160 Everything Left Unsaid with Mari and Allie
The VBAC Link - A podcast by Meagan Heaton
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“To the unsupportive OB:” “To that labor and delivery nurse:” “To my partner:” “To the midwife who believed in me:” “To myself:” The long-awaited episode is here. This is the one where YOU have the spotlight. Mari Vega and Allie Mennie are back to join Meagan and Julie as they read your letter submissions. Let your voices be heard. Let your trauma heal. We tell the world everything you weren’t given the chance to say during your birth. Additional links The VBAC Link’s Advanced VBAC Doula Certification Program Allie Mennie’s website Mari Vega’s website Episode sponsor This episode is sponsored by our Advanced VBAC Doula Certification Program. This course is designed for birth workers who want to take their VBAC education to the next level so you can support parents who have had a Cesarean in the most effective ways. Head over to thevbaclink.com to find out more information and sign up today. Sponsorship inquiries Interested in sponsoring a The VBAC Link podcast? Find out more information here at advertisecast.com/TheVBACLink or email us at [email protected]. Full transcript Note: All transcripts are edited to correct grammar and to eliminate false starts and filler words. Julie: Happy Wednesday, women of strength. We have a really incredible episode for you today. I can’t even put into words all of the things I am feeling about what we are about to do because it’s big. It’s big, and it’s emotional. Some of us are reading over these for the first time. I think there’s going to be lots of tears and crying. I don’t know. We’re going to try to not get angry and frustrated. We asked you back in December, or the end of November, maybe it was, to write an anonymous letter to a healthcare worker, your provider, somebody on your hospital staff, or somebody that negatively affected your birth. These are all anonymous letters. We have lots and lots of submissions, and we are excited to read them to you today. Now, I want you to be advised that some of these letters have some difficult experiences explained in them. But, I think it’s really, really important that we listen to these, we hear them, and we meet these anonymous letter writers where they are because this is the state of maternity care in our country. These things that we are about to read are not uncommon experiences. And this is why we as The VBAC Link, and we as birth doulas and all of us advocate so much for change and education, and all sorts of things. But before I start rambling on more, I don’t want to take too long. We are not going to read a review of the week. We are just going to get right into the letters after the intro. Episode sponsor Julie: Birth workers, listen up. Do you want to increase your knowledge of birth after a Cesarean? We created our Advanced VBAC Doula Certification Program just for you. It is the most comprehensive VBAC doula training in the world, perfectly packaged in an online, self-paced video course. This course is designed for birth workers who want to take their VBAC education to the next level so you can support parents who have had a Cesarean in the most effective ways. We have created a complete system, a step-by-step road map that shows exactly what you need to know to support parents birthing after a Cesarean. Head over to thevbaclink.com to find out more information and sign up today. That’s thevbaclink.com. See you there. Everything Left Unsaid Julie: Alright, as you know, we have invited Allie Mennie and Marilys back with us to this episode as a follow-up to Marilys’ episode. We are going to take turns reading the letters. You guys, these are really raw and vulnerable. We are going to rotate through and try not to scream, and yell, and hit our computer screens. But also, yeah. That’s it, nothing else. Mari, do you have the first one? Mari: Our first letter starts with: “Hello, beautiful doula angels! I just listened to Marilys’ episode and wanted to send you my letter. My letter may actually be the opposite of what you are looking for. It would be a positive one because although I ended up with a Cesarean, my provider made my birth experience amazing. It was the nurses I didn’t care for. ‘To my provider, thank you. Thank you for letting me make my own decisions. Thank you for asking for consent before doing any procedures or taking the next steps. For informing me of all the risks and benefits of any procedure, I had the OPTION for during my pregnancy, labor, and delivery. Thank you for not making me feel guilty or bad about my 60lb pregnancy weight gain. For giving me the option of which hospital I wanted to deliver at. For dealing with my many text messages asking you questions throughout my pregnancy. Thank you for coming to my birth even though you were not on call. For having me push for four hours before even mentioning a Cesarean. For being quiet and calm while having me and my son in our most vulnerable states-- my body open and my mind full of fear. Thank you for taking time going over the risks and benefits of a Cesarean as well as a VBAC and reminding me that the best-case scenario for me would be to VBAC. For assuring me that the risk of uterine rupture is extremely low and should not deter me from having a VBAC. Thank you for recommending a pelvic floor therapist when I came to you six months postpartum, still leaking urine and in agonizing pain during intercourse. Thank you for being the provider that performed my cesarean and the provider I have 110% confidence in to support my VBAC.’ I hope this letter can be a reminder that a negative birth experience is not always the result of the provider or their actions. My provider was one of the most positive aspects of my birth and the only time I was fully able to relax was with her in the room. The negative aspects of my birth experience came from the labor and postpartum nurses, as well as my lack of knowledge and education about the whole process. I didn’t know what I didn’t know. But because of The VBAC Link, I now know what I didn’t know, and more.” Meagan: Wow. Mari: Whew! Go, VBAC Link. Julie: I love that. Mari: What a nice start. Julie: What a great letter to start this episode off with. Perfect. Mari: It’s important. It’s important for people to know that it’s also the journey that matters and not the outcome. Julie: Absolutely. Absolutely. I love it. Alright. Allie, you are up with the next letter. Allie: Alrighty. They start by saying: “Thank you for posting the most recent podcast.” This is actually a member of Mari’s ICAN chapter. She says: “I'm so glad to have seen and heard her on your platform. This is such a good exercise. I'm glad to have had the chance to write out my feelings to MYSELF on my ‘failed’ VBAC.” So this is a letter that this mother wrote to herself. It says: “You are a warrior mama to your two beautiful babies. I wish you didn't cast so much self-doubt and ill feelings of your capacity to be a mom simply because you didn't push them out of your vagina. After your first C-section, which we both agree you naively weren't prepared for but still doesn't justify how traumatic it was (even these 30 months later), you did ALL the things in preparation of your next pregnancy-- switched providers, read all the books, listened to podcasts, went to ICAN meetings, hired a doula, found your voice to fight for the birth you knew you wanted and the chance to make that happen. That morning, four days before your due date when you went into labor, remember those feelings. You were ecstatic to go into labor on your own, something previously robbed of you, it escalated so fast. You got to the hospital two hours later to have your water break as you wobbled in, to find you were already at a ten and fully effaced and ready to push that baby out. As you started pushing, you had a deep gut feeling that this wasn't going to be a different outcome than last time. That no matter how much you prepared, this baby doesn't seem like he was going to come out on his own or anytime soon. You are brave for being more concerned with the baby's well-being and not wanting to send him into distress than of your own desire to have him exit vaginally. Your choices and decisions were not based on fear. They were based on what you knew and what you valued most-- a healthy baby and healing birth experience. Your baby being big AND OP had the cards stacked against you. But you know what? Up until being rolled into the OR, you stuck to your guns on what you wanted for this birth-- to go into labor naturally, to break your water on your own, to experience all those feelings, NO pain medication, and to push. Remember what your doula told you. You ran 26 miles of that marathon and needed assistance getting past the finish line. AND THAT'S OKAY. Your C-section this time was everything your first was not. You were AWAKE. You got to see the baby come out. Daddy got to cut the cord. You got to hear his cries and snuggle him right away. Not all VBACs are healing, and not all C-sections are traumatic. You've seen it all, and you are the best mama for your babies! Having a baby come out of your belly doesn't make you less of a mom. You carried those babies lovingly all those months and having them earthside with you; you know it doesn't matter how they got here. They are healthy, thriving, happy, and most importantly, are your whole world. If you have another baby and want to try for a VBA2C, that's still okay too! Your feelings are valid. YOU ARE THE BEST MOM to your kids. You gave it your all, did all the things with all the BEST resources you could, tried to change his position while pushing. You left no stone unturned. There is nothing to feel guilty about!” Julie: Chills. Mari: How beautiful. Julie: What a lovely letter to herself. I can relate to a lot of those things she said, and I am really proud of her for writing that letter. Mari: Me too. I can’t wait to see her. Meagan: I think that’s something we honestly, as birth workers, could encourage our clients to do, is write themselves a letter. Julie: Yeah. I think so. I think that’s really important to do. Even as birth workers, holy smokes, after some births that are really, really tough. Allie: Absolutely. Putting myself in that position, it would be harder to write a letter to me than to a provider. Julie: Totally. Allie: Even if I had angry things to say to a provider, it would be easier sometimes, as a parent, to say angry things to a provider than nice things about myself. I am so proud of this mom for finding those words to be kind to herself, and to be proud of herself, and to know that she is the best mom for her babies. I believe it. I know she is. Julie: Yeah, I agree. I think that’s a really important, brave, and courageous thing to do. Perfect. Alright, let’s move along. Meagan. You are up. Meagan: Alright. It says: “What a coincidence, in just a few days, it will be two years since I brought my son into this world. I have thought about how to begin this letter and could never put in words what I went through, mostly out of fear and not wanting to relive those events again. Many have told me how lucky I am to have a healthy baby and as I look back now, I can 1000% say that I am extremely grateful that the events after his birth were resolved and that he is a perfectly healthy two-year-old. However, two years ago, on December 3, 2018, I was in a dark, dark place. The day started out perfectly. I’ll admit, I was nervous, but I had been here before since this was my second baby. I was feeling all of the emotions of leaving my first baby at home and what she would think when she saw her baby brother, but that quickly quieted as I was induced, and this baby would be here before we knew it. Except we took a turn for the unexpected when my nurse told me she could not feel my baby’s head and thought he might not be in position. Cue panic. I had been to my OBGYN’s office just a day prior, and I was told, based off his expertise and ultrasound from a week prior, that my baby was head down and ready to go. How could this be possible? Clearly, in my mind, she was wrong, but I wanted to hear back from my doctor. She proceeds to call my doctor and send me into an ultrasound at 5 cm dilated. I can remember that there were about four nurses in the room when one abruptly states, “Yup! C-section!”. I immediately broke down. I had no idea what I was in for, and the words stung me to my core, and just as fast as she said it, they left my room, and my world was shattered. I could think back to a few days before I was induced at my routine appointment when my OB’s nurse was joking that hopefully, I would have a small baby since her husband, who was my doctor, almost led her to get a C-section because her baby was much larger than they ever anticipated. It was almost like she called my fate, to no fault of her own. My baby was big, and not only that, he was laying sideways across my belly, and somehow it was never suspected. I know these things happen. Babies turn at the last minute, but the way I was treated with no explanation and no options was barbaric. But it only gets worse from here. As I headed into the C-section, I was so afraid but confided in my doctor. He delivered my previous baby without a flinch. I can’t remember much, but I know things got stale for a moment. My husband can remember the nurses panicking and wanting to call in another surgeon. Had I heard this, it may have been worse for me. But moments later, I heard a little cry, and everything was right in the world again. The C-section didn’t matter anymore. He was here, and I was crying tears of joy. I was placed in recovery where my pain was unbearable, and my baby was taken as I couldn’t hold him. My nurse was stunned that I needed more pain medication and all I could do was cry. That’s when the pediatric nurse came in and said my son was doing great, but there seemed to be something wrong with his left arm. He needed to be taken to get an X-ray. While all of this was happening, my mom bumped into my doctor in the hallway. She remembers him telling her the issues with the baby’s delivery and how, ‘He doesn’t know what happened, but my baby was in a very bad position, and it was very difficult to pull him out.’ The next few days were quite possibly the worst I have ever experienced in my life. Advocating for my son and myself when I had no idea how untrustworthy these providers truly were. It took a whole 24 hours for a pediatrician to come assess my son, and that was after I had to make a complaint to the nurse manager. That night, my doctor came by to see me and never once asked how he could help me. He boasted about his new practice he was opening up, and all I felt was rage. How could he be so carefree? Everyone around me was so happy. My son was alive and breathing, yes, but he wasn’t moving his left arm! On day three, when I was supposed to be released, I began having panic attacks. So, I was held another day due to my mental health. On the fourth day, I was supposed to be released with a psychiatric clearance, and the psychiatrist NEVER showed up. I begged my doctor. I couldn’t stay one more day. I needed to start the process of finding out how to help my son get a diagnosis because all I could hear was “potential nerve damage,” “possibly Erb’s palsy.” No MRI’s to check his nerves, no neurologists, no one came by to see my son in FIVE days. How is this possible? I ask myself this question all the time now, but the one thing I learned is how to speak up. I learned not to take no for an answer. I advocated for my son while I was in a deep, deep depression where I couldn’t sleep for days on end. I would cry and cry and ask, why me? Why my baby? It is the only thing that kept me going. After my six-week follow-up, I never heard from my doctor again. If there is one thing I could tell him or ask him is, “Why weren’t you more supportive?” He knew that my son suffered an injury, and yes, at that point, he is only there to treat me, the mother, but as a human being who knows what this process is like for mothers, he failed me in every way. The hospital failed me and my son. The people who we put our very lives and health in their hands just washed them off and continued about their lives as if nothing happened. What I love about the experience is that when I went to get a second opinion for my son three months down the line with a specialist who works directly with the hospital where I gave birth, she was in utter disbelief. She couldn’t understand how a newborn with suspected nerve damage just flew under the radar. She validated me and my anger. She confirmed the errors that were done that day, and that was when I began to heal. Although it will never fully be erased from my mind and that trust is forever broken, time has been a wonderful ally and has helped me overcome what I went through.” Julie: That was a nice one. A nice, long, thorough explanation. Wow. That’s crazy. Meagan: That is crazy. Julie: She never said how her baby is. I want to know. Meagan: I know, and what the final diagnosis was. Julie: Alright, it’s my turn. I absolutely love this one. Short, sweet, and to the point. Kind of just like me, except for maybe I’m not sweet as much very often when I’m to the point. She said: “You told me I couldn't push my 10-pound baby without possibly killing me or him. Jokes on you, I pushed out an 11-pound baby out of my vagina!” Boom. That’s how it is. Just like that. Mari: It’s very normal. Many women have done that, yes. Big baby does not equal you are powerless. Julie: Yes, oh my gosh. Love it. Alright, Mari. You are next. Mari: Alright. “To my midwife: No. I wish I would have just said no. You failed me by not telling me my choices. You failed me by not explaining to me what all the interventions would do. No, you can't break my water. No, you can’t put an internal monitor on my baby. No, you can't give me an epidural. No, I will not push on my back for three hours. No, I WILL NOT HAVE A C-SECTION. My baby was not stuck. You just didn't try. But yes, I will have my VBAC!” Well, pretty straightforward and to the point. Sometimes we’ve got to practice saying that big N-O. Julie: Yes. No. No. That’s all you have to say. No explanation. Just no, period. Complete sentence. Love it. Alright, Allie. You’re up. Allie: Alright. “I wish you would have informed and educated me of potential outcomes of your choices for me. I wish you would have encouraged me to get up and move when I was scared in early labor. I wish you would have turned me and moved me once I had an epidural. I wish you would have given me more time to labor instead of insisting on the C-section when I had a slow progression for my first baby. I feel my outcome was chosen for me instead of chosen by me. You didn’t think of me as a person, but rather me as just another patient and delivery that you needed to complete on your timetable. My delivery was traumatic due to you.” Mari: I like that she gave that accountability to somebody because sometimes, it’s always the mom that failed. Julie: Yeah. Mari: We carry that guilt. Julie: Well, and the biggest thing is-- we are rewriting parts of our manual right now. I just read through the part about traumatic birth. The biggest part of whether a parent will have PTSD or not about their birth is how they perceive they were cared for. It doesn’t matter how they were actually cared for. It’s how they perceived they were cared for. Providers have a lot more influence on these birth outcomes emotionally than they think they do. Meagan: Okay, this next one. We can’t swear on our podcast. I’m just going to give you a brief intro, and then I will read it. Pretty much, they are saying that they felt fear-mongered, and they felt like it was made to be their fault for their traumatic birth. She encourages her provider to retire. Her words say: “To my midwife of my second birth: you empowered me, made me feel safe, and made calls for me when I couldn't while keeping in mind what I wanted. Thank you. Because of you, I no longer fear birth. To my partner: thank you for being my rock through both of the births of our babies. Watching you become a father never ceases to amaze me. Thank you for taking care of me and our babies.” Julie: I love it. I love that she found support through her second birth, and she had a supportive provider and partner. Sometimes, that’s all that is important. I remember we just said it on our podcast not too long ago. You shouldn’t have to have a bad birth in order to have a good birth. But I feel like a lot of times with VBAC parents-- Meagan: It’s kind of how it works. Julie: That’s kind of how it works, right? Meagan: I want to also congratulate her for recognizing fear-mongering because that’s sometimes a really hard thing to ever even look back and see. It’s really awesome that she could look back and recognize that. Julie: Yeah, absolutely. Alright, this next one really gets me to my core. She says: “Dear Doctor, I wish you'd been there. I wish you'd been there to help me get the natural birth that you knew I wanted so desperately. I wish you'd been there to help me stand up for myself, to truly inform me of my choices and options, to let me feel like I was making the decision, rather than having it made for me. Because you were gone, your colleague rushed me. Because you were gone, she made all the decisions for me. Because you were gone, my all-natural birth turned into an unwanted induction for reasons that didn't warrant an induction yet. And that induction turned into hell, twenty-nine hours of it, with every side effect in the book, and some that aren't. And then my all-natural birth turned into an unnecessary and unwanted C-section, and the birth after that as well. You were gone, and my son's birth became a traumatic experience that I barely remember. It's probably better that I don't remember most of it. Because there are truly no happy memories of my son's birth. I wish you'd been there because I think if you were, it would have been different.” That’s just-- I’m all choked up over here, guys. Somebody else talk. Mari: That one’s the reality, right? Sometimes when you go somewhere, and they tell you that this is the back-up doctor and you don’t feel good about the back-up provider-- it’s a reminder. That matters. Julie: Yeah, I agree. Meagan: I think that’s also a good question to ask when you are in care with a provider is, “Is there any chance that you won’t be at my birth?” Julie: Absolutely. We don’t know why this person‘s provider wasn’t there. Meagan: Right, we don’t. Julie: But it is important to know. Alright, Mari. You are up. Mari: Alrighty, well. “I was only 22; I wish I would have asked the medical staff to explain what was happening. A lot was happening TO me, but no one was speaking TO me.” Doesn’t that happen so often? Meagan: Mhmm. Julie: Yeah. Again, going back to perceived care and whether they feel like decisions are being made for them. So hard. Alright, Allie. Allie: This letter has a few different letters in it to different parts of the team and different professionals that this parent worked with. She starts: “To the hospital birthing team: Why? Why did you care more about helping my epidural work better because it couldn’t be full strength than about me actually progressing to avoid a C-section?? Did you decide I was a lost cause from the beginning because I had severe preeclampsia? Was it all just an act because all of you decided my fate for me? Why were you so dismissive of my thoughts and concerns? Why did you leave me on my back, refusing to help me lay in other positions and never trying a peanut ball? You forced me back to my back if I managed to move myself because “the epidural works by gravity,” so I have to lay mostly flat on my back for it to work since I couldn’t have a normal dose. Why couldn’t you have focused on frequent position changes to help baby move down and me progress to get me through labor faster?? My baby turned posterior because of your decision to leave me on my back. I truly think it made the contractions feel more intense, and that broke my spirit. That is why I gave up and gave in to a C-section. To my OB: Why did you tell me you were going to break my water instead of asking if you could? I didn’t speak up because I was in such shock but, ‘Uh? Okay?’ is NOT consent. You told me that everything seemed fine and I could keep laboring but made me feel like something was wrong and that waiting to have a C-section was the wrong choice, but your only reasoning in my records is failure to progress. Did you truly think something was wrong, or did you want the money from the C-section? My mom heard you arguing with your husband on the phone because you decided to stay late to perform a C-section again. My friends all say you tried to scare them into C-sections during moments their labors slowed, too. It makes me feel so weak that I gave in. You cut my son. He came into this world already scarred. It’s hidden by hair now, but it was a constant reminder of the hurt I feel about my birth for an entire year. To the postpartum nurse who yelled at me and threatened me with calling CPS for crying because I was so exhausted and hadn't truly slept in over 55 hours and struggled to stay awake while nursing my child. Find a new profession. You have ZERO business working with women who just gave birth.” Julie: Wow. Wow. I felt that way about a couple of nurses as a doula and as a parent, actually. I’m going to run a statistic. Jumping in here, 1 in 12 babies are cut during the Cesarean procedure. That’s the most common complication for babies. Mari: Wow. Meagan: Wild, huh? Julie: Alright, Meagan. Meagan: Okay, so yes. This next one: “Dear labor and delivery nurse, You sat next to me staring at the monitor all afternoon. You only said to me that my labor was stalling because I came to the hospital too soon, and the doctor probably was wrong to admit me. Yet you stayed there all afternoon. Were you worried about something you were seeing? I ended up after talking with my doctor and going with a C-section. I felt my body failed me, and I gave up having a natural birth. I ended up scheduling a repeat C-section with my second because no one had confidence in me that the same stalling of labor would not happen again. I ended up having my third daughter vaginally, but she was born at 21 weeks due to multiple fatal fetal anomalies. This labor was fast but intense. I was able to hold her immediately, even though she only lived a few minutes. I finally met a doctor who believes I could have a successful VBAC after two Cesareans. I'm hoping for a VBAC with my fourth, so I can hold my healthy baby right away.” Julie: Goosebumps and chills over here. So many hard things. So many hard things. Alright, we’re going to move on. This next letter says: “To the midwife I saw while in early labor who told me the baby was just moving and making me uncomfortable: 24 hours later, I was getting prepped for an emergency C-section. I often wonder what would have happened if you would've noticed I was in labor? Maybe I could've made it full-term. Maybe my baby would have it a little easier right now. Maybe I wouldn't be terrified to have a second.” Mari: Wow. I hope that mama can process that fear. Julie: Me too. Mari: And that trauma. That is so sad to be scared to even give birth again. Julie: Yeah, I agree. Mari: Okay. I’m up, right? “I needed love and support and a positive environment. You gave me nothing but a cold manner and no hope. Even after it wasn't my fault (crash C-section due to sudden placental abruption after 38 hours of natural labor), you made it seem like it was.” The end. Julie: I have a really hard time when providers and nurses place blame. Because sometimes, there is no blame. Sometimes things just happen, but we naturally as humans want to find a reason why. I had a client once with a really rough birth, and the nurses were very vocal about their displeasure with the decisions she made and the decisions I made in supporting her. It just adds so much pain, so much unnecessary pain, to what is already a painful experience. Alright, Allie. You are next. Allie: Okay. “My first birth was 3.5 years ago with my daughter. To this day, I have so much anger and hurt inside due to so many things that happened! My water broke at home. I wasn't feeling contractions, but we went in, and they confirmed that I'd be admitted. At that time, my midwife wasn't on, so the OB doctor that was on came in checked me. He said I was at 1 centimeter. He immediately wanted me to start taking a pill to progress labor and stated before leaving that he saw a C-section in my future. That alone made me so angry as we had planned and prepared for a completely natural vaginal birth. That night by 7:00 p.m., I wasn't where that same doctor wanted to see me, so he demanded I start Pitocin. I looked at my nurse and (who was amazing) and told her, “No way, my body needed time to do what it was supposed to.” She agreed! By midnight, they made me start Pitocin. By hour 38, they told me I had to go for a C-section even though baby and I were both stable and I had made slow progress. They had only allowed me clear liquids from the time I was admitted, so I was exhausted and had confined me to a bed after starting medications. I remember crying and my midwife coming in crying, telling me she was so sorry this was happening to me and that we would get a VBAC on the next one. I remember being on the OR table, hardly being able to talk, trying to tell them I couldn’t breathe when the anesthesiologist finally said, “You’re fine. Your oxygen is perfect,” then reaching over and putting oxygen on me stating it was for the baby, not me! Finally, my daughter was born. I felt so lifeless and defeated. I remember instantly, and still to this day, feeling like a terrible mom because I didn’t even cry when she was born. I held her with my husband’s help for a couple of minutes. They then took her away and sent me to recovery. My husband went with her and stayed with her. My second birth was a planned HBAC, which also ended in a C-section due to our state not allowing midwives at home to use herbs on patients who have had a previous C-section. Once again, my midwife at the hospital was comfortable augmenting labor, however, the doctors above her said, “Absolutely not. It’s a C-section!” However, this time I refused to let my baby out of my sight. He stayed with me and my husband in recovery and never left the room for tests. Overall, the second birth was much better, besides feeling like the hospital failed me by not trying to help my body. I am dreading a hospital birth with our third baby, which is due in April. I wish and pray that before this baby is born, I can release some of this anger and sadness I have held for the last 3.5 years so that maybe I can birth open-minded and feel the empowerment I did at home with my son! I want to know that my provider has my back 110% and that I’m not going to be bullied the way I was with my daughter! And I wish I had the chance to tell the doctor who told me he saw a C-section in my future how angry and defeated that made me feel, as I refuse to see that doctor to this day!” Meagan: Wow. Alright, here goes the next one. Julie: Heavy sighs over here. Alright, Meagan. Meagan: “Dear nurse, I’m sure you have long forgotten me, but I will never forget you. And not for a good thing. Two and a half years later, I am still so angry with you for making me not trust my doctor. You had no right to make me distrust her. You were my nurse. You were supposed to advocate for me, support me. Instead, you made my birth experience about you. I don’t care that you didn’t like my doctor or didn’t agree with everything she’s done in the past. You put so much doubt in me, in my doctor. And then you got to walk out the door at seven that night smugly saying that I wouldn't have my baby that night. Well, f*** you. I had my perfect little girl four hours later. And two and a half years later, I still don't know why I had an emergency C-section. Was it because you stressed me out so much? Was it because my water had broken? I’ll never know because you created so much distrust that I can’t even believe my records. You acted like you had all the answers, but clearly, you had no idea. In a way, I’m glad it was me and not another vulnerable mom who you made feel this way. But I also feel a lot of shame for never saying anything. I get to make it right. My contractions are seven minutes apart, and even if this isn’t true labor, this baby is coming within a week. I will get my VBAC, and I won’t be leaving the hospital without telling them how you made me feel, so in the case you’re still working there, you can’t make another mom feel the way I did. I can say thank you for one thing. Thank you for creating this rage within me to fight for what I want this time. I get a second chance, and no matter what happens, I am in charge.” Julie: I love that. I think it’s really important to point out that if you have a bad experience with any member of your birth team in the hospital staff, your provider, you can file a formal complaint with the hospital administration. It is your right to do that, and you should do that, because if this is a pattern of behavior that these nurses or providers are doing, then they need a serious talking to in the very least. So, thank you for sharing that with us. All right, next app. This is a hard one. “To the unsupportive OB: I only saw you once, but you immediately made me feel guilty for wanting to have a VBAC less than 18 months after my C-section. When I asked how you felt about unmedicated birth, you told me I wouldn’t be allowed to leave my bed anyway and that not having an epidural was a bad idea. You told me I’d have to come in as soon as labor started and that I couldn’t eat anything once I was checked in. You brought up all the things that could go wrong and told me I was at a much greater risk of rupture since I wouldn’t be meeting the 18-month ‘requirement.’ When I said I didn’t want a C-section unless it was truly an emergency, you told me that being put under anesthesia created a bigger risk for my baby. All you talked about that entire appointment was what could and probably would go wrong. But you didn’t scare me. Everything you said did nothing except fuel the fire I already had. I didn’t leave the office that day feeling guilty or afraid or in tears. I left pissed off at you and your ignorance and the fact that you heaped SO much guilt onto me. I left and found a new office that I felt would support me. At my first appointment, the midwife who I then met for the first time, spent most of the appointment asking me about my concerns and reassuring me. She affirmed all of my feelings and desires for an unmedicated VBAC. She saw no reason why I couldn’t go for it. And about a month later, when my water broke, and I called in, she encouraged me to labor at home as long as possible. She cheered me on as I labored all night with back labor. She encouraged me to eat and keep up my strength. And when the anesthesiologist came in to consent me for the ‘just in case’ scenario and tried to push an epidural on me, she shooed him away and reminded me what I’d wanted to accomplish- a birth without an epidural. She believed in me. And I freaking did it. I labored so effectively because I moved around as I pleased. I pushed my baby out so easily because I used different positions that worked for me. There was not a moment that I felt me or my baby were in danger. I actually felt strong and capable the entire time. I had an amazingly beautiful and redemptive birth experience. I think it was so great because you weren’t a part of it. I’m glad I didn’t listen to you. I’m glad I was already informed with facts and found a provider who was as well. I hope that you can be open to learning and growing and seeing that birth is a natural process and that women are capable. In your own fear, selfishness, or misinformation, you’re misleading women. And honestly, you’re missing out on what could be many beautiful, fear-free birth experiences because of it.” I am proud of her. It’s hard to switch providers, and especially after a provider is telling you all of the risks, whether they are true or not, and the things can happen to you. So, good job, anonymous mother. We are all proud of you over here. Mari: And a shout out to that nurse. I love good nurses. They don’t know they are so powerful. Julie: Yeah. Absolutely. I love it. Just having somebody that believes in you just makes such a big difference in your birth. I love it. Alright, Mari, you are up. Mari: Okay. We have a long one here, so I’m going to pick and choose a bit, but the backstory is, we have a mom who moved to the US from China at 26 weeks, and she was pregnant with Mono Di twins, which is monoamniotic, so identical twins that share the same amniotic sac. As a result, she was hit with all of the different risks to having this type of pregnancy and spent multiple times a week, four to five times a week in a variety of appointments needing to go to maternal fetal medicine appointments, ultrasounds, and NST’s. It filled her with so much fear and so much stress and worry in those waiting rooms. She also had to go ahead and get daily injections of blood thinner because one of the twins had little blood flow. They also misdiagnosed her at one point. She ended up having extreme pain with preterm labor contractions, which were all ignored leading to her water having been broken and the doctor suggesting she go back home when the nurse didn’t agree. She ends up actually being back into the hospital and having a crash C-section because baby A’s cord was prolapsed and her foot was coming out. Her doctor was not there when she gave birth. The doctor was not there at the six-week check-up. Her doctor last spoke to her the day before her twins were whisked away into the NICU. This mama shares that she was angry, that she felt like she had to listen to her doctor, that this was the most traumatic and physically painful experience of her entire life, that she’s angry that she put his foolish judgment above everybody else’s, that she didn’t try harder to find a different provider and that she felt so scared and confused. “It’s been six years, and I can barely speak about how traumatized I was by my experience.” The second time around, she writes a letter to the second doctor. She interviewed six different practices and even started with a midwife group, but at 14 weeks, she felt compelled to find someone else. She finally goes to another doctor, and long story short, she ends up being timed and having to have a C-section 12 hours after her water broke because she was only 4 centimeters. She wasn’t progressing fast enough for her VBAC, so ultimately, she ended up having to have another Cesarean while the doctors were blasting Maroon 5 and chatting with the resident about their upcoming holiday plans. “During one of the most meaningful moments of my life, giving birth to my son, I shouldn’t feel like I wasn’t allowed to cry or show any emotion for embarrassment of having you and the resident sitting there laughing about stitches tighter and straighter, not feeling like I had any say in wanting the experienced surgeon to do my second C-section because you, as my doctor, had already given your permission to the resident.” She never consented to the Cesarean. She is now pregnant with her fourth baby, her third pregnancy because she had twins the first time around, and she is in a better state. The last two pregnancies happened in New Jersey. This state, she has a wonderful doctor who is 100% VBAC supportive, listens to her, addresses every single concern and questions she has with compassion and expertise. She’s only 18 weeks pregnant, but she is so grateful for the resources like The VBAC Link that are teaching her how to prepare and find the right support. “Thank you for such a wonderful prompt to write down all of the things that have been left unsaid.” Whew, mama. That’s tough, especially when you have a high-risk pregnancy in the US. You’re treated so differently, especially if you come from another place outside the US. Julie: Yeah. Allie: The theme of OB’s not conducting themselves professionally in the OR continues with us next letter. Julie: Oh my goodness. Yeah. Allie: “To the OB who ‘mistakenly’ scheduled a C-section instead of an ECV and after the unsuccessful ECV said, ‘I'll see you tomorrow for your C-section,’ you should know that your bedside manner is horrible and the only image you are projecting is a money-driven one. To the OB who I consulted with before I went into labor: Thanks for telling me my baby would die if I didn't have a C-section before going into labor. To the OB who performed my C-section: Nice to meet you. You never introduced yourself. You never told me what was happening to me or my body because you were too preoccupied talking about your recent trip to Nicaragua. Is your job that mundane that you can't even provide a shred of humanity? Thanks for putting this mama into a full-blown panic attack and causing her to miss out on the birth of her first child. Glad you made your money that day. To the nurses and hospital staff that day: Thanks for treating me like an object void of feelings. To my family physician who scolded me after the birth of my child for choosing to travel two hours from home the day before she was born and said I would never VBAC my second child and to just ‘accept’ that I would need a C-section: I did it ON My OWN. To every practitioner / ‘professional’ who frowns or looks down upon women having a voice or opinion and advocating for themselves during pregnancy and labor, and really at any other point in life: I'd ask you, why did you choose this profession? You are stealing the miracle of pregnancy and birth from women on the daily.” Julie: Dang. That’s some serious stuff. I would echo that sentiment. Like why-- I don’t know. I could go on a tangent, but I won’t. Meagan, I love this next one. Well, I don’t love it. It’s short, but it’s really sad. Meagan: It’s short. They say, “I don't have any positive feelings about the day he was born,” which breaks my heart. Mari: That’s definitely unsaid. So many mamas go through that. Julie: And yet all we hear is, “Oh my gosh, I’m so glad you have a healthy baby. Aren’t you so glad for being able to have a Cesarean to save your life?” No. No, no, no. I mean, yes. We are grateful. Mari: I just want that mama to know if that mama is tuning in right now-- I just want you to know it’s okay that it wasn’t the best day of your life, and there will be other times that are. And it’s okay to feel that way. Julie: I agree. Every baby, relationship, and parent-child relationship forms and bonds so differently. You are going to have so many really amazing days with your child. I am really proud of you for putting that out there. That is a hard thing to do. Alright, moving on. This next one says, “I wish I had been more informed before having my son. I wish I had read more books, taken more classes, read more articles, listened to podcasts-- anything to prepare myself for success. I wish I would have done my own research instead of just taking what my provider said as gospel truth. As a first-time mom, I wanted to trust them. After all, I had no idea what I was doing! I never learned to advocate for myself. I let my fears take over and swallow me, and because of that immense fear, I let my doctors make decisions for me. I thought they knew best. But now, looking back one year later, I feel betrayed. I feel like they didn't give me all the facts. I feel like they did what was easier for them. I feel like they took advantage of a scared first-time mom with a big baby and pushed the C-section on me. I feel like they stole my birth from me. And that’s something I can never get back. It’s something I have to live with every single day.” That’s hard. That’s some hard stuff. Well, we are running low on time, so why don’t we each-- we only got through half of these, guys. It makes me so sad. But all those who don’t get your stories read today, I want you to know that we have read them. We read them all, and our hearts are with you. We are so proud of you for writing out your experiences, and for being vulnerable, and for tuning in and getting that out. If you haven’t done that already, we encourage you to do the same thing. But I want each of us to go through and pick one more rather short one. We can read it, and then I’m going to see a couple of things at the end to kind of just round it off. So, who had the last one? I forgot. Meagan: You. You did. Julie: That’s why. I’m like, “Alright, let’s each take one more.” Mari, do you have one? Mari: I just had the next one up, which was pretty long as well. But, I think that I want to highlight some of the things that this mama shared about when you are having a condition during your pregnancy that you have outside of pregnancy as well, and how it’s very important that sometimes there isn’t enough research about that condition during pregnancy. You might be treated in some default fashion. This mama was facing what’s called Mature Onset Diabetes of the Young II (MODY II). Basically, the doctor treated her as if she was just regular gestational diabetes and that she would have a big baby, and that she needed to go to a lot of maternal fetal appointments. Unfortunately, this mama ended up having to get that C-section as well and has a lot of thoughts creeping in, but of course, people kept telling her that, “You have a healthy baby, and that’s all that matters.” She felt robbed as though she had it delivered. She wanted The VBAC Link to know that she is so supportive for this platform because she is pregnant with baby number two. She’s 28 weeks pregnant and found the right doctor, found her voice, knows how to advocate for herself and is pursuing alternative birth options, asks the hard questions, and God-willing will have her VBAC.” So, thank you, Mama, for sharing that. Meagan: Yes, thank you. Julie: Yes, thank you so much. Allie: Okay, I will go. “My OB told me before (during a prenatal appointment) that I was strong and fit and should have no problems, but a quick, vaginal delivery. When I had a long labor that ended in a C-section, I felt like a failure because of this belief. That my body failed. I wasn't fit and strong enough. It took so, so much for me to get over these feelings and the feeling that it was my fault that I had a C-section. I had a C-section with my first child. And I am strong. And my body is amazing. To the MFM who told me that I probably couldn’t deliver a large baby and l had a 60% chance of a successful VBAC: I had my VBAC. My baby was 9 lbs 2 oz. Oh, and he was sunny-side up. And the ‘risk’ was worth it. So, there.” Meagan: And a fist pump right there. Julie: I love that. So, there. Meagan: This one says: “I want on-call doctors to understand that we can have VBACs. Please educate and stay up-to-date on current medical journals. I want on-call doctors to not dismiss me and write me off as an immediate repeat C-section, especially by not even seeing me unless agreeing to one. Please understand by me not allowing that to happen isn't me being stubborn or a troublemaker, but an informed, educated individual in control of her birth. Please see the person first, not the possibility of a surgery. Do not put us in the room closest to the OR ‘just in case,’ don't push an unwanted epidural ‘just in case.’ Don't say baby or I will die as a scare tactic because you think it's easier. I had a beautiful VBAC despite your negativity and doubt. Thanks to my provider for coming in, but please on-call doctors, advocate for patients!” That gave me the chills. Julie: Me too. I’m sitting here like, goosebumps! I think that’s so important to say. Okay, one last one. I’m going to wrap it up with something short and sweet, kind of on a more uplifting and positive point. But the last one that I’m going to read says: “I felt robbed. I've never told anyone. When the OB tested my skin to see if I could feel the sharp tool, I said, “Yes,” and the anesthesiologist told me that there's no way I could have felt it because it is so sharp, so when they started cutting me I've never screamed so loud or felt so much in my life. They instantly over-medicated me. I woke up puking in my hair. My husband gone. My baby gone. I had no idea if my baby was okay. I never got to hear the first cry. My family saw my baby’s face before I did. I feel robbed.” I think that’s a really hard thing. I know a lot of my personal doula client-- I almost always know their birth plan just almost automatically because one of the most important things for them is immediate skin-to-skin right away because it is so hard to miss those first moments. I know that I missed it with my baby. I didn’t get to see him for two hours, and that was really, really hard for me, and I think, Meagan, you had a similar experience with your first. How to prevent trauma in the birth room But because we are running low on time-- I am so sad we weren’t able to get through all of these letters, but I want to bring up something that we go over in our doula course. We teach about how to prevent birth trauma, PTSD and how to make it more likely that your clients will have a more positive birth experience. I think that this advice can go for not only doulas, but birth partners, sisters, mothers, whoever is in your support room, and also nursing staff and providers and OB/GYN ‘s. Everyone, listen up because there are three important things that you can do to best prevent trauma in the birth room. Make sure that the three S’s are met. The three S’s are: seen, safe, and soothed. Seen: mirror and observe your client. Repeat back to them what you think they are saying, but without giving your opinion on it and make sure that they are involved in the decision making. Listening makes a big difference here. You can kind of see that looking back on the stories we just read. Safe is the second S. Overall, communication is so important to create a feeling of safety. If you are uncertain if they feel safe, just ask them, “Do you feel safe right now?” Sometimes, that question can open up an avenue in order to actually help them feel safe. And then the third S is soothe. This is doula 101 stuff, but empathize with them. Speak affirming words. Use comfort measures and do all the things that you can to help them feel soothed and supported during labor. Science has shown-- there are actually studies to support this, that when those three S’s are met, parents are less likely to describe their birth as traumatic, less likely to have postpartum mood disorders, and less likely to develop postpartum PTSD. So, as you’re listening to this-- mamas, birth partners, all members of the birth team, make sure that your birthing parents feel seen, safe, and soothed. If you do all three of those, then I think you are on a pretty good track to making sure that you are taking great, great care of them. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For 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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