meagan: So Ms. Kathryn says, “I just found your podcast last night.” Yay! And now you’re here on the first live one. It says, “Bingeing ever since. What is Spinning Babies? I’ve heard it talked about a lot on the podcast.”

Spinning Babies is a wonderful resource. They have all sorts of circuits and tips and tricks on ways to navigate babies through the pelvis. Breech positions, so if you have a breech baby, they have positions and exercises to do that. We’ve got posterior. We talk and they also do baby mapping to help figure out where your baby is.

Julie: Belly mapping.

Meagan: What did I say?

Julie: You said “baby mapping.”

Meagan: Baby mapping. I meant belly mapping.

Julie: They’re the same thing.

Meagan: That’s what I meant. Baby mapping. I almost said it again. Belly mapping to help you figure out where your baby is. They can educate on if a baby is posterior, what types of things to do and what to do if a baby is asynclitic or comes over the pelvis, and what tips and tricks you can do. A lot of doulas are really educated in Spinning Babies. It is so awesome. So awesome when the client, don’t you think, is educated in this and they are familiar with it.

Julie: Yeah.

Meagan: So obviously, we talk about it a lot in the podcast, but we really encourage people to check out their website. They have updated their website and it’s really quite great now. It’s really friendly to navigate, so check it out. It can be a game changer. I have had positions in labor where things were just hanging out, stalling, not really going anywhere, and then we have done a Spinning Babies technique and boom, that baby rotates and labor is speeding along.

Julie: Yeah, I love that. I think one thing that I really like about Spinning Babies too is that it puts less emphasis on babies being in this specific position and it creates more emphasis on creating room and space in the pelvis.

Meagan: Balance.

Julie: And with the connective tissues and yes, balance and all of those things because sometimes, babies need to enter into the pelvis in a little bit what you would call “less than optimal.”

Meagan: “Less than ideal”, yeah.

Julie: But as long as baby has enough space and room to wiggle and progress through the pelvis in the way it needs to, then you’re going to have a great, not a great, that’s a bad promise. You’re not going to have a great labor necessarily, but you’re going to be able to encounter less problems that are created by a poorly positioned baby or tissues that might be more difficult to move and things like that. So yes, balance, space, and flexibility.

Do adhesions impact fertility?

Meagan: Yeah, absolutely. Okay, let’s see. AJ Hastings. “Do adhesions really impact fertility? Currently trying to conceive for seven months and was told by acupuncture that I need 12 months of weekly treatments. I definitely want another opinion.”

So the short answer is yes it can. It can affect things. In fact, we have an episode and I will go find it here. I’m going to go find it. I’m going to drop it. It’s so weird because we are on Zoom, but we are on Facebook over here. I’m going to drop it in the Facebook group right here because it definitely impacted her. It impacted her and adhesions, depending on how dense and how thick and everything, it can impact fertility. 12 months of treatment? I don’t know. I mean, I’m not a specialist in how intense that needs to be. I have adhesions as well, but I don’t know how dense they are.

I was fortunate enough to become pregnant, but it can impact it and it’s something to look into. I don’t think it’s bad to get a second opinion for a whole year of treatments, but I also wonder if scar massage, starting with scar massage by yourself, or going to a pelvic floor specialist and starting there might be beneficial. Julie, what would you think?

Julie: Yeah, right along with what you said, it can. That’s the thing. It doesn’t always, but it might. Adhesions, especially ones that are denser or thicker can tug and pull things in the wrong way. They can make it harder for eggs to implant and can cause a whole slew of problems for your overall health depending on the relation to different organs that they might be adhered to. All sorts of things, but it doesn’t always, right?

One thing that I would ask my provider that’s recommending that is what other options are available, what other things might be impacting my fertility? Have you seen any other types of providers? Have you seen an OB/GYN or maybe a fertility specialist in that regard or gotten a second opinion from them? Sorry, I think she said. Yep. I’m trying to see that it was told by acupuncture. Yeah, so I would maybe consult another type of provider. But trying to conceive for seven months is kind of a long time, but it also could take up to a year without there being any problems at all for just any random average to get pregnant too.

That is just what was going through my mind. Is that the only thing that you are treating and addressing or is it part of an overall care plan? Are you seeing anybody else? That type of thing.

Meagan: Mhmm, yeah. And like she was saying, maybe a different provider, maybe a pelvic floor specialist to even just dig into what those adhesions look like or a care provider, but yeah. It can. I’m going to go find it. I was just scrolling, but I’m going to go find it. Do you remember, Julie, do you remember her name?

Julie: You’re asking me if I remember anybody’s name?

Meagan: I’m the name person. I keep thinking it starts with a J. I’m going to find it though and I’m going to drop it in for you, AJ. Okay, “I just had a VBAC a few months ago and,” awww. “I’m so thankful for both of you.” Thank you, Allison. That’s so sweet. So, so sweet.

Julie: Thank you.

How to manage sciatica pain

Meagan: Congratulations! Okay, Jenn. “I’m 39 weeks. My sciatica only allows me to walk for about 20 minutes without cramping. I see a chiropractor twice a week, but other than that, what can I do to help keep my baby in a good position and get labor going?”

I would suggest the Miles Circuit right off the bat. Miles Circuit is wonderful. You can do it multiple times a day. There are three circuits and you want to try to do it for a minimum of 30 minutes but sometimes you have to lead up to that. That would be something that I would suggest. Maybe giving it a try. Also, Spinning Babies is very much a balance factor in creating balance.

It sounds like your sciatica is not loving you right now and that is hard. That is hard, so being mindful also of being symmetrical and getting out of the car. I know that sounds really weird, but not stepping out with your left. Stepping out with your right. Trying to move out together because that separation with relaxin and things like that can cause the pelvic to shift, which then causes sciatica issues and all of those things. But I would suggest Miles Circuit. I would also suggest a massage. Getting things relaxed and soft because sometimes when things are tense, we’ve got that sciatica issue. Julie, what else would you suggest on that?

Julie: Yeah. First of all, I would say that if you are in pain, then don’t do anything. It’s okay to stop. You don’t want to hurt yourself and cause pain, tension, and stress in your body because that could interfere with your natural labor hormones. But honestly, I would think going to a chiropractor twice a week and walking 20 minutes a day is great. I think that’s great to do. If that’s all you can do, then I don’t think you need to do anything else.

39 weeks could still be early based on when your baby wants to come, so don’t feel like you urgently have to do anything. If your provider is pushing you a little bit, then it might be time to have a conversation about what your boundaries are and where you are willing to go as far as how far along gestationally before you interfere. But yeah, what Meagan says for sure. The Miles Circuit, absolutely. Two positions in the Miles Circuit are that you are resting pretty much and just creating more space in the pelvis.

I would say maybe if you want to try changing it up from walking, one of my favorite things is going up and down the stairs sideways two at a time. It’s kind of like walking, but you are really opening up that pelvis. So you go up with the right foot first, down with the right foot first, then switch to the left foot first, up and down. That’s creating a nice, flexible, open space and lots of equal balance like Meagan said.

Meagan: And listening to your body on that. Listening to your body. If it’s too much, stop or just do three sets of stairs, three stairs. Just don’t push your body. Yeah. But I like that one. I actually did that with a client at a birth center where there were some stairs. We did that to get labor going and it totally helped. It was amazing.

Julie: Yeah, I love that. That’s my favorite or curb walking. You just walk right foot on the curb and left foot off the curb and then switch with the other foot to keep that balance and stretch both sides of the pelvis. But yeah, change it up a little bit. I think you are doing great, personally.

Meagan: Mhmm, yeah. Going to the chiropractor that often is amazing. Realigning. But yeah, 20 minutes, maybe cut it down to 15 minutes. Just a little less before you are in too much agony. Yeah, yeah.

Julie: It’s okay to take a rest. It’s okay to not do it one day too, or a few days, or every other day or twice a week.

Meagan: Yeah. I would also say shaking the apples which is a Spinning Babies thing, but that actually really relaxes and softens down there and can help with sciatica pain. That’s just where you put the rebozo around your bottom and have someone sift, so you’re kind of doing this.

Julie: It’s so fun.

Meagan: This is so hard to be on a Live because I talk a lot with my hands. If you can see this in this video, Julie is very much here and I’m dancing.

Julie: I even brushed my hair today.

Meagan: You kind of get sifted and it really is nice for that sciatica. Okay, oh let’s see. Just listened to all,” oh my gosh, “all 198 episodes of you guys.” Oh yes, yes. I just can’t believe that we are at 200 episodes. I was telling my husband today and he was like, “Whoa. That’s a lot.” Yeah, that’s awesome. So awesome. Okay, do you guys have any other questions coming in on here? What else would you like to talk about, Julie, while we are waiting on any other questions? It’s been a minute. It’s been a minute since you’ve been on here.

Julie: I know. It was 15 minutes before it was about to start. I was editing photos all day, so I was like, “Oh shoot, I should brush my hair and change my shirt,” because I had this frumpy little shirt on. I’m like, “We’re going to be on video today. We never usually do that.”

Meagan: Yeah.

You don’t have to be induced at 39 or 40 weeks!

Julie: So it’s just interesting. Let me think. I was just trying to think what has been bugging me from The VBAC Link Community lately. Not bugging me, but you know when you just want to grab ahold of people’s shoulders sometimes and say, “This doesn’t have to be this way. You don’t have to do this!” Or just like, “It’s okay to stand up for yourself.”

I think a lot of the things I have been seeing lately a little bit is when people talk about induction or their doctor not letting them go past a certain amount of weeks.

Meagan: Yeah.

Julie: That’s really kind of heartbreaking because, in America, we have a really frustrating maternal health care system. It’s really easy to get trapped in that if you’re not comfortable standing up for yourself if you don’t know that it’s okay to stand up to you’re provider, and if you don’t have an opinion about everything that you possibly can in birth.

It’s hard when I see people going in and getting induced. We’ll see posts all of the time where people will be like, “Oh my gosh, I’m 6 centimeters. I’ve been soft for 8 hours. I was induced at 39 weeks. My provider said this and that and the other.” I just want you to know, everybody. You do not have to be induced at 39 or 40 weeks in order to get a VBAC.

Meagan: You don’t. You don’t. I also wanted to talk about the opposite. On the flip side of that, I want to say that you can have a VBAC if you are induced.

Julie: Yes.

Nipple stimulation to induce labor

Meagan: So there are both sides where it’s like you have to be induced or you can’t go for a VBAC or it’s, “I will not induce you.” And so anyway, it’s so hard. I was just looking. We have a group member that posted a couple of hours ago and she said, “I have a question about nipple stimulation to induce labor. I’ve been trying since yesterday and I do get contractions although they might just be Braxton Hicks because they are not really painful. But as soon as I stop, the contractions also stop. Any advice?”

I just want to talk about this. In fact, I think Julie wrote a blog about this. I think, didn’t you write a blog about nipple stimulation and pumping to induce labor? I’m pretty sure you did.

Julie: I’m pretty sure that was you.

Meagan: It might have been. I don’t remember.

Julie: That doesn’t sound like anything I would write.

Meagan: Well, yes. So this is something that I actually did when I was in early labor. I wanted to talk about that, but my midwife kept saying, “Hook up to the pump. Hook up to the pump.” I hated that thing. That thing was not my friend, but it worked. It helped, I should say. But sometimes it doesn’t. And so kind of similar to what this group member is saying is that it sounds like it is releasing oxytocin in your body and it’s stimulating something. Something enough to cause your body to contract or have some sort of spasms in your uterus, right? Which is a contraction whether or not it is strong.

But when you stop, it stops and so that is– this is what I tell my clients too. That is a sign that your body is not quite ready or it’s not going to respond to this type of method right now. Pumping is a really great option, but if it’s not going, I would say to pause. Maybe just give it a break and see what happens. You can try again later or follow the advice of your provider.

I would say that it’s not bad that your body is not responding and it doesn’t mean anything like it’s not going to work ever, but it just sounds like your body may not be ready. So my advice is to maybe give it a break, try it a little bit more, try it a little bit longer and see, or maybe go have sex instead and try to release oxytocin in a different way in your body. So anyway, I just saw that. Are there other questions that have come in? Do you see any?

Julie: Yes, there is.

Meagan: Okay.

Julie: Hi Paige, by the way! Hi Paige. Paige commented on the pumping to induce labor blog.

Meagan: Oh yeah.

Julie: Okay, so Tiffany, nope. Not Tiffany. It’s before that one. Tiffany, I’m going to get there. Angel said that if we want to read her post in the group that she would love some thoughts. So I found Angel’s post and I will read it. I love this. I have lots of thoughts, so Angel, if you are still watching, could you drop your location in the comments so I know? Oh, you’re in New Zealand. You already said that.

VBA3C

Julie: She said, “I would love your opinions. I have contacted 15 midwives in New Zealand and all have said ‘no’ to a VBAC after 3 C-sections. The main reason why I don’t want a fourth Cesarean is because fentanyl is in a spinal block.” P.S. a lot of people don’t know that. When you have an epidural or when you have a spinal block, the epidural is not the medicine. It is the method of giving it into your body. An epidural has lots of different medications in it. Fentanyl is one of them. Tramadol is another one. Sometimes there are antibiotics in there with them. But a lot of people don’t know that fentanyl is in an epidural and a spinal block.

Okay, so she says, “Tramadol is the pain relief afterward.” Tramadol is a form of morphine. That will be present in the milk which is one of the reasons why she doesn’t want it. Antibiotics afterward, milk again, and all of her children have had severe colic and reflux to the point of sleeping four scattered hours overnight until they are 16 months old. All day naps are held upright. This is physically and mentally shattering. Could there be a link between colic, reflux, and antibiotics? It may be a possibility. “I live a 100% organic, tox-free lifestyle. I don’t even take pain relief for headaches. Cesareans go against my holistic lifestyle.”

“That being said, the first two Cesareans, I believe, were medically necessary.” Cord wrapped very tightly around necks, very thin and short. Babies were wrapped up by their necks tightly and couldn’t move down, couldn’t descend. Fetal distress straightaway for the first baby, second repeat Cesarean for the same issue. The third, the cord was fine, loosely on my tummy, but the amniotic fluid was a 4. It should have been a 7. She was pressured into a repeat Cesarean in case there was the same issue as the first two.

She said, “I just need tough love, realistic answers.” Should she just have a fourth Cesarean and do everything else holistically?

Meagan: That’s tough.

Julie: Yes.

Meagan: We had a message come in earlier. I’m wondering if it’s the same person because it sounds strangely familiar. New Zealand. I can’t speak. But wow, that’s tough. That’s tough because you have good, solid reasons, beliefs, and feelings. Yeah. You know, it sounds like you are getting a lot of pushback in your area. A lot. That’s a lot. There may be somewhere underground there that would allow it, but yeah. I don’t know. It seems like you have enough reason to not do certain things. I don’t know. I would maybe. I would maybe, actually. What would you do, Julie?

Julie: Well, she says she wants tough love and I love tough love. So when I get permission for it, I will fork it out.

Meagan: Yeah.

Julie: So here’s the thing. First of all, vaginal birth after three Cesareans, I love, love, love that we are seeing more stories come out about VBAC after 3 C-sections.

Meagan: Me too.

Julie: There’s not a lot of data to support its safety or not. We have a few studies if you want to google VBAMC. We have a whole blog about the information that is available, but there’s just not a lot out there. The way we get a lot of information out there is for more people to do it, right? That might not be a risk that a lot of people are willing to take. Personally, I would probably try it because I kind of know all of the information and everything, but I don’t know because I haven’t been there.

So here’s my tough love, okay? It sounds like you have talked to a lot of providers. This sounds like the providers you have talked to do not want to support you in your choice. And so when that happens, and this is for anybody who can’t find a supportive provider not necessarily just directed at you, Angel, you have a few options.

First is to go into labor and wait as long as you can and go to the hospital and fight and fight and fight. Out-of-hospital probably wouldn’t take you on as a patient. But depending on, I don’t know how the healthcare system is set up exactly out there. So go to the hospital, show up pushing, which I would never recommend that ideally if you could, but that’s an option for you, okay? Go into labor. Go into the hospital. Maybe get a doula. Have your partner on board or somebody there who can really heavily advocate for you and be fighting the whole time.

Or you can birth unassisted at home, which I also don’t necessarily recommend, but there are a lot of people that can do it and do it smartly.

Meagan: They have a lot of solid resources.

Julie: A lot of resources, have a really solid backup plan, know everything that you need to look for as far as warning signs in labor, maybe labor close to the hospital or in the hospital parking lot or something like that. Neither of those might be good options for you, but it sounds like there’s not really a good option anyway. I think also, sometimes I appreciate and envy, to some degree, the holistic lifestyle that you have.

Sometimes, if you don’t feel comfortable fighting in the hospital or having a baby unassisted, your third option is to have a repeat Cesarean.

Meagan: Make it really special.

Julie: Maybe you won’t have a holistic lifestyle at that moment. ** You’re going to have to get some medications that you don’t love, right? You’re going to risk having those things *** began with the colic and maybe the upset digestive tract from the antibiotics and things like that, but that also might not be the worst thing to have ***. The only thing that you are going to be able to know is what the best choice is even though there is not a good choice. I don’t know if that makes sense or not, but yeah.

I mean, you can create a nice, beautiful space like Meagan just said. You can ask for the spinal block and see if there are any alternatives to the fentanyl or other kinds of medication that they can put in there. You can ask for a shorter hospital stay. You can look into ways to heal your baby’s gut after the C-section. You can look into vaginal seeding which can get the baby’s gut populated with your flora from the vaginal canal which is really helpful for the baby’s microbiome and things like that. I feel really angry for you a little bit.

Meagan: I know.

Julie: –that the system is set up to work against you in such ways. But I feel like this is something that you are really going to have to sit with and tune into your intuition hardcore and figure out what risks you want to accept, right? Because it sounds like you are going to have to accept some whether it’s birthing with a C-section and not having the birth you want and introducing those different things to your baby, birthing unassisted without a provider present, or fighting as hard as you can in the hospital for your VBAC.

Meagan: It infuriates me that people even have to be in this space at all.

Julie: Yeah.

Meagan: The providers are so worried about supporting people doing vaginal birth after multiple Cesareans, yet they’re pushing people and making people feel like they have no choice other than to birth with no provider. I am not saying that someone who births without a provider– I’m not shaming anybody for sure, but I think it’s nice to have that supportive provider behind you, that trained, skilled provider. A lot of people that do go unassisted, I’m not kidding you guys, they dive in deep. They are prepared and that’s awesome. Good for them. Absolutely good for them.

But it just makes me so mad that someone even feels like they are stuck in making that option.

Julie: Yeah, I agree. Angel also asked a follow-up question if she could decline antibiotics. Here’s the thing. You can decline anything you want to decline. It’s just going to depend on what’s going to make your providers nervous and if they’re willing to provide care or not. I don’t know. I don’t know if your provider will be comfortable doing a C-section without having antibiotics available during and after the C-section or not, but that’s something that you can talk with your provider about ahead of time and see what that looks like. Or have a minimum dose or only one round or something like that.

Meagan: Mhmm, yeah. I love that. Sorry, my little boy, this was also part of our technical difficulties. Look at his head. Show everybody your head.

Julie: He got konked.

Meagan: And your arms, huh. Yeah, he fell today at recess.

Julie: All right, let’s move on to the next question. Angel, I give you all of my love and support.

Meagan: I wish you luck.

Julie: Yeah, I do. Please keep us updated. Us, again. You guys, this is killing me. Meagan, you have to let me know when Angel updates you because I’m invested now.

Gentle induction plans

Julie: Okay, what’s next? We have– oh, yes. Let’s get to Tiffany. Hi Tiffany. Tiffany M. Okay, so she said that her doctors told her that they will not allow her to go past 39-40 weeks. She was able to control her blood pressure thus far and she had hypertension in her last two pregnancies. Her doctor doesn’t want to induce because it allegedly increases the risk of rupture.

Meagan: Your voice.

Julie: Sorry. “They’ve been insanely supportive of VBAC but this contradicts what I’ve been seeing.” Yes. This is what we were talking about before, right? Induction. You can have a VBAC after being induced, but also you don’t want to have to be induced at some arbitrary deadline to have a VBAC. Induction does increase the risk of rupture slightly, but when it’s managed appropriately, the risk is very minimal.

So definitely look into that. Poke your provider. I say “poke your provider”. Don’t poke the bear, right? Don’t poke the bear. Ask your provider. Talk with them and see because that might not be a provider that is that supportive. It is sad that when you have a provider that you absolutely love and there’s this one thing. There’s one thing and it sounds like this is the one thing.

Meagan: But that’s a big deal.

Julie: It is a big deal, yeah.

Meagan: A big deal, yeah.

Julie: And people won’t allow you to go past 39-40 weeks. I would bust out the ACOG bulletins on VBAC and the late-term management of pregnancies or something.

Meagan: Yeah, and induction. Yes. I was just going to say. Bring them, even if it sounds over the top because I’m going to tell you, print it all off and take it to them.

Julie: Do it.

Meagan: And say, “But this is what this says. This is who you are under and this is what they are saying, so why can’t we discuss a gentle induction plan?” Or, “Let’s observe and do more monitoring with all of these things and take it day by day. Take it every other day. I’ll do an NST. Let’s break it down so you’re comfortable. I’m comfortable. We’re all doing what is safe for me and baby of course.” Sometimes it sounds extreme, but it might take bringing it in and saying, “Hey. This is what I have found. Let’s talk about it. Let’s break it down.”

Are you going and getting that for her? Is that what you’re doing?

Julie: I’m responding to whatever comments.

Meagan: Oh okay.

Julie: Obviously now, I’ll just do it verbally. So she said, “Managed how? Through a slow administration of induction medicine?” Yes, absolutely. Yes, so this is the thing. Sometimes you’ll hear the phrase “Pit to distress” where nurses will, this is a real thing. It’s sad but it is, where nurses will up the Pitocin so aggressively that it literally forces the baby to go into distress so they just do a C-section. It’s a very aggressive way to administer Pitocin. You don’t want that. You want to do a nice, slow dose. Increase it by 1 or 2 every 45 minutes to an hour. Give your body a chance to respond before upping it even more.

I’ve seen VBAC inductions where they konk out the Pitocin by 4 every 30 minutes and before two hours happens, you’re up at the max dose of Pitocin and then the baby gets so stressed out and you have a C-section.

Meagan: And the body isn’t responding fast enough.

Julie: The body’s not responding at all because it doesn’t know what the crap is going on. It’s being slammed with Pitocin, this artificial hormone. That is not an induction that is managed well. A managed well induction is nice and slow. Start with a Foley bulb. Start with a nice, slow dose of Pitocin. Rest during the beginning of it. Give your body time to catch up. While being monitored, that’s a nice compromise and making sure everything is being tolerated well. If your body is responding, stop turning the Pitocin up at all or even turn it off after your body kicks into labor.

Meagan: Yes. I was also going to say there is something called a “Pit holiday” where sometimes our uterine receptors get too full and overstimulated with Pitocin. It’s okay to do a “Pit holiday” and cut it in half. So say you’re at 20, let’s cut it down to 10 and see how our body responds because sometimes we can be overstimulated and our body is like, “This is too much too fast. I don’t know what’s happening.” It’s not responding and then we cut it in half, our uterine receptors empty, our body kicks into that natural labor, and then boom. We’re in labor and we don’t even need 20 mL of Pitocin, right?

Or like Julie said, we get into this active phase and we feel like we have to keep upping the Pitocin, but if we’re getting into the active phase and we’re making progress, we don’t need to keep pushing Pitocin. And yeah, slow dose.

Sometimes, some people, we recorded a story just now and talked about this. It’s coming out in October, so let’s talk about it right now. Sometimes we get in a space where induction is what’s needed this time, but we’re not cervically progressed enough to just put in a Foley or a Cook, right?

So sometimes, we have to start a low dose Pit, maybe 2, 4, 6 mL max and just let it be for hours. It could take hours, you guys. I’m not kidding. Not three hours, not four, but ten plus hours it can take sitting at that slow, low dose to get the uterus stimulated enough to open just enough to get a Foley or a Cook catheter in comfortably. And then, we start from there. We work with the Foley and the Cook. Maybe you leave Pit right there or maybe they start increasing it or they just do the Pit at 6 or 8 or 10, and then just let the Foley do its thing until it falls out and then we start from there. There are so many ways that we can manage and take things slowly.

Walking in, breaking someone’s bag of waters is not necessarily slow, managed, and controlled but that’s what a lot of providers will do also. They say, “Oh, I’ll just bring you in. We’ll just bring you in and break your water.” Sometimes, the body doesn’t respond to that and it takes hours, and then we’ve got Pitocin coming into play anyway. But then sometimes, that’s the perfect way, right? So we have to take it slowly. We have to decide what’s best for us and where we are at cervically can make a big difference of where we start.

Julie: Where we are at cervically, I love that.

Meagan: Yeah, where we are at cervically.

Julie: Cervically, cool. All right. Thank you, thank you. All right, let’s move on. Christine, Christina. She says, oh I think it’s maybe more of a review. Thank you. Okay, so she says, “Listening in from South Africa.” We have lots of people from South Africa lately by the way.

Meagan: Yay.

Julie: I say “we” like I’m, anyways. “Been listening to the podcast, binge listening all the time and so amazed at how much I’m learning in each story and from you both. I also love how listening to everyone’s stories, especially the C-section stories have helped me process mine and helped me feel much more peace going into my VBAC at the end of this year. Thank you so much for the podcast and everything you guys are doing. I keep sharing relevant episodes with friends that are currently pregnant with their first. Things I wish I had known despite having done a lot to prepare for my first birth.”

Meagan: I love that. Thank you.

Julie: Aww. I love that. Thank you. Yes, Meagan. Grab this and drop it into the review spreadsheet.

Meagan: I know, will you copy and paste it for me? I’m going to read this. I pulled into the group and found a question that just was posted. We actually got a lot of recent questions here in the group and so I figured I’d throw this one in.

Julie: Wait, but there are more in these comments, though.

Meagan: Oh, keep going.

Julie: Do you want me to do the comments first?

Meagan: Yes, sorry. I didn’t see it.

What happens if you don’t sign a C-section consent form?

Julie: No, you’re totally fine. There’s AJ, Juleea, and maybe more. Okay so AJ said, “Hypothetically, what happens if you don’t sign a C-section consent form? I know they can’t just make you take you back, but how would you handle this if they were being forceful?”

Meagan: Now that one’s super hard because you have to be strong. You have to be really strong. But how I would handle it, I would break it down. I would ask them to break it down and talk about why. “Why are you asking me to sign this form? Am I in danger? Is my baby in danger? Are we facing death?”

Julie: Facing death. “Will I die?”

Meagan: Yeah, complications by dying. “Are you telling me that my baby and I are going to die right now? Because if we are having this conversation then that probably means that it’s not the case.” But yeah, break it down and say, “No. I don’t consent to this. I don’t feel comfortable with this. If this is not life threatening right now, and this is not emergent, then I want to continue on the path that I’m going.” This sounds really bad and it’s so hard because everyone can be– we’ve got people all over the world, right?

Sometimes it’s saying, “Okay. I’m going to leave. I’m going to go somewhere else.” We’ve had that. Julie and I personally have had clients say, “Okay, I’m leaving then. If we’re not going to do this, if this is not what’s going to happen, then I’m going somewhere else.” And sometimes they change their tune right there because they don’t want you to leave. They usually don’t want you to leave, so they change their tune and say, “Okay, hold on.” But sometimes, it takes leaving and going to somewhere else that is supportive. But that’s not what you really want to do in labor.

Julie: Yeah, this is why you want to figure it out before labor starts.

Meagan: Yeah, it’s not the space that you deserve to be in during this labor journey, but sometimes it’s fighting. It’s fighting and it’s hard. It goes back to what we were talking about with Angel. It makes me so mad that there’s not the support that everyone really deserves. We deserve the support, you guys. We’re just going in to have babies. That’s all. We’re just going in to have a baby just like everybody else, but sometimes we’re not viewed as that.

So yeah. Any other tips, Julie? I mean, yeah. I would say breaking it down and having that conversation, but what would you say?

Julie: I mean, I would kind of say the same thing. A lot of the times, I feel like, they just have you sign all of the forms that you might possibly ever need while you are in labor at the beginning of labor because it saves on admin time and it saves on things you have to do later on and things like that. But what I would ask about the C-section form, when they’re going through that whole process is, “Do you make first-time moms sign this form?” Because I bet you, I know their answer because they don’t make every laboring person sign a C-section form, but they will if they are getting you ready for a C-section or they think that you are at an increased risk for one.

And so, we all know what the numbers are surrounding VBAC and what your chance of success is and how, if given the option to try, you are very likely to succeed. So I would just ask that. And if they say, “No,” or whatever their answer is, I would change my next question or next statement. My next statement after they answered would be that, “I will sign it if it is looking like that is going to be an option, but for now, I am planning on a vaginal delivery. Until a C-section becomes imminent, I will refrain from signing the form.”

And then if they raise a big fuss after that, I might go to more extremes like what Meagan talked about. But I mean, this is the thing. If it’s a life or death situation and you’re not looking great or baby is not looking great and I’m not talking about, “Oh, we have some concerns.” I’m talking about, “We need to do something now.” They’re not going to care whether the consent form is signed or not, they’re going to wheel you to the operating room and save your life or save your baby’s life.

And so I think that waiting and asking to wait until it looks like a C-section is needed or necessary is a perfectly reasonable option.

Meagan: Yeah, I agree. Okay, so I realized that I didn’t see because I only saw one last comment from Tiffany saying that she is anti-Pitocin over there.

Releasing fear around childbirth

Julie: Yeah. Julie has one. And this is a great one for you, Meagan, too. It’s how do you release fear around childbirth? I’m 40 weeks today and I’m anxious for labor. My first arrived via C-section at 37 weeks due to high blood pressure and being breech. I never experienced any part of labor and I’m just fearing the unknown. Fearing uterine rupture, not progressing, tearing, all of it.

Meagan: Yeah. You know, fear release is so important. So important and I think I’ve talked about this maybe on my story or maybe in other things, talking about how I thought I released everything, and then I was in labor and there were still stuff that I was processing and working through and having to go through. But a few tips that I have are actually Julie’s fear release that she did a long time ago on our YouTube and it’s a smokeless or flameless.

Julie: Smokeless fear release except that’s used very loosely because we did create smoke at a fear release once.

Meagan: We did. We did. We did.

Julie: There were a lot of people releasing their fears, but yes.

Meagan: Yes, I actually remember. That was really crazy. We did that in a VBAC class actually.

Julie: Yeah, at my house.

Meagan: Yeah, so I actually really, really, really love that activity and suggest it all of the time. I’ve actually done it with my own clients in labor. We’ve done it in living rooms on the floor. Obviously, it’s hard to do if you’re in a hospital at this place, you can’t just break that out.

Julie: Light a fire, yeah.

Meagan: But doing it, and even if it’s every night because for me, when I was preparing, I had different thoughts and being on social media didn’t help me quite honestly in that very end. And so some of the tips would be the fear release activity, going through, writing them down, burning them, and truly burning them. Burning your fears. Letting them go. Letting them go and accepting whatever is coming your way.

Know that you have done all that you can to prepare for whatever does come your way. So that and I also suggest doing that with partners because sometimes partners’ fears will trickle in and create fear. Not that they’re meaning to do it, but they have fears and then they say things and our minds are like, “Oh, I didn't think about that.” And we have to process that.

Another thing would be a social media break. Sometimes social media in the end is wonderful and motivating and positive and keeps us in a great place, and sometimes, it just starts creating more fear. So sometimes we think that taking a total social media break is really healthy and helps process because you can just be with your own thoughts and not with all of the other hundreds and thousands of people on social media’s thoughts because everyone is going to have an opinion. Everyone is going to have an experience. You love hearing those just like we love hearing this podcast and these stories, right? But sometimes, those feelings and those experiences can rub off on us, sometimes in a negative way.

So if you’re noticing that some of your fears and things you’ve seen and heard on Facebook or social media, any social media platform, maybe take a break from that. I would say journaling is one of the best things I did for myself in processing fear. I was told by my OB that I was for sure going to rupture. He told me that. As I was on the table, he was so glad I didn’t have a VBAC because I for sure would have ruptured. For sure. When I heard the words “for sure”, that was very dominant in my mind and it hung with me. So when I’m laboring with my third, I was feeling that in my head. “What if I rupture? What am I doing? Am I doing the right thing?”

I knew in my heart that I was doing the right thing but I had self doubt. And so if that starts creeping in, voice it. I would say that my suggestion would be to get it out. Get it out. I’m sure that Julie has seen it, but as a doula, sometimes we can see our clients are thinking really hard in here and they’re maybe having self-doubt and things like that. It’s just so good to get it out. Get it out. Processing. Getting it out, talking, saying it out loud, hearing yourself say it is the first step to processing it as well.

So if you’re doing a fear release, don’t just write it down. Write it down. Say it out loud and then burn it. That would be some of my suggestions. And then keep educating yourself. Keep educating yourself. You said tearing, rupture, and these are all valid feelings and fears. I want you to know that. These are all valid and you’re not alone. But yeah. Fearing not progressing, that’s a big fear. I know that. But again, setting yourself up with a great supportive provider who’s going to give you time, trust, and giving you the things you need to progress. That will help. Anything you’d like to add?

Julie: No, I love that. I want to get a little bit sciency and nerdy on here. I don’t know. It’s not a secret or anything but I’ve been doing a butt load of therapy over the last year and a half and part of the things that, at some point, I learned this in therapy, but your brain, I think we all know that your emotional brain and your logical brain are in separate parts. They do not touch each other. They do not talk to each other. They do not know what each other has going on, right?

Your emotional brain is very reactive and responsive. It’s where a lot of this anxiety comes from. It’s where your fear comes from. It’s where all of your negative feelings live, well, all of your emotions live. All of your big things. Your logical brain doesn’t know what’s going on in your emotional brain. They do not communicate with each other or else we would probably all be a lot more reasonable about our entire lives.

In order to process your emotions and reconcile them and get rid of your fears, the best thing you can do like Meagan just said, in lots of different ways, is to get them out there. Get them out. Verbally talking about them, writing them down, talking to a therapist, talking to whoever is a nice, safe space for you. Any safe way that you can get them out of your emotional brain, then your logical brain can say, “Oh. That’s what’s going on over here.” It gives your logical mind a chance to take over and reconcile a lot of these things that are going on and put this emotional brain at ease so they’re not fighting and conflicting. They’re able to reconcile with each other. I don’t know if that makes sense.

That’s a big thing for me which is like, “Oh yes. I need to get these things out.” Don’t stuff your emotions down or stuff your feelings down. Get them out and it helps your brain process and work through them together so that you’re not so isolated and your feelings are not so isolated from the other parts of your body that are a lot more logical.

Meagan: Yes. Oh my gosh. I love that. Thank you, Julie.

Julie: You’re welcome.

Meagan: Okay, let’s see. She has been thinking about taking a social media break, actually. It’s really refreshing. Worried about tearing more than uterine rupture. And yeah, tearing is scary. It is scary to think about. Lots of people do tear and it is repairable, but I would say my tip for that would be to really follow your body when it comes time to push whether it be unmedicated or medicated, really listen to your body and when that baby is crowning, just little, little nudges, assuming all is going well and that will help.

And then really, baby position, right? We want to work on baby’s position because the more the baby is in an ideal position, the better it is for baby to come out. But sometimes we have these little things where we have babies doing this and sometimes we have babies doing this.

Julie: Or doing this.

Meagan: Or doing this or they come out like this and they do funny things. Tears happen, but try your hardest and let gravity help. Squatting on your side, positions that may reduce tearing and may focus on centered gravity versus a perfect spot, I don’t know the word that I’m looking for. A specific spot of gravity. Does that make sense? On your back, the bottom of your perineum has more direct pressure than when you’re squatting. It’s more central.

So working on positions and even if you have an epidural, you can push on your side. You can push squatting assisted. It’s totally possible. But yeah, anyway. Tearing is scary.

Julie: Tearing happens. I love that you said that.

Meagan: Tearing happens. It does. I mean, I’m going to be honest.

Julie: Most of the time, it’s not that bad. Most of the time.

Meagan: No.

Julie: I had a first degree with my first VBAC. I didn’t tear with my other two. I heard somebody say once, maybe it was on social media or something recently, but the biggest impact on whether you tear or not and how bad is your provider.

Meagan: Yeah. We’ve got providers that just are a little rough.

Julie: They force you to push on your back or stretch your perineum out so much. A lot of people think that helps, but it can actually increase your chance of tearing too. I don’t know. But yeah, give that a chance too, and talk to your provider seriously about not pushing on your back. Even with an epidural, you can push on your side.

Meagan: Yeah. Totally. Totally. Love it, love it, love it. Okay, any other questions that you are seeing coming in? I love that she was like, “Yeah. People say this and then we just nod and assume they’re scheduling a C-section.” They just nod like, uh-huh. We have a ton of questions coming in on social media, so are you okay if we do a couple more?

Julie: Yeah, I just have to grab my kids in 25 minutes, so I’ve got some time. And then I want to wrap up and do a little short catch-up on how I’ve been doing since The VBAC Link. That would be fun, right? Do you think?

Meagan: Yeah. Yes.

Julie: Okay.

Labor expectations

Meagan: Okay, so this is from an Instagram follower and she says, “VBAC after a scheduled C-section. Should I expect labor as long as a first-time mom?”

Julie: Can you say that again? You broke up just a little bit. Did she say what should I expect as a first-time mom?

Meagan: “After a scheduled C-section, should I expect,” assuming she’s going to VBAC, “Should I expect just as long of labor as a first-time mom?” So meaning that she’s scheduled the C-section, never went into labor, never dilated, things like that. In short, yes possibly.

Julie: Yes.

Meagan: Yes, right? So my VBAC was my third baby, my first real labor. It was kind of freaking long. It was long. But then, we sometimes have moms that had a breech baby and it was a scheduled C-section. They go in, right? Yes.

Julie: Pick me, pick me. I’ve got some stories.

Meagan: Don’t share her story.

Julie: Did she talk to you?

Meagan: No, but I’m going to talk to her.

Julie: Okay, good.

Meagan: So anyway, but sometimes it just goes really fast and we don’t know. So just like a first-time mom, not everyone goes long. Some people are precipitous. Some people can go really long. That can happen too and so yes, maybe is my answer.

Okay, let’s see.

Julie: Wait, wait, wait, wait, wait, wait, wait. Before you go on.

Meagan: Oh, you really wanted me to pick you. I pick you, Julie.

Julie: Pick me. Pick me. Pick me.

Okay, so I just want to let you know that yeah like Meagan said, you are more likely to labor for longer identical to a first-time mom, but man, sometimes this baby is going to fly out and it’s going to catch you off guard. And I have two stories, I’m not going to tell them, but I have two stories where the labors were super short. Moms got their VBACs at home on their bathroom floors because the labor just catches you off guard so much.

Meagan: It can happen.

Julie: Plan on going to 42 weeks. Plan on a 24-hour labor because it’s probably not going to be that long, but the more you can, if you expect that, then anything shorter is just going to be encouraging rather than planning on a shorter amount of time and having a longer thing being discouraging. That’s my advice.

Double-layer suture versus single-layer

Meagan: Yeah, for sure. For sure. Okay, this next question is, “Does the type of suture matter much? I had a single-layer but read that double was better.”

Julie: Oh, pick me again.

Meagan: Yeah.

Julie: Sorry, you’re looking at me.

Meagan: I’m looking at you.

Julie: All right, so here’s the thing. There used to be a belief that a double-layer suture is, because there are several layers of the uterus, right? The single-layer versus double-layer. A single-layer closure means they sew all of the layers up with one stitch, one suture. Double-layer is where they close it in two separate layers, right? So there used to be a belief that a double-layer suture was safer and would decrease your risk of uterine rupture if you go through vaginal birth, or I guess, overall because you don’t have to go for a vaginal birth to have a rupture.

But since then, there have been several studies come out that show that there’s no significant difference in rupture rates between single-layer versus double-layer closures. So, no. It doesn’t make that big of an impact. Now, there has been one recent study that shows that a double-layer closure is optimal, but that one study isn’t very big. It’s not very credible. It’s not as big and not as inclusive as a Cochrane review and things that show that there are not really big differences.

So sometimes, people will say, “There’s this one study in 2021 that shows this.” See, probably not in that voice, but anyways. But the majority of information that we have shows that it does not matter. However, ten years ago, people used to think that it would make a big impact. Things have shifted since then.

Meagan: Yeah, we still have many providers that say it actually determines eligibility based on that. Like, tons. We get emails all of the time. It’s like, “Hey, I really want a VBAC but I found out that I only have a single-layer suture, so I can’t. Is this true?” So yeah. Okay, ready for the next one?

Julie: Yeah.

Special scars

Meagan: Low, transverse uterine incision that extends one side vaginally. Vaginally? Can I VBAC? Vaginally?

Julie: Vaginally? I wonder if it’s a J?

Meagan: That’s what I’m wondering.

Julie: Except she said, “Vaginally.”

Meagan: I’ve actually never heard of a uterine incision extending all the way.

Julie: I don’t think it can. It can go down into the cervix.

Meagan: Yeah, the uterus is up and then it has the cervix. It goes like this.

Julie: Yeah.

Meagan: Yeah, and then that comes down into the vagina, but they’re separate.

Julie: I wonder if there’s some word confusion there.

Meagan: Maybe. I will ask her, but I’m wondering if this is meaning a special scar.

Julie: Well, yeah.

Meagan: I’m wondering if maybe there is some confusion about a special scar and yeah. People still VBAC with special scars. They do. We have special scars on the podcast.

Julie: Leslie’s is my favorite birth story. She goes into such detail about the data and everything about that.

Meagan: Yes, Leslie did a home birth, right?

Julie: Yeah, I think it’s episode 18 or something in the teens I think.

Meagan: She was really early on. So yes you can. It’s still possible. You still want to educate yourself. Just because you can doesn’t mean you are going to choose to or that you’re going to want to.

Julie: Or that you’re going to find a provider that’s going to support you.

Meagan: Or that you’re going to find a provider that’s going to support you, and so we encourage everybody to do the research, look at the education. We have some blogs. We talk about special scars in our parent’s course. We have some episodes, so there is information out there for you guys.

Julie: Yeah, the risk of rupture is a little bit higher with special scars, so that’s something to consider too, but what an acceptable risk is to you is going to be different for everybody. So I think it goes from about half a percent to maybe 1.2% or something in that range. It’s less than 2% overall, and so is a less than 2% risk of rupture acceptable for you? You’re going to be the only one to answer that.

Meagan: Yeah. Yeah.

Julie: Does that make sense? I feel like I didn’t understand the words coming out of my mouth.

Meagan: Yeah, no. No, it made sense.

Julie: Okay, do you ever do that? Anyways.

Warning signs and symptoms for uterine rupture

Meagan: Yes. Okay, next question was, “Warning signs and symptoms for uterine rupture?” This is a really great question because we were talking about that, the fear of uterine rupture, and there are signs. There are, I should say, symptoms. Some of the signs and symptoms may be one, pain. Pain down there and if there’s an epidural in place, it might radiate up. The uterine rupture that I attended a long time ago, she had an epidural and they kept calling it a hot spot, but it was way, can you guys see me? Way up here in her ribs where it was hurting which is kind of an interesting spot, but it was just radiating where she wasn’t numb, where she could feel. So yeah, pain.

And also pain that doesn’t go away. Pain and discomfort during a contraction or surge comes and is there, and then it goes away, that may be different than the pain that is there, increases with contractions, doesn’t go away, and is still very intense. Bleeding, lots of bleeding, lots of bleeding. Stall of labor, where your labor is just not progressing. Baby going up, so moving stations, but dramatically. Like your baby was +2 and now your baby is -2. Stations can be subjective, they say their baby is a 0 but now it’s a -1, and they’re saying that maybe it’s a 0 to +1. It’s kind of subjective.

Julie: Yeah, they’re just centimeters that we’re talking about with baby’s station. It can vary from provider to provider.

Meagan: If you think about my hand to Julie’s hand, right? Our hands are very different. They look different. I have long skinny bony dumb fingers that I can’t stand.

Julie: Not dumb.

Meagan: Really wide palms, so my long, skinny fingers versus someone with shorter fingers may be different. One of the number one things that providers look for, although I will say that this isn’t always the number one first symptom is fetal heart tones. Fetal heart tones that are just tanking and not recovering, that is a concern. That is a concern and that is a sign. Let’s see, what else am I missing?

Julie: I’m trying to think. I think that’s it.

Meagan: I think that might be all.

Julie: Yeah, and that’s the biggest reason why they’re really particular about continuous fetal monitoring for a VBAC. But yes, if you can feel the head on top of your pubic bone, it’s kind of weird to really describe that, but I’m not going to show you.

Meagan: You can usually see it. There’s a bulge. Baby’s not in the right spot.

Julie: Yeah.

Meagan: We also have a blog on that. So, okay. Are there any other questions in the Facebook group that I’m missing, Julie? Because I’m on Instagram right now.

Julie: Let me check.

Meagan: This one is, “My C-section was because of failure to descend. Do I still have a chance to VBAC?” Absolutely. Failure to descend means that baby just didn’t come down. A lot of the time, that’s due to positioning, that’s due to more failure to wait and let the baby have time to come down. Just because you’ve reached 10 centimeters doesn’t mean it’s time to have a baby necessarily. Sometimes baby needs to have time to rest and descend and come down, but yes. Absolutely. You guys, on Instagram, if you’re not there, we did pull over. So if you’re over here, yay. If not, then I’m going to try and get these answered on Instagram as well. Do we have any other questions?

Julie: I didn’t see any. Yep, nope. Still no.

Meagan: Okay, any other final questions for the eight of you that are left? We’d love to finish up, but yeah. While we are waiting for any other final questions, Julie, did you want to update everybody on how the last couple of months have been for you?

Julie’s update

Julie: Yeah, I think it was a little bit of a hard transition for both of us. Meagan is doing amazing trucking along, keeping everything going and I’m super excited to see all of the changes and stuff that are going on over on social media and the website and everything like that. I’m really proud of you. You’re doing amazing.

Meagan: Thank you.

Julie: And welcome the new admin, Katie, helping. She’s doing an amazing job too, it seems like so that is really great. Yeah, I mean, I’ve been trucking along with the birth photography thing. I think we talked about that on the podcast episode where I made the announcement that I was leaving, but it’s been going really good. I’ve been to several, many births since then.

Meagan: Tons of births.

Julie: Yeah, the last two weeks, I did five and it was actually ten days. It was five in ten days. Two of them, I was a backup for somebody, so it kind of doesn’t really count, but it kind of does. Several of them have been VBACs which have been amazing because I love still being able to be in that space and supporting people. Things are going well and I’m really excited.

I do have, it’s a hard and separate feeling. I don’t know how to describe it because I know it was the right choice for me, but it’s also kind of sad at the same time. And so, yeah. I’m excited. I’m glad to still be kind of part of the community and being here in and out with Meagan every once in a while. I’ll pop back in to give an update and talk more.

Yeah, I would love it if anybody wants to keep in touch. You can find me on Instagram, I’m just @juliefrancombirth. All one word, you can give me a follow or ask me questions. I’d be happy to talk or answer questions about anything, but I’m just so excited to see The VBAC Link thriving as it is. It makes me happy. I still talk about it. I still say “we” whenever I talk about The VBAC Link. I think it’s going to be a long time before that goes away.

But yeah. I’m just proud of you for doing a great job. I’m excited. Life is just busy with other things.

Meagan: Just other things, yeah.

Julie: I’m able to manage all of my priorities right now instead of having everything halfway.

Meagan: Yes, which is important.

Julie: Yeah, it is important. What other questions do we have?

Meagan: Let’s see. “I had second-degree tears with my VBAC. Unmedicated, no coached pushing. It is still–” Oh, this is probably to comfort. “It was still worlds better than my C-section recovery was.” So yeah, like we were saying, tears happen, but it is a lot less invasive, usually those tears aren’t full tears cutting through all of the layers and things for a C-section. But yeah, I would agree. I didn’t end up tearing necessarily, but it was really tender down there. I just pushed a baby out of my vagina.

Julie: A vaginal tear heals up way easier and faster, yeah. Certain parts of your body are more inclined to heal faster.

Meagan: Yeah.

Julie: But then, Tiffany asked, what’s the podcast name, and your Instagram? So obviously people listening and you replied there, but I want to say it for people listening. Obviously, if you’re listening to the podcast, you already know what the podcast name is, but it’s just The VBAC Link podcast just like our Facebook group. See? There I go again with “our.” We’re on Instagram and everywhere. The VBAC Link on Instagram, Facebook, YouTube. There’s a Twitter. I don’t think we’ve tweeted in a really long time, but anywhere you want to find The VBAC Link, you just search. They are on so many platforms. Same with all of the podcast hosts, any major podcast platform or you can listen on thevbaclink.com/podcast.

Meagan: Yeah, we’re everywhere. Instagram, all of the places. Yeah, and then like Julie said, Julie Francom Birth if you want to still follow Julie and her journey. We’re all supportive. I have a doula business. It’s Tiny Blessings Doula Services. You can see what we’re up to on the other side. But we really appreciate everybody. I think that’s all of the questions. We really appreciate everybody for coming on today, and dealing with our 34-minute delay.

Julie: That sucked.

Meagan: Because we knew there was one setting. We knew it had to be in the group, but we figured it out.

Julie: But we figured it out.

Meagan: That’s what matters.

Julie: That’s what matters.

Meagan: This has been really fun. So let us know if you really like this, this live podcasting, because that might be something fun that we can do here in the future in this amazing group. So yeah. As always, we love you. We thank you. Love any other reviews that you want to leave. You can email us if you have any other further questions at info@thevbaclink.com. Instagram, Facebook, you can drop it still down in this, it’s going to be I think it will be in there. So yeah. We love you. Thank you so much. And Julie, I’ve missed you.

Julie: I know. Gosh, it’s been so weird.

Meagan: It is.

Julie: So weird, and yeah. All of the feelings.

Meagan: Yeah, but I’m really happy for you and we’re having fun over here at The VBAC Link still. We’ve got Katie helping out, so you guys will probably see Katie’s husband flipping around on Facebook.

Julie: That was fun.

Meagan: Or her cute face. She’s a cute little blonde so you’ll see her and you’ll see more of me as well. We’re really excited. Thank you so much for being with us today and mwah. We love you a lot.

Closing

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


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200 Episodes with JULIE!

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Treść dostarczona przez Meagan Heaton. Cała zawartość podcastów, w tym odcinki, grafika i opisy podcastów, jest przesyłana i udostępniana bezpośrednio przez Meagan Heaton lub jego partnera na platformie podcastów. Jeśli uważasz, że ktoś wykorzystuje Twoje dzieło chronione prawem autorskim bez Twojej zgody, możesz postępować zgodnie z procedurą opisaną tutaj https://pl.player.fm/legal.

Meagan welcomes Julie back today to celebrate 200 episodes of The VBAC Link podcast! They celebrate this milestone with a special live Q&A podcast recording session joined by followers of The VBAC Link Facebook community.

Topics include: how to talk to your provider, all about Spinning Babies, adhesions, managing sciatica pain, induction, nipple stimulation to induce labor, VBAMC, C-section consent forms, and much, much more.

We can’t wait to continue sharing new episodes with you as we stay committed to our mission of making birth after Cesarean better!

Additional links

Spinning Babies website

The VBAC Link Blog: Pumping to Induce Labor

Fear Release YouTube Video

Episode 18 Leslie’s HBAC + Special Scars

Julie’s Instagram

The VBAC Link Community on Facebook

How to VBAC: The Ultimate Prep Course for Parents

Full transcript

Note: All transcripts are edited to correct grammar, false starts, and filler words.

Julie: Welcome to The VBAC Link podcast. This is our 200th episode and yes, you are listening to Julie. I’m back just for this episode and probably some more in the future at some point, but we are so excited, Meagan and I, because this is the 200th episode. We are now live in our Facebook group. Not now when you are listening to it, but right now in this moment in our timeline.

It took us way too long to get in here live, but we are doing a Facebook Live podcast episode. We have never done that before and we probably will never do it again because this was kind of traumatic.

Meagan: Yeah, this was a little rough, but that’s okay. Now that we know, now that we know, we are good. We’re good.

Julie: Now we know.

Meagan: It just took 34 minutes to figure it out.

Review of the Week

Julie: Oh my gosh. Cool. So, let’s get started first. There is a Review of the Week. Meagan, are you ready? Do you have one?

Meagan: Yep, I do. This is from blpinto and it’s from Apple Podcasts. It says, “Wonderful resources for ALL moms, not just VBACs.” It says, “I didn’t have a C-section for my first birth, but I had a traumatic experience with a forceps delivery and an induction that was not at all what I was looking for. I started listening to the podcast before I even got pregnant a second time to prepare for a better experience. Julie and Meagan were a huge part of my process and journey. I ultimately had a beautiful home birth and a 10-pound, 6-ounce baby. I felt this podcast helped me overcome my fear that I couldn’t push my baby out without help because many VBAC moms had the same feeling.”

I love that. I don’t know many first-time or second-time moms who haven’t had previous C-sections that have listened and left a review. So that was awesome. We truly believe that this is also a podcast for everybody. Just like wonderful Brian says at the beginning of this podcast, it’s for all expectant parents who want to avoid a Cesarean and want to learn their options and learn what’s happening out there. So that is so exciting that we had someone who hadn’t even had a C-section before.

If you know someone who is expecting and has fear or maybe a first-time mom who has some doubts and problems and traumatic experiences in birth, definitely share the podcast. These stories are amazing for all to listen to. I would 100% agree with her.

Julie: I love that. Do you remember years ago when we first started and we were trying to figure out how we could make something, maybe not separate, for first-time parents? We were like, “How do we get first-time parents to understand that these are things they need to know?” Because you didn’t. I didn’t. As a first-time mom, I didn’t even think about a C-section until the doctor said, “We need to do a C-section,” and we never really got very far with that because the focus of The VBAC Link is a vaginal birth after Cesarean.

Yeah, so we love that. We, I say “we”. I will always say “we” talking about The VBAC Link.

Meagan: Literally, just earlier today, I was recording a podcast and I was like, “we”. I mean, “I”, but Julie is just over here.

Julie: My spirit and presence exist in the VBAC realm.

Meagan: Yes. But it’s so much fun. It’s so fun to be here and I’m excited. If you guys haven’t had a chance or if you are watching live right now, we would love your reviews. Love, love, love your reviews. You can send us an email. You can write right here and I will copy it over and put it in the reviews. We are excited to dive in today on episode 200!

Q&A

Julie: Yeah. All right, all eight people who are watching. I guess one of those is me and maybe you, so six. Six people. Drop your questions. Nothing is off-limits. We are going to talk about everything you want to know. Everything you want to hear. We are going to get down and dirty with everything VBAC, wives, and kids. If you want to know what Meagan’s kid is doing right now in the background, we will talk about it.

Meagan: Yeah, drop your questions. I’m posting here letting people know that we actually are live now.

Julie: Oh heavens.

VBAC: Where do I start?

Meagan: Yes. It’s so funny. I keep looking on the wrong forum. Okay, who do we have in here? Who do we have? Kathryn, Jen, and AJ thank you so much for being here. Let us know your questions. I want to maybe start off just on VBAC options. We had someone write in yesterday and was like, “One, I didn’t know VBAC was an option. I didn’t even know what it was.” So that’s wonderful that they’re starting to find out that VBAC is an option, but let’s talk about how we can have a conversation about VBAC being an option with a provider. That’s just random, I know.

But what would you think, Julie, if you’re starting to discover VBAC, learning what it is, feeling like you want to feel it out, maybe you want to learn more about it and do it, how would you suggest approaching your provider?

Julie: Oh man, that’s a great question. First of all, we’ve got some good questions coming in too so I’m excited to answer these. Provider, honestly, I would just ask where their thought process is. I would approach them and say, “Hey. this is what I’m considering. What are your thoughts about it?” And I will tell you what. No matter what their response is and no matter what ultimately your birth plan is, you’re going to get a really good feeling for how your provider feels about body autonomy, informed consent, and birth in general because if they answer and say, “Oh, well I don’t think you are a great candidate. I don’t do VBAC. I don’t support them,” or anything that’s very sounds set in stone, so, “I don’t do this. We won’t let you do that. We would have to look at this and make sure your percentage is high,” or whatever.

Anything that is set in stone shows you that your provider is not as supportive of other options or your provider has a very set way of doing things and may not be a good choice for you. But if they answer and say, “Yeah. We can consider VBAC as an option. Let’s talk about some things about what your goals are. I do VBACs a lot. I love VBACs” or anything like that with a more open or a more fluid answer is going to let you know that your provider is going to not only be good with whatever outcomes that you choose but is also very open to having the parent or the mother be part of the birth process and be involved in the decisions regarding their care.

That’s really what you want to have on your side no matter what type of birth you’re having or where you are giving birth. You want to have a provider that is going to be open to your input, be a little flexible, a lot flexible based on what your needs are and the type of birth you want, and is able to accommodate that.

Meagan: Yeah, and just that’s willing to have that conversation because a lot of providers don’t honestly come out and say, “Hey, do you want to have a TOLAC?” which is a trial of labor after a Cesarean. That may be something that you have to take charge of and say, “Hey. I’m learning about this. What are your thoughts? How do you feel about it? Tell me about some experiences.”

We always talk about open-ended questions but really, truly if you can ask an open-ended question, you’re going to be able to get more information than a “yes” or a “no” or an, “Oh yeah. Sure,” versus, “Yeah. I feel really comfortable with that. We do that all of the time. This is why.” So I love that. I know it was a random question, but a lot of people are asking, “How do I even approach this topic with my provider?”

Okay, are you ready? I’m going to read some questions. We’ll bounce back and forth.

Julie: Yes, let’s do it.

What is Spinning Babies?

Meagan: So Ms. Kathryn says, “I just found your podcast last night.” Yay! And now you’re here on the first live one. It says, “Bingeing ever since. What is Spinning Babies? I’ve heard it talked about a lot on the podcast.”

Spinning Babies is a wonderful resource. They have all sorts of circuits and tips and tricks on ways to navigate babies through the pelvis. Breech positions, so if you have a breech baby, they have positions and exercises to do that. We’ve got posterior. We talk and they also do baby mapping to help figure out where your baby is.

Julie: Belly mapping.

Meagan: What did I say?

Julie: You said “baby mapping.”

Meagan: Baby mapping. I meant belly mapping.

Julie: They’re the same thing.

Meagan: That’s what I meant. Baby mapping. I almost said it again. Belly mapping to help you figure out where your baby is. They can educate on if a baby is posterior, what types of things to do and what to do if a baby is asynclitic or comes over the pelvis, and what tips and tricks you can do. A lot of doulas are really educated in Spinning Babies. It is so awesome. So awesome when the client, don’t you think, is educated in this and they are familiar with it.

Julie: Yeah.

Meagan: So obviously, we talk about it a lot in the podcast, but we really encourage people to check out their website. They have updated their website and it’s really quite great now. It’s really friendly to navigate, so check it out. It can be a game changer. I have had positions in labor where things were just hanging out, stalling, not really going anywhere, and then we have done a Spinning Babies technique and boom, that baby rotates and labor is speeding along.

Julie: Yeah, I love that. I think one thing that I really like about Spinning Babies too is that it puts less emphasis on babies being in this specific position and it creates more emphasis on creating room and space in the pelvis.

Meagan: Balance.

Julie: And with the connective tissues and yes, balance and all of those things because sometimes, babies need to enter into the pelvis in a little bit what you would call “less than optimal.”

Meagan: “Less than ideal”, yeah.

Julie: But as long as baby has enough space and room to wiggle and progress through the pelvis in the way it needs to, then you’re going to have a great, not a great, that’s a bad promise. You’re not going to have a great labor necessarily, but you’re going to be able to encounter less problems that are created by a poorly positioned baby or tissues that might be more difficult to move and things like that. So yes, balance, space, and flexibility.

Do adhesions impact fertility?

Meagan: Yeah, absolutely. Okay, let’s see. AJ Hastings. “Do adhesions really impact fertility? Currently trying to conceive for seven months and was told by acupuncture that I need 12 months of weekly treatments. I definitely want another opinion.”

So the short answer is yes it can. It can affect things. In fact, we have an episode and I will go find it here. I’m going to go find it. I’m going to drop it. It’s so weird because we are on Zoom, but we are on Facebook over here. I’m going to drop it in the Facebook group right here because it definitely impacted her. It impacted her and adhesions, depending on how dense and how thick and everything, it can impact fertility. 12 months of treatment? I don’t know. I mean, I’m not a specialist in how intense that needs to be. I have adhesions as well, but I don’t know how dense they are.

I was fortunate enough to become pregnant, but it can impact it and it’s something to look into. I don’t think it’s bad to get a second opinion for a whole year of treatments, but I also wonder if scar massage, starting with scar massage by yourself, or going to a pelvic floor specialist and starting there might be beneficial. Julie, what would you think?

Julie: Yeah, right along with what you said, it can. That’s the thing. It doesn’t always, but it might. Adhesions, especially ones that are denser or thicker can tug and pull things in the wrong way. They can make it harder for eggs to implant and can cause a whole slew of problems for your overall health depending on the relation to different organs that they might be adhered to. All sorts of things, but it doesn’t always, right?

One thing that I would ask my provider that’s recommending that is what other options are available, what other things might be impacting my fertility? Have you seen any other types of providers? Have you seen an OB/GYN or maybe a fertility specialist in that regard or gotten a second opinion from them? Sorry, I think she said. Yep. I’m trying to see that it was told by acupuncture. Yeah, so I would maybe consult another type of provider. But trying to conceive for seven months is kind of a long time, but it also could take up to a year without there being any problems at all for just any random average to get pregnant too.

That is just what was going through my mind. Is that the only thing that you are treating and addressing or is it part of an overall care plan? Are you seeing anybody else? That type of thing.

Meagan: Mhmm, yeah. And like she was saying, maybe a different provider, maybe a pelvic floor specialist to even just dig into what those adhesions look like or a care provider, but yeah. It can. I’m going to go find it. I was just scrolling, but I’m going to go find it. Do you remember, Julie, do you remember her name?

Julie: You’re asking me if I remember anybody’s name?

Meagan: I’m the name person. I keep thinking it starts with a J. I’m going to find it though and I’m going to drop it in for you, AJ. Okay, “I just had a VBAC a few months ago and,” awww. “I’m so thankful for both of you.” Thank you, Allison. That’s so sweet. So, so sweet.

Julie: Thank you.

How to manage sciatica pain

Meagan: Congratulations! Okay, Jenn. “I’m 39 weeks. My sciatica only allows me to walk for about 20 minutes without cramping. I see a chiropractor twice a week, but other than that, what can I do to help keep my baby in a good position and get labor going?”

I would suggest the Miles Circuit right off the bat. Miles Circuit is wonderful. You can do it multiple times a day. There are three circuits and you want to try to do it for a minimum of 30 minutes but sometimes you have to lead up to that. That would be something that I would suggest. Maybe giving it a try. Also, Spinning Babies is very much a balance factor in creating balance.

It sounds like your sciatica is not loving you right now and that is hard. That is hard, so being mindful also of being symmetrical and getting out of the car. I know that sounds really weird, but not stepping out with your left. Stepping out with your right. Trying to move out together because that separation with relaxin and things like that can cause the pelvic to shift, which then causes sciatica issues and all of those things. But I would suggest Miles Circuit. I would also suggest a massage. Getting things relaxed and soft because sometimes when things are tense, we’ve got that sciatica issue. Julie, what else would you suggest on that?

Julie: Yeah. First of all, I would say that if you are in pain, then don’t do anything. It’s okay to stop. You don’t want to hurt yourself and cause pain, tension, and stress in your body because that could interfere with your natural labor hormones. But honestly, I would think going to a chiropractor twice a week and walking 20 minutes a day is great. I think that’s great to do. If that’s all you can do, then I don’t think you need to do anything else.

39 weeks could still be early based on when your baby wants to come, so don’t feel like you urgently have to do anything. If your provider is pushing you a little bit, then it might be time to have a conversation about what your boundaries are and where you are willing to go as far as how far along gestationally before you interfere. But yeah, what Meagan says for sure. The Miles Circuit, absolutely. Two positions in the Miles Circuit are that you are resting pretty much and just creating more space in the pelvis.

I would say maybe if you want to try changing it up from walking, one of my favorite things is going up and down the stairs sideways two at a time. It’s kind of like walking, but you are really opening up that pelvis. So you go up with the right foot first, down with the right foot first, then switch to the left foot first, up and down. That’s creating a nice, flexible, open space and lots of equal balance like Meagan said.

Meagan: And listening to your body on that. Listening to your body. If it’s too much, stop or just do three sets of stairs, three stairs. Just don’t push your body. Yeah. But I like that one. I actually did that with a client at a birth center where there were some stairs. We did that to get labor going and it totally helped. It was amazing.

Julie: Yeah, I love that. That’s my favorite or curb walking. You just walk right foot on the curb and left foot off the curb and then switch with the other foot to keep that balance and stretch both sides of the pelvis. But yeah, change it up a little bit. I think you are doing great, personally.

Meagan: Mhmm, yeah. Going to the chiropractor that often is amazing. Realigning. But yeah, 20 minutes, maybe cut it down to 15 minutes. Just a little less before you are in too much agony. Yeah, yeah.

Julie: It’s okay to take a rest. It’s okay to not do it one day too, or a few days, or every other day or twice a week.

Meagan: Yeah. I would also say shaking the apples which is a Spinning Babies thing, but that actually really relaxes and softens down there and can help with sciatica pain. That’s just where you put the rebozo around your bottom and have someone sift, so you’re kind of doing this.

Julie: It’s so fun.

Meagan: This is so hard to be on a Live because I talk a lot with my hands. If you can see this in this video, Julie is very much here and I’m dancing.

Julie: I even brushed my hair today.

Meagan: You kind of get sifted and it really is nice for that sciatica. Okay, oh let’s see. Just listened to all,” oh my gosh, “all 198 episodes of you guys.” Oh yes, yes. I just can’t believe that we are at 200 episodes. I was telling my husband today and he was like, “Whoa. That’s a lot.” Yeah, that’s awesome. So awesome. Okay, do you guys have any other questions coming in on here? What else would you like to talk about, Julie, while we are waiting on any other questions? It’s been a minute. It’s been a minute since you’ve been on here.

Julie: I know. It was 15 minutes before it was about to start. I was editing photos all day, so I was like, “Oh shoot, I should brush my hair and change my shirt,” because I had this frumpy little shirt on. I’m like, “We’re going to be on video today. We never usually do that.”

Meagan: Yeah.

You don’t have to be induced at 39 or 40 weeks!

Julie: So it’s just interesting. Let me think. I was just trying to think what has been bugging me from The VBAC Link Community lately. Not bugging me, but you know when you just want to grab ahold of people’s shoulders sometimes and say, “This doesn’t have to be this way. You don’t have to do this!” Or just like, “It’s okay to stand up for yourself.”

I think a lot of the things I have been seeing lately a little bit is when people talk about induction or their doctor not letting them go past a certain amount of weeks.

Meagan: Yeah.

Julie: That’s really kind of heartbreaking because, in America, we have a really frustrating maternal health care system. It’s really easy to get trapped in that if you’re not comfortable standing up for yourself if you don’t know that it’s okay to stand up to you’re provider, and if you don’t have an opinion about everything that you possibly can in birth.

It’s hard when I see people going in and getting induced. We’ll see posts all of the time where people will be like, “Oh my gosh, I’m 6 centimeters. I’ve been soft for 8 hours. I was induced at 39 weeks. My provider said this and that and the other.” I just want you to know, everybody. You do not have to be induced at 39 or 40 weeks in order to get a VBAC.

Meagan: You don’t. You don’t. I also wanted to talk about the opposite. On the flip side of that, I want to say that you can have a VBAC if you are induced.

Julie: Yes.

Nipple stimulation to induce labor

Meagan: So there are both sides where it’s like you have to be induced or you can’t go for a VBAC or it’s, “I will not induce you.” And so anyway, it’s so hard. I was just looking. We have a group member that posted a couple of hours ago and she said, “I have a question about nipple stimulation to induce labor. I’ve been trying since yesterday and I do get contractions although they might just be Braxton Hicks because they are not really painful. But as soon as I stop, the contractions also stop. Any advice?”

I just want to talk about this. In fact, I think Julie wrote a blog about this. I think, didn’t you write a blog about nipple stimulation and pumping to induce labor? I’m pretty sure you did.

Julie: I’m pretty sure that was you.

Meagan: It might have been. I don’t remember.

Julie: That doesn’t sound like anything I would write.

Meagan: Well, yes. So this is something that I actually did when I was in early labor. I wanted to talk about that, but my midwife kept saying, “Hook up to the pump. Hook up to the pump.” I hated that thing. That thing was not my friend, but it worked. It helped, I should say. But sometimes it doesn’t. And so kind of similar to what this group member is saying is that it sounds like it is releasing oxytocin in your body and it’s stimulating something. Something enough to cause your body to contract or have some sort of spasms in your uterus, right? Which is a contraction whether or not it is strong.

But when you stop, it stops and so that is– this is what I tell my clients too. That is a sign that your body is not quite ready or it’s not going to respond to this type of method right now. Pumping is a really great option, but if it’s not going, I would say to pause. Maybe just give it a break and see what happens. You can try again later or follow the advice of your provider.

I would say that it’s not bad that your body is not responding and it doesn’t mean anything like it’s not going to work ever, but it just sounds like your body may not be ready. So my advice is to maybe give it a break, try it a little bit more, try it a little bit longer and see, or maybe go have sex instead and try to release oxytocin in a different way in your body. So anyway, I just saw that. Are there other questions that have come in? Do you see any?

Julie: Yes, there is.

Meagan: Okay.

Julie: Hi Paige, by the way! Hi Paige. Paige commented on the pumping to induce labor blog.

Meagan: Oh yeah.

Julie: Okay, so Tiffany, nope. Not Tiffany. It’s before that one. Tiffany, I’m going to get there. Angel said that if we want to read her post in the group that she would love some thoughts. So I found Angel’s post and I will read it. I love this. I have lots of thoughts, so Angel, if you are still watching, could you drop your location in the comments so I know? Oh, you’re in New Zealand. You already said that.

VBA3C

Julie: She said, “I would love your opinions. I have contacted 15 midwives in New Zealand and all have said ‘no’ to a VBAC after 3 C-sections. The main reason why I don’t want a fourth Cesarean is because fentanyl is in a spinal block.” P.S. a lot of people don’t know that. When you have an epidural or when you have a spinal block, the epidural is not the medicine. It is the method of giving it into your body. An epidural has lots of different medications in it. Fentanyl is one of them. Tramadol is another one. Sometimes there are antibiotics in there with them. But a lot of people don’t know that fentanyl is in an epidural and a spinal block.

Okay, so she says, “Tramadol is the pain relief afterward.” Tramadol is a form of morphine. That will be present in the milk which is one of the reasons why she doesn’t want it. Antibiotics afterward, milk again, and all of her children have had severe colic and reflux to the point of sleeping four scattered hours overnight until they are 16 months old. All day naps are held upright. This is physically and mentally shattering. Could there be a link between colic, reflux, and antibiotics? It may be a possibility. “I live a 100% organic, tox-free lifestyle. I don’t even take pain relief for headaches. Cesareans go against my holistic lifestyle.”

“That being said, the first two Cesareans, I believe, were medically necessary.” Cord wrapped very tightly around necks, very thin and short. Babies were wrapped up by their necks tightly and couldn’t move down, couldn’t descend. Fetal distress straightaway for the first baby, second repeat Cesarean for the same issue. The third, the cord was fine, loosely on my tummy, but the amniotic fluid was a 4. It should have been a 7. She was pressured into a repeat Cesarean in case there was the same issue as the first two.

She said, “I just need tough love, realistic answers.” Should she just have a fourth Cesarean and do everything else holistically?

Meagan: That’s tough.

Julie: Yes.

Meagan: We had a message come in earlier. I’m wondering if it’s the same person because it sounds strangely familiar. New Zealand. I can’t speak. But wow, that’s tough. That’s tough because you have good, solid reasons, beliefs, and feelings. Yeah. You know, it sounds like you are getting a lot of pushback in your area. A lot. That’s a lot. There may be somewhere underground there that would allow it, but yeah. I don’t know. It seems like you have enough reason to not do certain things. I don’t know. I would maybe. I would maybe, actually. What would you do, Julie?

Julie: Well, she says she wants tough love and I love tough love. So when I get permission for it, I will fork it out.

Meagan: Yeah.

Julie: So here’s the thing. First of all, vaginal birth after three Cesareans, I love, love, love that we are seeing more stories come out about VBAC after 3 C-sections.

Meagan: Me too.

Julie: There’s not a lot of data to support its safety or not. We have a few studies if you want to google VBAMC. We have a whole blog about the information that is available, but there’s just not a lot out there. The way we get a lot of information out there is for more people to do it, right? That might not be a risk that a lot of people are willing to take. Personally, I would probably try it because I kind of know all of the information and everything, but I don’t know because I haven’t been there.

So here’s my tough love, okay? It sounds like you have talked to a lot of providers. This sounds like the providers you have talked to do not want to support you in your choice. And so when that happens, and this is for anybody who can’t find a supportive provider not necessarily just directed at you, Angel, you have a few options.

First is to go into labor and wait as long as you can and go to the hospital and fight and fight and fight. Out-of-hospital probably wouldn’t take you on as a patient. But depending on, I don’t know how the healthcare system is set up exactly out there. So go to the hospital, show up pushing, which I would never recommend that ideally if you could, but that’s an option for you, okay? Go into labor. Go into the hospital. Maybe get a doula. Have your partner on board or somebody there who can really heavily advocate for you and be fighting the whole time.

Or you can birth unassisted at home, which I also don’t necessarily recommend, but there are a lot of people that can do it and do it smartly.

Meagan: They have a lot of solid resources.

Julie: A lot of resources, have a really solid backup plan, know everything that you need to look for as far as warning signs in labor, maybe labor close to the hospital or in the hospital parking lot or something like that. Neither of those might be good options for you, but it sounds like there’s not really a good option anyway. I think also, sometimes I appreciate and envy, to some degree, the holistic lifestyle that you have.

Sometimes, if you don’t feel comfortable fighting in the hospital or having a baby unassisted, your third option is to have a repeat Cesarean.

Meagan: Make it really special.

Julie: Maybe you won’t have a holistic lifestyle at that moment. ** You’re going to have to get some medications that you don’t love, right? You’re going to risk having those things *** began with the colic and maybe the upset digestive tract from the antibiotics and things like that, but that also might not be the worst thing to have ***. The only thing that you are going to be able to know is what the best choice is even though there is not a good choice. I don’t know if that makes sense or not, but yeah.

I mean, you can create a nice, beautiful space like Meagan just said. You can ask for the spinal block and see if there are any alternatives to the fentanyl or other kinds of medication that they can put in there. You can ask for a shorter hospital stay. You can look into ways to heal your baby’s gut after the C-section. You can look into vaginal seeding which can get the baby’s gut populated with your flora from the vaginal canal which is really helpful for the baby’s microbiome and things like that. I feel really angry for you a little bit.

Meagan: I know.

Julie: –that the system is set up to work against you in such ways. But I feel like this is something that you are really going to have to sit with and tune into your intuition hardcore and figure out what risks you want to accept, right? Because it sounds like you are going to have to accept some whether it’s birthing with a C-section and not having the birth you want and introducing those different things to your baby, birthing unassisted without a provider present, or fighting as hard as you can in the hospital for your VBAC.

Meagan: It infuriates me that people even have to be in this space at all.

Julie: Yeah.

Meagan: The providers are so worried about supporting people doing vaginal birth after multiple Cesareans, yet they’re pushing people and making people feel like they have no choice other than to birth with no provider. I am not saying that someone who births without a provider– I’m not shaming anybody for sure, but I think it’s nice to have that supportive provider behind you, that trained, skilled provider. A lot of people that do go unassisted, I’m not kidding you guys, they dive in deep. They are prepared and that’s awesome. Good for them. Absolutely good for them.

But it just makes me so mad that someone even feels like they are stuck in making that option.

Julie: Yeah, I agree. Angel also asked a follow-up question if she could decline antibiotics. Here’s the thing. You can decline anything you want to decline. It’s just going to depend on what’s going to make your providers nervous and if they’re willing to provide care or not. I don’t know. I don’t know if your provider will be comfortable doing a C-section without having antibiotics available during and after the C-section or not, but that’s something that you can talk with your provider about ahead of time and see what that looks like. Or have a minimum dose or only one round or something like that.

Meagan: Mhmm, yeah. I love that. Sorry, my little boy, this was also part of our technical difficulties. Look at his head. Show everybody your head.

Julie: He got konked.

Meagan: And your arms, huh. Yeah, he fell today at recess.

Julie: All right, let’s move on to the next question. Angel, I give you all of my love and support.

Meagan: I wish you luck.

Julie: Yeah, I do. Please keep us updated. Us, again. You guys, this is killing me. Meagan, you have to let me know when Angel updates you because I’m invested now.

Gentle induction plans

Julie: Okay, what’s next? We have– oh, yes. Let’s get to Tiffany. Hi Tiffany. Tiffany M. Okay, so she said that her doctors told her that they will not allow her to go past 39-40 weeks. She was able to control her blood pressure thus far and she had hypertension in her last two pregnancies. Her doctor doesn’t want to induce because it allegedly increases the risk of rupture.

Meagan: Your voice.

Julie: Sorry. “They’ve been insanely supportive of VBAC but this contradicts what I’ve been seeing.” Yes. This is what we were talking about before, right? Induction. You can have a VBAC after being induced, but also you don’t want to have to be induced at some arbitrary deadline to have a VBAC. Induction does increase the risk of rupture slightly, but when it’s managed appropriately, the risk is very minimal.

So definitely look into that. Poke your provider. I say “poke your provider”. Don’t poke the bear, right? Don’t poke the bear. Ask your provider. Talk with them and see because that might not be a provider that is that supportive. It is sad that when you have a provider that you absolutely love and there’s this one thing. There’s one thing and it sounds like this is the one thing.

Meagan: But that’s a big deal.

Julie: It is a big deal, yeah.

Meagan: A big deal, yeah.

Julie: And people won’t allow you to go past 39-40 weeks. I would bust out the ACOG bulletins on VBAC and the late-term management of pregnancies or something.

Meagan: Yeah, and induction. Yes. I was just going to say. Bring them, even if it sounds over the top because I’m going to tell you, print it all off and take it to them.

Julie: Do it.

Meagan: And say, “But this is what this says. This is who you are under and this is what they are saying, so why can’t we discuss a gentle induction plan?” Or, “Let’s observe and do more monitoring with all of these things and take it day by day. Take it every other day. I’ll do an NST. Let’s break it down so you’re comfortable. I’m comfortable. We’re all doing what is safe for me and baby of course.” Sometimes it sounds extreme, but it might take bringing it in and saying, “Hey. This is what I have found. Let’s talk about it. Let’s break it down.”

Are you going and getting that for her? Is that what you’re doing?

Julie: I’m responding to whatever comments.

Meagan: Oh okay.

Julie: Obviously now, I’ll just do it verbally. So she said, “Managed how? Through a slow administration of induction medicine?” Yes, absolutely. Yes, so this is the thing. Sometimes you’ll hear the phrase “Pit to distress” where nurses will, this is a real thing. It’s sad but it is, where nurses will up the Pitocin so aggressively that it literally forces the baby to go into distress so they just do a C-section. It’s a very aggressive way to administer Pitocin. You don’t want that. You want to do a nice, slow dose. Increase it by 1 or 2 every 45 minutes to an hour. Give your body a chance to respond before upping it even more.

I’ve seen VBAC inductions where they konk out the Pitocin by 4 every 30 minutes and before two hours happens, you’re up at the max dose of Pitocin and then the baby gets so stressed out and you have a C-section.

Meagan: And the body isn’t responding fast enough.

Julie: The body’s not responding at all because it doesn’t know what the crap is going on. It’s being slammed with Pitocin, this artificial hormone. That is not an induction that is managed well. A managed well induction is nice and slow. Start with a Foley bulb. Start with a nice, slow dose of Pitocin. Rest during the beginning of it. Give your body time to catch up. While being monitored, that’s a nice compromise and making sure everything is being tolerated well. If your body is responding, stop turning the Pitocin up at all or even turn it off after your body kicks into labor.

Meagan: Yes. I was also going to say there is something called a “Pit holiday” where sometimes our uterine receptors get too full and overstimulated with Pitocin. It’s okay to do a “Pit holiday” and cut it in half. So say you’re at 20, let’s cut it down to 10 and see how our body responds because sometimes we can be overstimulated and our body is like, “This is too much too fast. I don’t know what’s happening.” It’s not responding and then we cut it in half, our uterine receptors empty, our body kicks into that natural labor, and then boom. We’re in labor and we don’t even need 20 mL of Pitocin, right?

Or like Julie said, we get into this active phase and we feel like we have to keep upping the Pitocin, but if we’re getting into the active phase and we’re making progress, we don’t need to keep pushing Pitocin. And yeah, slow dose.

Sometimes, some people, we recorded a story just now and talked about this. It’s coming out in October, so let’s talk about it right now. Sometimes we get in a space where induction is what’s needed this time, but we’re not cervically progressed enough to just put in a Foley or a Cook, right?

So sometimes, we have to start a low dose Pit, maybe 2, 4, 6 mL max and just let it be for hours. It could take hours, you guys. I’m not kidding. Not three hours, not four, but ten plus hours it can take sitting at that slow, low dose to get the uterus stimulated enough to open just enough to get a Foley or a Cook catheter in comfortably. And then, we start from there. We work with the Foley and the Cook. Maybe you leave Pit right there or maybe they start increasing it or they just do the Pit at 6 or 8 or 10, and then just let the Foley do its thing until it falls out and then we start from there. There are so many ways that we can manage and take things slowly.

Walking in, breaking someone’s bag of waters is not necessarily slow, managed, and controlled but that’s what a lot of providers will do also. They say, “Oh, I’ll just bring you in. We’ll just bring you in and break your water.” Sometimes, the body doesn’t respond to that and it takes hours, and then we’ve got Pitocin coming into play anyway. But then sometimes, that’s the perfect way, right? So we have to take it slowly. We have to decide what’s best for us and where we are at cervically can make a big difference of where we start.

Julie: Where we are at cervically, I love that.

Meagan: Yeah, where we are at cervically.

Julie: Cervically, cool. All right. Thank you, thank you. All right, let’s move on. Christine, Christina. She says, oh I think it’s maybe more of a review. Thank you. Okay, so she says, “Listening in from South Africa.” We have lots of people from South Africa lately by the way.

Meagan: Yay.

Julie: I say “we” like I’m, anyways. “Been listening to the podcast, binge listening all the time and so amazed at how much I’m learning in each story and from you both. I also love how listening to everyone’s stories, especially the C-section stories have helped me process mine and helped me feel much more peace going into my VBAC at the end of this year. Thank you so much for the podcast and everything you guys are doing. I keep sharing relevant episodes with friends that are currently pregnant with their first. Things I wish I had known despite having done a lot to prepare for my first birth.”

Meagan: I love that. Thank you.

Julie: Aww. I love that. Thank you. Yes, Meagan. Grab this and drop it into the review spreadsheet.

Meagan: I know, will you copy and paste it for me? I’m going to read this. I pulled into the group and found a question that just was posted. We actually got a lot of recent questions here in the group and so I figured I’d throw this one in.

Julie: Wait, but there are more in these comments, though.

Meagan: Oh, keep going.

Julie: Do you want me to do the comments first?

Meagan: Yes, sorry. I didn’t see it.

What happens if you don’t sign a C-section consent form?

Julie: No, you’re totally fine. There’s AJ, Juleea, and maybe more. Okay so AJ said, “Hypothetically, what happens if you don’t sign a C-section consent form? I know they can’t just make you take you back, but how would you handle this if they were being forceful?”

Meagan: Now that one’s super hard because you have to be strong. You have to be really strong. But how I would handle it, I would break it down. I would ask them to break it down and talk about why. “Why are you asking me to sign this form? Am I in danger? Is my baby in danger? Are we facing death?”

Julie: Facing death. “Will I die?”

Meagan: Yeah, complications by dying. “Are you telling me that my baby and I are going to die right now? Because if we are having this conversation then that probably means that it’s not the case.” But yeah, break it down and say, “No. I don’t consent to this. I don’t feel comfortable with this. If this is not life threatening right now, and this is not emergent, then I want to continue on the path that I’m going.” This sounds really bad and it’s so hard because everyone can be– we’ve got people all over the world, right?

Sometimes it’s saying, “Okay. I’m going to leave. I’m going to go somewhere else.” We’ve had that. Julie and I personally have had clients say, “Okay, I’m leaving then. If we’re not going to do this, if this is not what’s going to happen, then I’m going somewhere else.” And sometimes they change their tune right there because they don’t want you to leave. They usually don’t want you to leave, so they change their tune and say, “Okay, hold on.” But sometimes, it takes leaving and going to somewhere else that is supportive. But that’s not what you really want to do in labor.

Julie: Yeah, this is why you want to figure it out before labor starts.

Meagan: Yeah, it’s not the space that you deserve to be in during this labor journey, but sometimes it’s fighting. It’s fighting and it’s hard. It goes back to what we were talking about with Angel. It makes me so mad that there’s not the support that everyone really deserves. We deserve the support, you guys. We’re just going in to have babies. That’s all. We’re just going in to have a baby just like everybody else, but sometimes we’re not viewed as that.

So yeah. Any other tips, Julie? I mean, yeah. I would say breaking it down and having that conversation, but what would you say?

Julie: I mean, I would kind of say the same thing. A lot of the times, I feel like, they just have you sign all of the forms that you might possibly ever need while you are in labor at the beginning of labor because it saves on admin time and it saves on things you have to do later on and things like that. But what I would ask about the C-section form, when they’re going through that whole process is, “Do you make first-time moms sign this form?” Because I bet you, I know their answer because they don’t make every laboring person sign a C-section form, but they will if they are getting you ready for a C-section or they think that you are at an increased risk for one.

And so, we all know what the numbers are surrounding VBAC and what your chance of success is and how, if given the option to try, you are very likely to succeed. So I would just ask that. And if they say, “No,” or whatever their answer is, I would change my next question or next statement. My next statement after they answered would be that, “I will sign it if it is looking like that is going to be an option, but for now, I am planning on a vaginal delivery. Until a C-section becomes imminent, I will refrain from signing the form.”

And then if they raise a big fuss after that, I might go to more extremes like what Meagan talked about. But I mean, this is the thing. If it’s a life or death situation and you’re not looking great or baby is not looking great and I’m not talking about, “Oh, we have some concerns.” I’m talking about, “We need to do something now.” They’re not going to care whether the consent form is signed or not, they’re going to wheel you to the operating room and save your life or save your baby’s life.

And so I think that waiting and asking to wait until it looks like a C-section is needed or necessary is a perfectly reasonable option.

Meagan: Yeah, I agree. Okay, so I realized that I didn’t see because I only saw one last comment from Tiffany saying that she is anti-Pitocin over there.

Releasing fear around childbirth

Julie: Yeah. Julie has one. And this is a great one for you, Meagan, too. It’s how do you release fear around childbirth? I’m 40 weeks today and I’m anxious for labor. My first arrived via C-section at 37 weeks due to high blood pressure and being breech. I never experienced any part of labor and I’m just fearing the unknown. Fearing uterine rupture, not progressing, tearing, all of it.

Meagan: Yeah. You know, fear release is so important. So important and I think I’ve talked about this maybe on my story or maybe in other things, talking about how I thought I released everything, and then I was in labor and there were still stuff that I was processing and working through and having to go through. But a few tips that I have are actually Julie’s fear release that she did a long time ago on our YouTube and it’s a smokeless or flameless.

Julie: Smokeless fear release except that’s used very loosely because we did create smoke at a fear release once.

Meagan: We did. We did. We did.

Julie: There were a lot of people releasing their fears, but yes.

Meagan: Yes, I actually remember. That was really crazy. We did that in a VBAC class actually.

Julie: Yeah, at my house.

Meagan: Yeah, so I actually really, really, really love that activity and suggest it all of the time. I’ve actually done it with my own clients in labor. We’ve done it in living rooms on the floor. Obviously, it’s hard to do if you’re in a hospital at this place, you can’t just break that out.

Julie: Light a fire, yeah.

Meagan: But doing it, and even if it’s every night because for me, when I was preparing, I had different thoughts and being on social media didn’t help me quite honestly in that very end. And so some of the tips would be the fear release activity, going through, writing them down, burning them, and truly burning them. Burning your fears. Letting them go. Letting them go and accepting whatever is coming your way.

Know that you have done all that you can to prepare for whatever does come your way. So that and I also suggest doing that with partners because sometimes partners’ fears will trickle in and create fear. Not that they’re meaning to do it, but they have fears and then they say things and our minds are like, “Oh, I didn't think about that.” And we have to process that.

Another thing would be a social media break. Sometimes social media in the end is wonderful and motivating and positive and keeps us in a great place, and sometimes, it just starts creating more fear. So sometimes we think that taking a total social media break is really healthy and helps process because you can just be with your own thoughts and not with all of the other hundreds and thousands of people on social media’s thoughts because everyone is going to have an opinion. Everyone is going to have an experience. You love hearing those just like we love hearing this podcast and these stories, right? But sometimes, those feelings and those experiences can rub off on us, sometimes in a negative way.

So if you’re noticing that some of your fears and things you’ve seen and heard on Facebook or social media, any social media platform, maybe take a break from that. I would say journaling is one of the best things I did for myself in processing fear. I was told by my OB that I was for sure going to rupture. He told me that. As I was on the table, he was so glad I didn’t have a VBAC because I for sure would have ruptured. For sure. When I heard the words “for sure”, that was very dominant in my mind and it hung with me. So when I’m laboring with my third, I was feeling that in my head. “What if I rupture? What am I doing? Am I doing the right thing?”

I knew in my heart that I was doing the right thing but I had self doubt. And so if that starts creeping in, voice it. I would say that my suggestion would be to get it out. Get it out. I’m sure that Julie has seen it, but as a doula, sometimes we can see our clients are thinking really hard in here and they’re maybe having self-doubt and things like that. It’s just so good to get it out. Get it out. Processing. Getting it out, talking, saying it out loud, hearing yourself say it is the first step to processing it as well.

So if you’re doing a fear release, don’t just write it down. Write it down. Say it out loud and then burn it. That would be some of my suggestions. And then keep educating yourself. Keep educating yourself. You said tearing, rupture, and these are all valid feelings and fears. I want you to know that. These are all valid and you’re not alone. But yeah. Fearing not progressing, that’s a big fear. I know that. But again, setting yourself up with a great supportive provider who’s going to give you time, trust, and giving you the things you need to progress. That will help. Anything you’d like to add?

Julie: No, I love that. I want to get a little bit sciency and nerdy on here. I don’t know. It’s not a secret or anything but I’ve been doing a butt load of therapy over the last year and a half and part of the things that, at some point, I learned this in therapy, but your brain, I think we all know that your emotional brain and your logical brain are in separate parts. They do not touch each other. They do not talk to each other. They do not know what each other has going on, right?

Your emotional brain is very reactive and responsive. It’s where a lot of this anxiety comes from. It’s where your fear comes from. It’s where all of your negative feelings live, well, all of your emotions live. All of your big things. Your logical brain doesn’t know what’s going on in your emotional brain. They do not communicate with each other or else we would probably all be a lot more reasonable about our entire lives.

In order to process your emotions and reconcile them and get rid of your fears, the best thing you can do like Meagan just said, in lots of different ways, is to get them out there. Get them out. Verbally talking about them, writing them down, talking to a therapist, talking to whoever is a nice, safe space for you. Any safe way that you can get them out of your emotional brain, then your logical brain can say, “Oh. That’s what’s going on over here.” It gives your logical mind a chance to take over and reconcile a lot of these things that are going on and put this emotional brain at ease so they’re not fighting and conflicting. They’re able to reconcile with each other. I don’t know if that makes sense.

That’s a big thing for me which is like, “Oh yes. I need to get these things out.” Don’t stuff your emotions down or stuff your feelings down. Get them out and it helps your brain process and work through them together so that you’re not so isolated and your feelings are not so isolated from the other parts of your body that are a lot more logical.

Meagan: Yes. Oh my gosh. I love that. Thank you, Julie.

Julie: You’re welcome.

Meagan: Okay, let’s see. She has been thinking about taking a social media break, actually. It’s really refreshing. Worried about tearing more than uterine rupture. And yeah, tearing is scary. It is scary to think about. Lots of people do tear and it is repairable, but I would say my tip for that would be to really follow your body when it comes time to push whether it be unmedicated or medicated, really listen to your body and when that baby is crowning, just little, little nudges, assuming all is going well and that will help.

And then really, baby position, right? We want to work on baby’s position because the more the baby is in an ideal position, the better it is for baby to come out. But sometimes we have these little things where we have babies doing this and sometimes we have babies doing this.

Julie: Or doing this.

Meagan: Or doing this or they come out like this and they do funny things. Tears happen, but try your hardest and let gravity help. Squatting on your side, positions that may reduce tearing and may focus on centered gravity versus a perfect spot, I don’t know the word that I’m looking for. A specific spot of gravity. Does that make sense? On your back, the bottom of your perineum has more direct pressure than when you’re squatting. It’s more central.

So working on positions and even if you have an epidural, you can push on your side. You can push squatting assisted. It’s totally possible. But yeah, anyway. Tearing is scary.

Julie: Tearing happens. I love that you said that.

Meagan: Tearing happens. It does. I mean, I’m going to be honest.

Julie: Most of the time, it’s not that bad. Most of the time.

Meagan: No.

Julie: I had a first degree with my first VBAC. I didn’t tear with my other two. I heard somebody say once, maybe it was on social media or something recently, but the biggest impact on whether you tear or not and how bad is your provider.

Meagan: Yeah. We’ve got providers that just are a little rough.

Julie: They force you to push on your back or stretch your perineum out so much. A lot of people think that helps, but it can actually increase your chance of tearing too. I don’t know. But yeah, give that a chance too, and talk to your provider seriously about not pushing on your back. Even with an epidural, you can push on your side.

Meagan: Yeah. Totally. Totally. Love it, love it, love it. Okay, any other questions that you are seeing coming in? I love that she was like, “Yeah. People say this and then we just nod and assume they’re scheduling a C-section.” They just nod like, uh-huh. We have a ton of questions coming in on social media, so are you okay if we do a couple more?

Julie: Yeah, I just have to grab my kids in 25 minutes, so I’ve got some time. And then I want to wrap up and do a little short catch-up on how I’ve been doing since The VBAC Link. That would be fun, right? Do you think?

Meagan: Yeah. Yes.

Julie: Okay.

Labor expectations

Meagan: Okay, so this is from an Instagram follower and she says, “VBAC after a scheduled C-section. Should I expect labor as long as a first-time mom?”

Julie: Can you say that again? You broke up just a little bit. Did she say what should I expect as a first-time mom?

Meagan: “After a scheduled C-section, should I expect,” assuming she’s going to VBAC, “Should I expect just as long of labor as a first-time mom?” So meaning that she’s scheduled the C-section, never went into labor, never dilated, things like that. In short, yes possibly.

Julie: Yes.

Meagan: Yes, right? So my VBAC was my third baby, my first real labor. It was kind of freaking long. It was long. But then, we sometimes have moms that had a breech baby and it was a scheduled C-section. They go in, right? Yes.

Julie: Pick me, pick me. I’ve got some stories.

Meagan: Don’t share her story.

Julie: Did she talk to you?

Meagan: No, but I’m going to talk to her.

Julie: Okay, good.

Meagan: So anyway, but sometimes it just goes really fast and we don’t know. So just like a first-time mom, not everyone goes long. Some people are precipitous. Some people can go really long. That can happen too and so yes, maybe is my answer.

Okay, let’s see.

Julie: Wait, wait, wait, wait, wait, wait, wait. Before you go on.

Meagan: Oh, you really wanted me to pick you. I pick you, Julie.

Julie: Pick me. Pick me. Pick me.

Okay, so I just want to let you know that yeah like Meagan said, you are more likely to labor for longer identical to a first-time mom, but man, sometimes this baby is going to fly out and it’s going to catch you off guard. And I have two stories, I’m not going to tell them, but I have two stories where the labors were super short. Moms got their VBACs at home on their bathroom floors because the labor just catches you off guard so much.

Meagan: It can happen.

Julie: Plan on going to 42 weeks. Plan on a 24-hour labor because it’s probably not going to be that long, but the more you can, if you expect that, then anything shorter is just going to be encouraging rather than planning on a shorter amount of time and having a longer thing being discouraging. That’s my advice.

Double-layer suture versus single-layer

Meagan: Yeah, for sure. For sure. Okay, this next question is, “Does the type of suture matter much? I had a single-layer but read that double was better.”

Julie: Oh, pick me again.

Meagan: Yeah.

Julie: Sorry, you’re looking at me.

Meagan: I’m looking at you.

Julie: All right, so here’s the thing. There used to be a belief that a double-layer suture is, because there are several layers of the uterus, right? The single-layer versus double-layer. A single-layer closure means they sew all of the layers up with one stitch, one suture. Double-layer is where they close it in two separate layers, right? So there used to be a belief that a double-layer suture was safer and would decrease your risk of uterine rupture if you go through vaginal birth, or I guess, overall because you don’t have to go for a vaginal birth to have a rupture.

But since then, there have been several studies come out that show that there’s no significant difference in rupture rates between single-layer versus double-layer closures. So, no. It doesn’t make that big of an impact. Now, there has been one recent study that shows that a double-layer closure is optimal, but that one study isn’t very big. It’s not very credible. It’s not as big and not as inclusive as a Cochrane review and things that show that there are not really big differences.

So sometimes, people will say, “There’s this one study in 2021 that shows this.” See, probably not in that voice, but anyways. But the majority of information that we have shows that it does not matter. However, ten years ago, people used to think that it would make a big impact. Things have shifted since then.

Meagan: Yeah, we still have many providers that say it actually determines eligibility based on that. Like, tons. We get emails all of the time. It’s like, “Hey, I really want a VBAC but I found out that I only have a single-layer suture, so I can’t. Is this true?” So yeah. Okay, ready for the next one?

Julie: Yeah.

Special scars

Meagan: Low, transverse uterine incision that extends one side vaginally. Vaginally? Can I VBAC? Vaginally?

Julie: Vaginally? I wonder if it’s a J?

Meagan: That’s what I’m wondering.

Julie: Except she said, “Vaginally.”

Meagan: I’ve actually never heard of a uterine incision extending all the way.

Julie: I don’t think it can. It can go down into the cervix.

Meagan: Yeah, the uterus is up and then it has the cervix. It goes like this.

Julie: Yeah.

Meagan: Yeah, and then that comes down into the vagina, but they’re separate.

Julie: I wonder if there’s some word confusion there.

Meagan: Maybe. I will ask her, but I’m wondering if this is meaning a special scar.

Julie: Well, yeah.

Meagan: I’m wondering if maybe there is some confusion about a special scar and yeah. People still VBAC with special scars. They do. We have special scars on the podcast.

Julie: Leslie’s is my favorite birth story. She goes into such detail about the data and everything about that.

Meagan: Yes, Leslie did a home birth, right?

Julie: Yeah, I think it’s episode 18 or something in the teens I think.

Meagan: She was really early on. So yes you can. It’s still possible. You still want to educate yourself. Just because you can doesn’t mean you are going to choose to or that you’re going to want to.

Julie: Or that you’re going to find a provider that’s going to support you.

Meagan: Or that you’re going to find a provider that’s going to support you, and so we encourage everybody to do the research, look at the education. We have some blogs. We talk about special scars in our parent’s course. We have some episodes, so there is information out there for you guys.

Julie: Yeah, the risk of rupture is a little bit higher with special scars, so that’s something to consider too, but what an acceptable risk is to you is going to be different for everybody. So I think it goes from about half a percent to maybe 1.2% or something in that range. It’s less than 2% overall, and so is a less than 2% risk of rupture acceptable for you? You’re going to be the only one to answer that.

Meagan: Yeah. Yeah.

Julie: Does that make sense? I feel like I didn’t understand the words coming out of my mouth.

Meagan: Yeah, no. No, it made sense.

Julie: Okay, do you ever do that? Anyways.

Warning signs and symptoms for uterine rupture

Meagan: Yes. Okay, next question was, “Warning signs and symptoms for uterine rupture?” This is a really great question because we were talking about that, the fear of uterine rupture, and there are signs. There are, I should say, symptoms. Some of the signs and symptoms may be one, pain. Pain down there and if there’s an epidural in place, it might radiate up. The uterine rupture that I attended a long time ago, she had an epidural and they kept calling it a hot spot, but it was way, can you guys see me? Way up here in her ribs where it was hurting which is kind of an interesting spot, but it was just radiating where she wasn’t numb, where she could feel. So yeah, pain.

And also pain that doesn’t go away. Pain and discomfort during a contraction or surge comes and is there, and then it goes away, that may be different than the pain that is there, increases with contractions, doesn’t go away, and is still very intense. Bleeding, lots of bleeding, lots of bleeding. Stall of labor, where your labor is just not progressing. Baby going up, so moving stations, but dramatically. Like your baby was +2 and now your baby is -2. Stations can be subjective, they say their baby is a 0 but now it’s a -1, and they’re saying that maybe it’s a 0 to +1. It’s kind of subjective.

Julie: Yeah, they’re just centimeters that we’re talking about with baby’s station. It can vary from provider to provider.

Meagan: If you think about my hand to Julie’s hand, right? Our hands are very different. They look different. I have long skinny bony dumb fingers that I can’t stand.

Julie: Not dumb.

Meagan: Really wide palms, so my long, skinny fingers versus someone with shorter fingers may be different. One of the number one things that providers look for, although I will say that this isn’t always the number one first symptom is fetal heart tones. Fetal heart tones that are just tanking and not recovering, that is a concern. That is a concern and that is a sign. Let’s see, what else am I missing?

Julie: I’m trying to think. I think that’s it.

Meagan: I think that might be all.

Julie: Yeah, and that’s the biggest reason why they’re really particular about continuous fetal monitoring for a VBAC. But yes, if you can feel the head on top of your pubic bone, it’s kind of weird to really describe that, but I’m not going to show you.

Meagan: You can usually see it. There’s a bulge. Baby’s not in the right spot.

Julie: Yeah.

Meagan: We also have a blog on that. So, okay. Are there any other questions in the Facebook group that I’m missing, Julie? Because I’m on Instagram right now.

Julie: Let me check.

Meagan: This one is, “My C-section was because of failure to descend. Do I still have a chance to VBAC?” Absolutely. Failure to descend means that baby just didn’t come down. A lot of the time, that’s due to positioning, that’s due to more failure to wait and let the baby have time to come down. Just because you’ve reached 10 centimeters doesn’t mean it’s time to have a baby necessarily. Sometimes baby needs to have time to rest and descend and come down, but yes. Absolutely. You guys, on Instagram, if you’re not there, we did pull over. So if you’re over here, yay. If not, then I’m going to try and get these answered on Instagram as well. Do we have any other questions?

Julie: I didn’t see any. Yep, nope. Still no.

Meagan: Okay, any other final questions for the eight of you that are left? We’d love to finish up, but yeah. While we are waiting for any other final questions, Julie, did you want to update everybody on how the last couple of months have been for you?

Julie’s update

Julie: Yeah, I think it was a little bit of a hard transition for both of us. Meagan is doing amazing trucking along, keeping everything going and I’m super excited to see all of the changes and stuff that are going on over on social media and the website and everything like that. I’m really proud of you. You’re doing amazing.

Meagan: Thank you.

Julie: And welcome the new admin, Katie, helping. She’s doing an amazing job too, it seems like so that is really great. Yeah, I mean, I’ve been trucking along with the birth photography thing. I think we talked about that on the podcast episode where I made the announcement that I was leaving, but it’s been going really good. I’ve been to several, many births since then.

Meagan: Tons of births.

Julie: Yeah, the last two weeks, I did five and it was actually ten days. It was five in ten days. Two of them, I was a backup for somebody, so it kind of doesn’t really count, but it kind of does. Several of them have been VBACs which have been amazing because I love still being able to be in that space and supporting people. Things are going well and I’m really excited.

I do have, it’s a hard and separate feeling. I don’t know how to describe it because I know it was the right choice for me, but it’s also kind of sad at the same time. And so, yeah. I’m excited. I’m glad to still be kind of part of the community and being here in and out with Meagan every once in a while. I’ll pop back in to give an update and talk more.

Yeah, I would love it if anybody wants to keep in touch. You can find me on Instagram, I’m just @juliefrancombirth. All one word, you can give me a follow or ask me questions. I’d be happy to talk or answer questions about anything, but I’m just so excited to see The VBAC Link thriving as it is. It makes me happy. I still talk about it. I still say “we” whenever I talk about The VBAC Link. I think it’s going to be a long time before that goes away.

But yeah. I’m just proud of you for doing a great job. I’m excited. Life is just busy with other things.

Meagan: Just other things, yeah.

Julie: I’m able to manage all of my priorities right now instead of having everything halfway.

Meagan: Yes, which is important.

Julie: Yeah, it is important. What other questions do we have?

Meagan: Let’s see. “I had second-degree tears with my VBAC. Unmedicated, no coached pushing. It is still–” Oh, this is probably to comfort. “It was still worlds better than my C-section recovery was.” So yeah, like we were saying, tears happen, but it is a lot less invasive, usually those tears aren’t full tears cutting through all of the layers and things for a C-section. But yeah, I would agree. I didn’t end up tearing necessarily, but it was really tender down there. I just pushed a baby out of my vagina.

Julie: A vaginal tear heals up way easier and faster, yeah. Certain parts of your body are more inclined to heal faster.

Meagan: Yeah.

Julie: But then, Tiffany asked, what’s the podcast name, and your Instagram? So obviously people listening and you replied there, but I want to say it for people listening. Obviously, if you’re listening to the podcast, you already know what the podcast name is, but it’s just The VBAC Link podcast just like our Facebook group. See? There I go again with “our.” We’re on Instagram and everywhere. The VBAC Link on Instagram, Facebook, YouTube. There’s a Twitter. I don’t think we’ve tweeted in a really long time, but anywhere you want to find The VBAC Link, you just search. They are on so many platforms. Same with all of the podcast hosts, any major podcast platform or you can listen on thevbaclink.com/podcast.

Meagan: Yeah, we’re everywhere. Instagram, all of the places. Yeah, and then like Julie said, Julie Francom Birth if you want to still follow Julie and her journey. We’re all supportive. I have a doula business. It’s Tiny Blessings Doula Services. You can see what we’re up to on the other side. But we really appreciate everybody. I think that’s all of the questions. We really appreciate everybody for coming on today, and dealing with our 34-minute delay.

Julie: That sucked.

Meagan: Because we knew there was one setting. We knew it had to be in the group, but we figured it out.

Julie: But we figured it out.

Meagan: That’s what matters.

Julie: That’s what matters.

Meagan: This has been really fun. So let us know if you really like this, this live podcasting, because that might be something fun that we can do here in the future in this amazing group. So yeah. As always, we love you. We thank you. Love any other reviews that you want to leave. You can email us if you have any other further questions at info@thevbaclink.com. Instagram, Facebook, you can drop it still down in this, it’s going to be I think it will be in there. So yeah. We love you. Thank you so much. And Julie, I’ve missed you.

Julie: I know. Gosh, it’s been so weird.

Meagan: It is.

Julie: So weird, and yeah. All of the feelings.

Meagan: Yeah, but I’m really happy for you and we’re having fun over here at The VBAC Link still. We’ve got Katie helping out, so you guys will probably see Katie’s husband flipping around on Facebook.

Julie: That was fun.

Meagan: Or her cute face. She’s a cute little blonde so you’ll see her and you’ll see more of me as well. We’re really excited. Thank you so much for being with us today and mwah. We love you a lot.

Closing

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


Support this podcast at — https://redcircle.com/the-vbac-link/donations
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