CAM #3 Blyss Young Answers Your Questions

Blyss Young is a seasoned home birth midwife who has so much knowledge, experience, and a special heart for VBAC. Blyss hosts her own podcast, Birthing Instincts, alongside her cohost Dr. Stuart Fischbein where they normalize physiologic birth outside of the hospital.We asked our VBAC community what questions you have for a midwife who supports home births after Cesarean and Blyss has answers! You will leave feeling inspired, educated, supported, and loved for whatever your birthing choices may be after listening to this beautiful discussion. We absolutely adore Blyss and know you will too!Additional LinksBlyss’ WebsiteHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello, hello women of strength. It is Wednesday. Actually, it’s Monday the day of this episode and we are coming at you with another Cesarean Awareness Episode. I am so excited to be doing extra episodes this month. Today we have our friend Blyss Young. You guys, if you don’t follow her and her podcast with Dr. Stu, you need to do that right now. Push pause and go find them because they are amazing. They are a wealth of knowledge. They just make me smile. I feel like every time I’m done listening to an episode, my face hurts because I’ve just been smiling. Really, though. I remember I fell in love with Blyss and Stu years and years ago. We’ve been so fortunate to have them on the podcast before and Blyss agreed today to be on the podcast blessing you again with her wealth of knowledge and answering some of your questions. We put out in The VBAC Link Community, “What questions do you have for a midwife?” and we got quite a few surrounding home birth. I know this might sound like a really heavy month of talking about home birth because Julie and I got a little salt at the beginning of April talking about a home birth but it’s just such an important topic that a lot of people don’t know is an option. Review of the WeekSo we’re excited to dive into today’s episode with cute Blyss but of course, I have a review of the week that I would like to read. The title says, “Thank You” and it’s from cara05. It says, “I just wanted to drop a review and say thank you. Because of listening to some of your podcasts, I felt empowered to talk to my OBGYN about skipping the repeat Cesarean in the event that I go past my due date. This was something I had in my head that I really wanted. Opting for induction to still try for a VBAC was important. She was and just over all of this so supportive.” Sorry, that was a little weird for me to read.“She was so supportive of the idea and totally on board which helped me get more excited about championing–” Blyss, I can’t read this morning. Sorry, Cara. “--this VBAC so thank you.” Oh, man. This is where Julie always would come in handy. She would really read reviews really well. So going on and having her VBAC. Congrats, Cara, for feeling empowered and that you were able to talk to your OBGYN. This is something that is so important whether you are a VBAC mom or not. We want to have a good relationship with our provider and we want to make sure that we can have those tough conversations. When they may be suggesting induction or a repeat Cesarean for going past your due date, but if something in your heart is telling you no or you are seeing the evidence and you’re like, “That doesn’t feel right,” have those conversations. I encourage you to have those conversations with your providers. I mean, is there anything that you would say to that as well with being a provider in the world? I feel like as a provider in my head, I would want someone to tell me their thoughts and feelings. Blyss: My relationship with my clients is very intimate. Meagan: It is. Blyss: Yeah. One of my teachers, Elizabeth Davis, who wrote Heart and Hand is a longtime midwife and teacher. She talks about the more we do prenatally, the less we have to do in labor. So I feel like that relationship that we have and hearing the internal landscape of the client is so important because when we are in labor, our body responds. Our hormones respond to feeling safe and having trust and being able to really relax. That’s true for every one of my clients but especially with my VBAC clients because they have another level of trauma many times that they are having to go with. That could be their experience that happened in the hospital or maybe they were transported from a home birth and had a Cesarean. And then there’s that level of, “Does my body really work? Can I trust my instincts?” So the more that we can dialog about those things and start to really pull that apart and work with them prenatally, I feel like the better chances we have in having that successful experience. Meagan: Yeah, absolutely. I will never forget it. I transferred to my midwife at 24 weeks with my third, my son, my VBAC baby. I just remember looking forward to those days when I got to go see my midwife because I would be feeling angst and hearing all of the static in the world. I remember just walking and she would always greet me with a hug and say, “How are you doing today? What do we need to talk about?” We talked. We dissected those fears and really talked about the things that were going through my mind at that time. I remember always leaving, going with a weight on my shoulders and leaving just feeling refreshed and more connected to her. Blyss: Yeah. Meagan: I think it’s important. I know that it’s hard in the system because we have providers that are restricted on time. They have so many patients. They’ve got bogged schedules. They’re tired so it’s a little harder for them to be more intimate, but I still encourage our listeners to have those conversations, to let them know where you’re at so like you said, you can work through it prenatally so that during the birth, those things aren’t coming up. We talk about that in our course. VBAC can be different and need more time prenatally. So yeah. If we don’t do those things ahead of time, it can definitely impact us during labor. Blyss: Yeah. You know, expect that kind of care. You’re not getting that kind of care if you’re not feeling the way that you just described when you leave your provider’s office. Start to think about what it is that you really want. I know not everybody has the option to either financially or because of availability be able to work with a midwife necessarily, but plan to have somebody on your team that you do feel can support you that way whether it’s a doula or maybe doing some concurrent care with a midwife in your area where she can hold the space for you and give you those positive feelings that can help prepare you for your delivery.Meagan: Absolutely. Talking about that, I did dual care for just a little bit as I was debating a little bit and figuring out logistics. Just doing dual care made me feel so much better. I would go to one place and hear one thing and then go to the other and have to work through that. She did have the time and the resources to provide me with that comfort. I love it. Q&A with Blyss YoungMeagan: Okay, well like I said, we have some questions and I think they are really good questions from our listeners. We’ll just dive into those if you don’t mind and then feel free if we need to stagger away from them on any other topics or passions. This is one of the questions actually that was put in. We talked about this right before we jumped on. What is a CPM versus CNM or a licensed midwife? There are so many questions that people ask. There is a myth that CPMs are not qualified or able to handle VBAC and especially HBAC. I feel like this is the big myth. If you wouldn’t mind, could we debunk this a little bit? I don’t necessarily agree with that. Blyss: Yeah. I think it all comes down to what you feel aligns best with your values. Just so you understand a little bit about how we’re trained. Certified professional midwives, our licensing body is different across the United States. This is one of the problems with our systems whereas we look at other European countries where midwives are integrated into the medical system, we don’t really have it together in that way here in the States. The licensure is different from state to state depending on the local jurisdiction. CPMs’ certification is our national certification. I practice here in California so when I take my board exams, I’m licensed by the medical board. It’s the same licensing board that licenses OBs that gives me my exams. I take my exam and I take the CPM and the LM. That may not be the case across the country. We learn our bookwork and then we have an apprenticeship. We work side by side with midwives or doctors to learn our hands-on skills and then we take a board exam similar to many doctors and nurses and people like that who have this professional capacity. A CNM is a certified nurse midwife. They are licensed by the nursing board and they become nurses first and then have their specialty added to it of midwifery. As professional midwives, all we train for is out-of-hospital birth. That is our specialty. We specialize in low-risk, normal, healthy pregnant moms and their babies. A mom who has had previous Cesarean labor and delivers exactly the same as any other mom. They have an increased consideration because they have this scar so the integrity of risk has been affected but other than that, everything is exactly in terms of their pregnancy and their labor and delivery. We absolutely are champions for these moms being able to have and experience a vaginal delivery for the healing of all of that trauma that we talk about. And also because of your long-term health as a woman who is delivering maybe multiple babies in your lifetime, it’s actually much better for you to be able to have a vaginal delivery than to continue to go and have Cesareans. The benefits for the baby of being able to pass through the biome and have those mechanics that help empty their lungs as they are delivered and all of those things that the baby benefits from having physiologic birth. We are champions for that for these moms and for these families because we know. There are some things that we watch for in case there is a uterine rupture or dehiscence as we would say where the scar opens a little bit. There are things that will be a little bit different than a mom who has not had a previous surgery, but other than that, this mom is just a mom who is pregnant and wants to have her baby. So we’re absolutely skilled to be able to support that. If you look at the statistics of success because a mom who has had a previous Cesarean is a TOLAC. She is desiring to have a trial of labor after a Cesarean. I lost my train of thought. Meagan: You are just fine. You were just talking about uterine rupture. We have a small increased risk but we are just having a baby as well so at home we have to pay attention to uterine rupture and dehiscence and things like that. There are signs and then you were going to the statistics. Blyss: Yeah, there are signs that we are skilled to be able to look for. Meagan: Yeah. Statistically, uterine rupture happens at 0.4-1%. It’s pretty minimal but having someone who is trained in out-of-hospital birth is a little bit different but it doesn’t mean that anyone is less qualified to support someone giving birth after having a previous Cesarean or previous Cesarean. Blyss: Oh, yeah. So what I was going to say and where I lost my train of thought was the statistics in terms of success so actually having that vaginal delivery is much higher out of the hospital with a midwife than it is in the hospital. That is something to consider as well. If that’s your desire, you want to put yourself in a situation where you’re going to have the best possible support to be able to have the vaginal birth that you are desiring. Meagan: Absolutely. That’s what Julie and I spoke about at the beginning of April kicking this special episode series of home birth and the chances of success outside of the hospital. We talked about how I want to say it was 18% of people may transfer. Tell me if you know the stat. I think it was 18 or so percent. But within that 18% of transfers, it was usually exhaustion, needing an epidural, or maybe we’ve got some scar tissue or something that we can’t work through, it’s a failure to progress, and maybe we need something else if we can’t get a homeopathic way to work. I want to say that was what we found. Is that approximately what you would say?Blyss: That’s not my statistic. Meagan: Well, yeah. Your statistic is low.Blyss: I would say for a mom attempting to have a vaginal delivery after a Cesarean is the same statistic as a mom who is attempting a first-time delivery. We treat them in the same way in a lot of ways because they haven’t had that pushing phase. They haven’t pushed a baby out. Their labor depending on how far they dilated in their previous labors is going to give us some information as well. If a woman got all the way to 10 and was pushing her baby out and then they for whatever reason decided that a Cesarean was appropriate, her labor is going to be more like a multip, so someone who has labored except for that pushing phase. And someone who maybe didn’t ever get to have labor– you’re raising your hand. Meagan: Yep. Blyss: Or I think one of the questions that is coming up is that you only dilated to so far and you’re not sure if you’re going to be able to get past that point? Those moms are going to be treated more similarly to a mom who has never had labor before. We are going to support them in that way. You have to really, I think this is what we don’t understand. A lot of the studies and statistics that are done when you’re looking things up or hearing about things are from a medical perspective. They’re from medical perspectives. The way that they treat– and I was a doula for many years before I owned a center. I was a doula for many years before I started doing a private home birth practice. I know what it looks like in the hospital to support a VBAC. I’ve been there with them. Your provider and their faith in you and the way that you are treated by the nursing staff and all of that has a huge impact on your ability to be able to labor and progress normally. We are mammals so our bodies are going to respond the same way a cat or a dog or a cow who wants to go and be off by themselves and have privacy and not feel like they’re being watched. Your hormones respond to that. Labor moving straightforwardly in a normal way is affected by you feeling that way. That’s what I was saying when we were talking about the different licensure. It really depends on where you’re going to feel the most comfortable but you want to have a team that really believes in you and makes you feel, as we were talking about in the beginning, relaxed, comfortable, and empowered because those are the things that are going to affect your body progressing normally. Meagan: Absolutely. Absolutely. As a doula, I’ve supported VBAC clients both in and out of the hospital but there are times where there is a lot of pressure and angst that is created. That is not helping our labor. Julie and I mentioned it in our episode. We have to think about it like we wouldn’t give birth in the same place where we conceived. We don’t conceive in front of a whole bunch of people with bright lights on a bed with things strapped to our bodies, right? Blyss: Right. Meagan: But then we do give birth this way. It’s just something to be mindful of for sure. Blyss: I didn’t get a chance to say that my statistics for first-time moms are a little bit higher than for moms who have already had a vaginal delivery. That statistic is about 10%. As you pointed out, the majority of those are not emergent transports. Those are transports where we are ready for something a little bit different. Again, this is when even midwives have a different level of comfort in terms of how they care for you. I don’t transfer someone to the hospital because I’m ready for them to go. I transfer people to the hospital unless there is a medical indication. If there’s a medical indication then obviously, I’m like, “Okay, we need to go,” but in terms of this exhaustion and wanting something different and maybe wanting to rest and get an epidural or get access to Pitocin to augment the labor, those kinds of things, for me, if everything is looking great medically, then this is the mom’s choice. This is not something that I’m going to make that decision for her. I had a mom the other day. This didn’t happen to be a VBAC mom, but just in a normal labor. She had the pushing instinct. It went away. We labored with her for another nine hours because she had a lip and then she pushed her baby out. All of the doulas who were with us were talking about how if that happened in the hospital, that mom probably would have definitely been augmented, definitely not left alone, given a lot of pressure, a lot of vaginal exams, and then probably would have ended up having a Cesarean or a “failure to progress.” But what that mom needed was rest. She needed to eat. She needed to feel like she was ready for the next level of her labor. It was a very mental thing for her we believe. That’s not something that is always given either at home or in the hospital. Sometimes, especially, I was just talking to a VBAC mom right before we got on the phone because she went in to see if she could get a consult with a backup doctor in her local area. I sent her to the most common doctors that are supportive of transport. This doctor said, “No doctor in their right mind would back up a mom attempting to have a vaginal delivery at home.” And this is the best we’ve got. We got on the phone and we were talking about her feelings about all of that because she would really love to know if she’s going to have a repeat Cesarean, she would really like to know the person with who she’s having a Cesarean. Meagan: Totally. That’s one of the reasons why I did it. Blyss: Yeah. That’s a reasonable thing to desire but what she’s finding out is that she might not have that option and just being in that doctor’s office, she said that the nurse came in and said, “Can you take off your pants so we can do a pap smear?” She said, “I’m not coming in for a pap smear.” Just that was a perfect example of being treated like every other person and not being individualized. This woman was coming in for a consult. But it solidified her desire, “This is why I’m not going into the hospital again. If I need it, then it’s a good option but it’s not something that I’m feeling like I want to choose.” It’s just solidifying her desire to have this out-of-hospital experience. Meagan: Absolutely. I think for those who are doing dual care, it’s important to still learn the stats and the facts because they can sometimes inflate these numbers and these statistics then you are left thinking, “Wait, am I making the right choice?” My provider told me, “Good luck, no one is going to want you out there.” It was a little different than what she was told but very similar. No one was going to want me out there. It made me question, “Why? Am I that scary of a patient?” That’s just not a good feeling and it’s not how you should be feeling during pregnancy and especially not during birth. I’m going to lead into one of the first questions that were actually written. Why is there so much backlash around HBAC? When we were talking about backlash, I think it really just means so much hate and distrust about HBAC. I mean, do you find that a lot of people are coming to you saying, “Everyone’s telling me not to do this,” or maybe they’re even scared? I feel like maybe by the time they come to you, they are confident in their decision, but do you ever have any clients come to you who are still unsure?Blyss: I think that people can be in care and still feel a little unsure. There is part of the process of just unraveling the experience that you had last time and being with somebody who consistently says, “Everything looks good. You’re doing great,” and just normalizing the experience of having a joyful pregnancy. The mom that I just talked to, she’s like, “There are risks in everything.” I think that’s true too. You can look at a statistic that says, “You have a 1% chance of having this happen,” and you can try and say, “I want to try and take that risk down to zero.” Obviously, there is risk in everything. You can’t have no risk, but there are people who look at it and go, “I have a 99% chance of having success.” Meagan: That’s what we say. Flip it and be like, “I have a 90.9 or 99% chance of full success.” It’s like, “Well, dang. That means I’m pretty high up there.” Blyss: Yeah. That’s probably how you look at life in general. So if you’re wanting to flip the script for yourself not just about this particular instance but about how you look at life in general because you talk about how the birth of your child is just one day. You’re actually going to be raising this baby and they’re going to have all kinds of risks. Do you want to spend the rest of that time with this child being worried all of the time about what possibly could happen or do you want to enjoy what life has in store for you? That’s a lifestyle thing, but you can have a transformative experience and you have this thing in your life that people are looking at. They are projecting onto you their own fear. You have the ability to ground yourself in your own belief about how you are wanting to take control of not just this delivery but your life in general. I think it can help you move into feeling more confident about your choices in general. Meagan: Absolutely. I think you just nailed it right there. A lot of the time, the people that are feeding the backlash are people that have experienced an unfortunate circumstance or have experienced something personal. They are feeding it out there to the world because that’s where they’re at. Blyss: Yeah, or not. Or they haven’t had any. Meagan: Or they haven’t. Exactly, yeah. Blyss: You know, I had a mom one time in my care who was attempting to have an HBAC. Her previous doctor was sending me the records. She was transferring out of care. She was like, “This is so dangerous. How are you going to know how the baby is doing? How are you going to know the signs?” She didn’t even know what we do at a home birth. She didn’t know that we monitor the baby, that we have all kinds of medications, and the ability to be able to manage things at home. I think a lot of times, there is just ignorance too. There is just not an understanding of the role that midwives play. We’re not doing a seance with our incense and our Birkenstocks and just hoping for the best. We actually have been trained to know what to look for. Because we do normal all day every day, that’s our specialty. When something is not normal, it stands out. It’s like a bad nook. You’re like, “Huh. This is not normal.” If there’s something going on with the mom’s uterus during labor and delivery, there are going to be signs. There’s going to be pain in between the contractions near the site that’s unusual. There might be bleeding that’s unusual. The baby’s heart tone might be unusual. The patterns of her labor might be a little bit funky. There are a lot of things that will stand out to us as “This is not normal labor progressing. Something is going on.” If you’re being conservative and it’s a question mark, “Huh. Does this mean that something is happening with the scar?” then you can conservatively transport to the hospital and be monitored continuously because we use intermittent monitoring. Maybe nothing. Maybe you’ll have a vaginal delivery at the hospital, but you have the ability to do that and not wait for something catastrophic to happen. You have plenty of time to get there and do the more conservative management of this labor just in case. Meagan: Right. One of the questions was, what are the stats of transfer for an emergency? Again, everyone’s stats might be a little bit different, but what she is saying is that there are signs that indicate a change of plan before there is a crazy emergency.Blyss: Right. Meagan: I do think that what you are saying is that she didn’t know what the care was. It circles back to the backlash. I think that a lot of people don’t.My mom said some really crazy things. Years later, it wasn’t until I really understood the mental process of my mom and everything. She was saying those things out of fear, the unknown, and uncertainty. She didn’t know what out-of-hospital birth looked like because she only knew what Cesarean birth looked like. It’s so important to learn those things and learn those signs but know like Blyss said, that it’s not usually even just one. Blyss, you would know way more than I do. But from my experience, there are usually a couple of symptoms. It’s not usually one. It’s like, “Okay, we’ve got this, this, and this” or “We’ve got this happening. Let’s transfer. Let’s take a plan of action.”Blyss: Yeah. You were talking about my cohost, Dr. Stuart Fischbein, and one of the things he says– he was a doctor in the hospital for many, many, many years and has now been providing out-of-the-hospital support for families for 12 years now. He has the benefit of both worlds. He talks about when we say that a uterus has a rupture, we imagine a tire bursting on the freeway where it’s all of a sudden a pop. But usually what it is, is what we call dehiscence. There’s a little opening in the uterus. Oftentimes, that can go without having any real incidence and the only way they would know that happened is if they went in and did another surgery. So a lot of times those things will heal on their own. I think you were saying there’s a 6.2% out of the people that do have a dehiscence or a rupture that have something really catastrophic that can happen. The statistics are really on your side but you have to be the one who makes that decision to say, “I would really just rather have another Cesarean,” or “I really want to try,” because there is such a high statistic of having success.One of the things that I was saying to this mom earlier is what I notice and I would consider myself a specialist in VBAC. I really love caring for these women. One is because I feel like their options are limited especially in the area that I am in. There is actually a ban on VBACs in the local hospital where they would deny these women pain relief if they came in to try and have a vaginal delivery. The women in my area are driving 40 minutes to go to a hospital in another town to be able to have this support. I feel really honored to provide this option for people who desire that. It’s really important to me. And, I was transported in my first delivery and had a forceps, an instrument delivery. I didn’t end up having a C-section. But when I had my vaginal delivery on my own at home after that, the triumph of reclaiming my body and knowing that my body wasn’t broken and that it was just a mismanagement of my labor that led to that. I know what it’s like for these women to be able to have that redemptive birth after the surgery. What I notice with VBACs is that they’re totally straightforward and normal just like another mom giving birth which I talked about earlier or they come really fast. It’s like the uterus knows, “I can’t do this for very long. I need to be super effective.” I actually just had a woman who had a VBAC after two Cesareans with me and it was so fast that I didn’t make it. That’s how fast it was. I was so happy for her and her husband because he’s a paramedic and he caught the baby and it was absolutely amazing. I was on the phone and on my way there. All the work that we did to prepare her for this and she just popped that baby out like she had done it her whole life. Or we might have a labor that meanders. The uterus is wise in that way too. It’s like, “I need to be really conservative with my energy.” So you might have these contractions that are really far apart. Just like I did in that birth when I was telling you that we gave her nine hours to try to have that lip back, nothing was wrong. We weren’t getting any signs that anything was wrong. If you’re a mom attempting to have a vaginal birth after a Cesarean and you have labor like that, you want somebody with you who is going to honor and respect that your body is progressing, it’s just going to take a little bit longer because the integrity of that scar, the uterus knows, “I just need to be smart about this.” If you augment that labor or push that body past what it’s saying it can do, that’s when you can have a problem. Meagan: Yeah. I love that you said that because I was one of those where my uterus tinkered around for a little bit. I had a 42-hour-long labor. I was like, “This is never going to happen,” but it did and I’m so grateful for that. I think that’s just what my uterus needed. It needed to take its time and then it was 6-10 hours to get baby out really quickly. It just took a long time to get there. Blyss: You said you hadn’t had labor before, right? Meagan: I labored like a first-time mama. I only went to a 3. My water broke before contractions really started so it had to kick in. There was a lot. Blyss: Yeah, yeah. Sometimes first-time laborers can be that way. I tell my families to be prepared for three days. That’s normal. That’s normal labor for a first-time dilation and delivery. I don’t think that’s what you’re going to hear from a medical provider because they don’t know normal. They only know what they decide as being normal so most of those labors get augmented in some way. Either they’re induced or they give them Pitocin at some point or they just call it and say, “Your body’s not doing this so we’re just going to give you a Cesarean.” Meagan: Yeah. That’s what happened with my second. They were like, “Oh, it’s just not going to happen.” It hadn’t been very long. So it does happen. Another question was going into failure to progress. If we didn’t want to transfer and if there was no need to transfer but maybe we’re getting tired and we’re trying to progress at home, obviously we know time is our best friend. Time, trust, and faith in our body, and sometimes it is going to sleep, getting some food, and maybe doing a fear clearing. I truly believe, I’ve seen it so much through my own doula work and my own personal self and through the podcast and everything, that clearing your mental fears during labor can change our pattern just like that. It’s crazy. But for home birth midwives, are there things that they can do to help things progress? In the hospital, we talked about how you are more likely to be augmented with Pitocin or something like that. Maybe they’d break your water. But are there things that you can do out-of-hospital to avoid a transfer because it’s not really necessary at that point but to help progression if we’re starting to get tired and things like that?Blyss: Well, I think that when you do have that scar, you want to be mindful of pushing the body like I said. I’m not against augmenting a VBAC but it’s something to really give really good informed consent and talk through. I would probably lean more toward, “Let’s sleep. Let’s take the pressure off. Let’s figure it out.” If you’re in early labor, sometimes you can take a Benadryl and maybe even have half a glass of wine. Sometimes that can help you sleep. If you’re in full-blown labor, it’s a little bit harder to do. But like you said, maybe having a conversation about, “Is there something that you’re afraid of? Are there people at birth that are nervous and that’s affecting you?” Sometimes you have too many people there too early. Your mind can be wanting to take care of those people like, “Gosh, this is taking forever. I feel bad that my midwife is here and that my mom is here.” Send people home. Keep one person there just in case, but clear it out. You can refresh the space. If you’ve been in labor at home for a long time, sometimes you just change the smells. Clean up a little bit. Meagan: Go outside. Blyss: Go outside. We send our mama outside barefoot in the grass in her backyard. Those things can be really healing. I send people on walks all of the time. I know it’s really hard. You don’t want to get your clothes on and go outside but this is going to be really good because it takes your mind off of it. Also, going back to that hormone flow, you want to increase oxytocin so do things that can do that. Maybe put on a funny movie and get distracted that way. Maybe you and your husband can go and get in the shower together. You can have a little bit of making out and a little bit of nipple stimulation. If your bag is intact, I know this sounds totally crazy, but I’ve had people actually have sex and it’s very effective. Or if you have a toy or something. I just saw a post the other day talking about how masturbating during labor can bring on the sensation of being able to relax a little bit more. Meagan: I’ve had a client do that. Blyss: Yeah, totally. Meagan: It totally worked. He did it for her but it totally worked. I was like, “I don’t know what you just did and I don’t need to know the details.” I was like, “Why don’t we all leave? Why don’t we grab some lunch? You guys do your thing.” We came back and it was business. Baby was coming. I mean, seriously, baby came three hours later. It can work, yeah. Blyss: Totally, 100%. One of the other things you can do is have a dance party. Change up the music. You don’t need the spa music and Hypnobirthing or something the whole time. Put on some fun music and laugh. Shake your booty a little bit. All of these things can be really helpful. Doesn’t that sound much better than laying in a hospital bed being monitored and strapped? Meagan: Or hooking up to a pump?Blyss: Yeah. So facilitating oxytocin is another one that can be really, really helpful. But you know, midwives have homeopathy. We have herbs. Our big gun is castor oil. Those things can be utilized. I think it’s just a matter of really talking it through. The first thing I would always recommend is respecting the body and respecting that there’s a reason why it’s having a challenge. If labor really can’t get going and you’re really tired, then the hospital might be the appropriate place because that again might be your body telling you, “This may not feel the right way for my uterus. There might be something else going on that the uterus is protecting itself from working too hard and causing that scar to maybe not keep its integrity.” Meagan: Yeah. That’s a really good point. I want to talk about how you did transfer. You weren’t a VBAC. You have transferred. I want our listeners to know that if a transfer takes place, that’s okay. That is okay. You’re not failing because you left and changed your plan. There is no giving up because you decided that you wanted an epidural. There’s no failing in that. It doesn’t need to be negative is what I’m trying to say. A lot of the time, people writing in are a home birth turned Cesarean and feel totally deflated like they failed. That’s just not how it is. It’s not how it is. You are doing an amazing thing. You are birthing a baby. You are birthing a child out of your body. You are giving birth and you are becoming a mother to a human being. It doesn’t really matter how you do it or if the plan has to change but like Blyss said, sometimes we need to tune in and say, “What is our body saying right now?” Is our body saying that we need to do nothing? Is our body saying that we need to do something? I think that is one thing that we need to remember. I think sometimes too that people think, “Oh, home birth midwives will do everything they can to avoid a transfer.” I really disagree with that. Yes, they are going to help you get the birth that you want. They are going to do everything they can and they are passionate, but I’m telling you right now listeners, or an OB that helps at home too. We know that those exist with Stu and I think there are some others. They’re not going to just do something for themselves. They’re not just going to keep you. “You can’t leave. Nope. You can’t leave because you’re going to change my statistic.” It’s just not going to be. It’s important for you to remember that you are going to be safe. They are going to have these discussions with you and it’s okay for you to have those discussions if you’re feeling like you need to transfer. If your intuition is saying, “Something is not feeling right,” and not feeling like you are giving up, failing, or disappointing anybody because you’re not. You’re doing what’s best for you. Blyss: Yeah. Again, going back to the work that you do prenatally is going to really help you in labor. The more that you can tune into your own body and know what’s important to you and what you need as a sovereign person, the more you’re going to be able to tune into that in labor. You don’t want to be handing over your power to a provider. You want to be the one who is in charge of what’s happening to yourself. They may give you information and consult with you about how things are going from their expertise, but ultimately, it’s about you being the one who’s saying, “This is really what I want and this is what my body is telling me.” You don’t want to just wait until you get into labor to do that. You want to practice that throughout your whole pregnancy. I think that is a really important piece. And yep. Thank God we have medical advances. What I find with my clients is if we end up transferring, we’ve done all of these things. They’ve had great prenatal care. They’ve been able to talk and process all of these things. If they’re going to have a repeat Cesarean, what they would like to do differently this time that they learned from their last experience? So if they get to that point, they know that they did everything that they could to give themselves the best chances and they feel empowered throughout the process. I think that the most important thing is that you feel like you weren’t bullied or made to do something and that each step of the way, you are making a choice that feels right for you and your family. As human beings, we deserve that for everything. We deserve to be able to make these choices for ourselves. Meagan: Yeah, and I think with being able to make those choices and to feel that empowerment to be able to do that, even if the outcome isn’t what we planned on, we’re going to have an overall better view from that experience because we aren’t going to feel like birth happened to us. We’re more likely to feel like we were the active participant in our journey and the leader or the driver in the seat and have a better postpartum experience.Blyss: Yeah. And welcome to life, right? Meagan: Yeah. Blyss: Our lives don’t turn out exactly the way that we planned. We ultimately have to meet life on life’s terms and know that we are not in control of every single thing that happens. It’s how you respond and how you move forward through a challenge that really makes you who you are and gives you the life experience that you want to have because labor and birth and being a mom is the greatest lesson in not being in control of things. It’s an important one. It’s a really important one. The only thing that you can really have control over is going in and deciding, “I’m going to deliver on this day and have a repeat Cesarean.” That is within your control. But if you are really wanting to trust your body and to have a physiologic birth experience, you have to be willing to let go of that control and ride the waves and see where it takes you and meet each moment with the best that you’ve got at that time. Meagan: Yes. Oh, I love that. I love that. Ride the waves. That is the perfect ending. I have one more question but I want to just end on that. Ride the waves. Ride the waves. Trust your body. So if I’m having an out-of-hospital birth, what should I be asking? Are there specific questions I should ask my midwife? Do I have qualifications? Are there certain things where you would say, “You’re probably not a good candidate for a VBAC at home?” Are there any final tips that you would give as people are researching this option and talking to people?Blyss: Yeah, I think it goes back to what we were saying in the beginning. How do you feel when you are in this person’s presence? That’s a big one. Telling your story to them, telling them how you feel and what you are desiring this time and then just really feeling into do you feel that this is somebody that you want to have by your side? Ask them about their experience with VBACs. Ask them what would be the situation in which they would require a transport or that they would want to transport? See if that aligns with how you are feeling about this decision and what you would want from a provider. Maybe ask their statistics how many VBACs they have done. What is their transfer rate? When did they transfer with those people? I think that’s all really important and how comfortable are they? Are you a mom who has had multiple Cesareans? How comfortable are they with those risks and do you feel aligned with what it is that they are sharing with you about their philosophies? I think that is a big part. Again, your provider and how they feel and how they approach things whether it’s in the hospital with an OB or a certified nurse midwife or at home with a CPM, their feelings about it and their trust in this process is going to have a huge impact on your experience because they are going to bring those fears or concerns into the birth room or into your pregnancy and you don’t need that. You need someone who believes in you 100% and when you’re with them, you feel better than when you got there. That’s what you’re looking for. If you don’t have those options available in your area, find somebody who can provide that for you virtually or find a doula who can be there with you as a continuity of care that you do have that connection and trust and faith with. I feel like that is probably the most important part of the process. Meagan: Absolutely. That’s what I was looking for. I had a lot of questions at my visits but ultimately, one of the biggest things I was looking for was how I felt in their presence, their confidence in me, my confidence in them, and yeah. I mean, I liked to know what would happen if I needed to transfer or what would they be looking at to make me transfer so I would know, “Okay, this is happening. She talked about transfer,” but overall, I needed to know that that person was in my corner because I had never been in anybody else’s corner if that makes sense. I was in my own corner with my first two babies and I didn’t want to feel that way again because it’s a very lonely corner. Blyss: Yeah, yeah. The only contraindication would be a classical incision. Other than that, I think that it’s just about exploring what the risks are. Let’s say it’s a short interval or something like that. I think giving true informed consent to that family and making sure they understand the increased potential risk, if this is an option that they want, I would rather be able to support them in this option than send them to the hospital if that’s not necessary or having those people maybe do an unassisted birth because no one’s willing to support them. That’s me. Not all providers feel that way but I believe if this is something that you’ve researched, you understand the risks, and this is what you’re desiring, you deserve to have somebody there by your side. That’s what we’re there for. Birth is meant to happen with nobody around just like a mammal. We’re designed to survive. Our babies are designed to survive. You don’t actually need anybody with you, but when you hire somebody to be there by your side, we are there to be able to help you decide when it is time to get support or be able to step in and offer that medical support if needed. So if someone never wants to deal with any kind of complication that may potentially arise in childbirth, you probably shouldn’t be a provider because that’s our job. We’re the ones who are supposed to step in calmly and help you make a decision that’s going to keep you and your baby healthy. Like you were saying earlier, us keeping you home when you don’t want to stay home, none of us want to have a bad outcome. We don’t go to work thinking that we want to force somebody to stay home and have a bad outcome. We all want the same thing, a healthy mom and a healthy baby. For us, there’s that additional layer of transformation, elation, joy, rights of passage, and having the family have an experience of understanding that this is how we were meant to deliver our babies. Meagan: I have feelings about the healthy mom, healthy baby. Just like you were saying, I add to it. Healthy mom, healthy baby, and a good experience. That’s going to look different for everyone. I hope that as you are listening to this episode, you know you have options. You have options. I know sometimes Blyss talked about financially or maybe even location-wise, you are feeling that those options are stripped or you are feeling restricted. I understand that and I know it sucks. But don’t ever hesitate to explore your options or maybe look for those virtual support meetings and things like that. Or maybe drive 40 minutes because deciding what is best for you is most important. Here at The VBAC Link and Blyss, I’m going to speak for you, there’s no judgment in the way you birth. There’s no judgment. We just want you to have a good experience and know your options. Blyss: Absolutely. Thank you for having me on. I love you and as I said, I love supporting families in general but I have a special place in my heart for VBAC moms and for the work that you are doing so thank you so much for inviting me to have this conversation. I am available for people to come out to Santa Barbara if they feel like they don’t have options which I know is not for everybody. I’m also happy to do consults with people over the phone if they just need somebody who can tell them that they can do this. Meagan: Yes, I know it sounds crazy that I’m going to go to another state and have a baby, but you guys, people do it. Before COVID, I had a Russian clientele. People from Russia would come to the states here to Utah. Think about how far that is. It’s not super crazy. A lot of the time, people are like, “It’s a lot of money. It’s a lot of effort. It’s a lot of this.” You guys, this is one day in your life that will impact you forever. It really will. I will never forget my births. Money will come and go but your experience will stick with you. Blyss: Forever. Meagan: So if you can make it work, if you have a VBAC ban, or you are restricted or something like that, check out Blyss. Check out midwives in the next state over. Look at these options. Expand your ideas. Expand your ideas and know that you have options. Blyss: Yeah. Take back your power. Meagan: Take back your power. Take back your power and know that it’s okay. It’s okay to do something that seems weird. People are going to be like, “What are you doing?” but it’s okay to do that. Blyss: And that’s how change happens. If we all do the same thing, no one is ever able to see that this is possible. You deserve that. You deserve to listen to your own heart and your own instincts and what your soul is telling you is right for you. That’s okay if it’s not right for everybody. Meagan: Yes. Absolutely. Just like we were talking about earlier, there are going to be different outcomes and that’s okay if that wasn’t your outcome or if that wasn’t your choice. We have people who after learning about VBAC and the statistics, the risk is too much for them and that is okay. That’s okay. ClosingWould 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 Meagan’s bio, 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/donationsAdvertising Inquiries: https://redcircle.com/brands