Episode 194 VBAC Q&A + A Sad Announcement

This episode is exclusively with Meagan and Julie, here to answer your burning questions! Topics include due dates, induction, membrane sweeping, diastasis recti, scar tissue, pelvis size, and head size.We also have a sad announcement to share. Thank you, VBAC Link Community, for being with us through all of our seasons of change and growth. We feel that you are there for us as much as we love being there for you!Additional linksACOG Practice Bulletin 146: “Management of Late-Term and Postterm Pregnancies”Julie Francom Birth PhotographyHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Julie: Welcome to The VBAC Link podcast. This is Episode 194 and this is Julie. I’m here with Meagan today. We have a not-as-fun of an episode. It’s fun because we are going to do some FAQ’s. We are going to talk about questions that we get all of the time. We had you guys submit questions on our social media pages, questions that we have been getting through our email, so we are so happy to answer your questions as usual. We also have an announcement to make that is not as fun. But before we do any of those things, Meagan has a Review of the Week for us. Review of the WeekMeagan: Yes, I do. This is from Ashley. She says, “This podcast is a gold mine of knowledge when it comes to VBACs. I have been bingeing these episodes ever since I got pregnant with my second. I have learned so much and gained a lot of confidence on how to find a truly supportive provider. I have enjoyed the birth stories so much. I mostly listen on my commute and can also say that these ladies are my car doulas.”That’s fun. Julie: Yay!Meagan: I have cried tears of happiness and/or tears of pain and understanding during so many of these stories. No matter what happens in my birth in August, which I hope will be a VBAC, this podcast has prepared me for it. P.S. I am now caught up on all of the episodes and I am sad that I have to wait for just one weekly episode.” That is so hard. You know what? I have listened to podcasts like that. I am a big– Julie: You just binge.Meagan: I am a big crime podcast listener. I will wait and wait and wait, and then I will catch up really fast, then I’m like, “No. I need to listen any time I want. All day every day if I need to.” It’s so hard to wait for the next week’s episode. So Ashley, you actually posted this in April. It doesn’t say the year. It just says April 27th, so if it was this year and your VBAC is coming really soon–Julie: I think if you double-click the cell, it brings up the year. Meagan: 2021. So Ashley, you– Julie: Already had her baby. Meagan: No, she’s due in August. Julie: Girl, it’s 2022 right now. Meagan: Oh duh. It’s 2022. So Ashley, tell us how your birth went. Julie: We may need to– our admin, Sarah, has left and she was so good at putting all of the new reviews in our spreadsheet. I don’t think either of us has done that for a long time. Meagan: I have not. We need some more, so drop us some reviews. Go to Apple Podcasts, Google, or wherever and drop us some reviews. We would love it and very much appreciate it. And Ashley, if you are still listening, we would love to know how things went and we are sending you congrats right now.The VBAC Link’s AnnouncementJulie: Aww. Meagan: Okay. Julie: Oh my gosh.Meagan: Ms. Julie, I am turning the time over to you. Julie: No, the time is for you. I don’t want to tell them. I don’t want to say it. I feel like I am doing something wrong. It’s the first time I feel like I’m doing something wrong. Meagan: So, we do. We have some news and the news is pretty crummy in my opinion. Julie is leaving us. She is leaving us. She is no longer going to be with The VBAC Link, although, let’s be honest, I’ll probably be bringing her back here and there. Julie: Will I ever really be gone? Meagan: Yeah, will you ever really, really be gone? I don’t know if I’m going to be able to allow that to happen. But that is the truth. So, Julie, I don’t know if you want to share a little bit. Julie: Yeah. Meagan: I don’t know if you want to share a little bit. I am just so sad. Julie: Oh my gosh. Yeah. It’s sad, but it’s the right choice for me. Oh my gosh. I don’t know how much I should share or how much is appropriate to share. First of all, there’s nothing wrong. Meagan and I are 110% good. I love Meagan. She loves me, at least I hope she still loves me. She hasn’t told me otherwise.  Meagan: I adore you. Julie: There’s nothing wrong with The VBAC Link or with any– there’s no controversy or drama or anything like that. It’s just that there are things in my life that have lined up in a way that it doesn’t make a lot of sense for me to continue with The VBAC Link anymore. But I am so grateful to Meagan for keeping it forward and I know that she is going to do an amazing job doing that. I’m still in half of the course. I’m still on half the blogs. There are going to be remnants of me.  But yeah. I guess we can just talk a little bit about how I came to this decision. I think a lot of people would appreciate some vulnerability and some honesty here. Maybe a lot of people here just don’t care very much and that’s totally fine. If you want to know, then definitely stick around, and then we are going to get to answering some VBAC FAQ’s. I don’t know if it’s FAQ. Meagan: Just Q&A’s. Julie: Yeah, Q&A’s. Those are the right letters. I don’t know how much you really know about this, but I had a pretty traumatic childhood with a lot of trauma involved growing up. I have recently been diagnosed with PTSD related to that childhood. I know that a lot of people here can relate to that. Trauma is trauma, right? Whether it happens in childhood, whether it happens in adulthood, whether it happens because of this thing, that thing, or childbirth, or whatever, trauma is trauma. Trauma responses are the same no matter what. Everyone’s trauma stories are different, but trauma responses are the same. I have pretty complicated trauma from my childhood that happened for many, many, many years. I thought I was doing fine and coping well through life, and I was because I was really good at stuffing things down, not feeling things, just trucking on, moving forward, and pushing through. That was my identity and then I started having kids because kids bring up– you guys can probably relate to this– all of the emotions, all of the feelings, all of the hormone shifts, and everything like that. Having kids started bringing up all of these things that I have been stuffing down and moving fine and doing comfortably not addressing and ignoring throughout my entire life. And so slowly but surely, I started having a lot of mental health issues. I was doing pretty well but the depression and the anxiety came. My different triggers with PTSD started showing up. It came to a point last year at the beginning of 2021 where I knew that something had to change. Something had to change. I was so anxious. I felt like everything was out of control and was kind of spiraling. I was not doing very good in life and I knew that I needed to be better for myself, better for my kids, better for my husband, better in all of my relationships, better in my partnership with Meagan, a better doula for my doula clients and now, I’m turning into a birth photographer. I started taking charge of my mental health and I went into a pretty big program that took a lot of time which is one of the reasons why we decided to take a break from the podcast because I was investing so much time in my mental health, healing my past, and healing the traumas that I had dealt with so long ago, that we needed a break from the podcast. And so anyway, it’s been a little while since things have settled down. I am doing a lot better now, but I am also trying to figure out how to exist. I don’t know if that’s the right word. How to find the right balance between me while I am still healing– it’s probably going to be a lifelong thing. As all people do, we all have our things. We all have our issues to work on, right? I’m just trying to find my balance and what feels right to me. I used to be the person that gets a lot of things thrown at her. I get a lot of things done. I knock stuff out. I accomplish so many things and everybody says, “Oh my gosh, I don’t know how you do so much.” Well, I’ll tell you how I do so much. I do so much by completely ignoring my self-care, by having a really unhealthy relationship with work and no boundaries with people and things. I’m rediscovering how to find a balance in all of those things. And so I have a lot of priorities right now. First of all, of course, is my family– my husband and my kids. Second of all is myself. My therapist gets mad at me all of the time for not making myself a priority in my life. But I am working on that and that self-care but also, healing and making better and improving constantly those important, eternal relationships to me which are my family and myself. Also, my business is now birth photography so if you are in Utah, I know a girl who can take your birth pictures for you. I’m reidentifying that and giving more to my usual clients as a birth photographer and doula. I am still a doula as well, a doula and photographer together which is called a doula-tog if you didn’t know. Doula-togs are a thing now. It’s pretty exciting. I’ve really invested a lot of myself into those areas. I’m improving myself, my relationships, and my other business which has been very fulfilling. Unfortunately, The VBAC Link is the next priority. I say “unfortunately” because after I put all of my time and energy into these other priorities of mine, there’s just not a lot left to give to The VBAC Link and it makes me sad to say. I am so sad to say it. I can’t continue with the unhealthy relationship with everything that I have had going on in my life. And so this is me setting my healthy boundaries. It has taken a really long time. I think I started really considering it in January and now it’s July. It has taken a really long time to get comfortable with that because The VBAC Link has been such a big part of my identity and who I am as a birth worker for so long. It’s taken a long time for me to get comfortable with the need to let it go so that I free up myself to put the energy into my higher priorities and the things that matter more and that are more significant in my life. I guess that is the best way to say it but t’s hard because The VBAC Link has been so significant. My priorities are kids, the husband, birth photography, and VBAC Link, and then maybe myself, right? So probably that’s not a good thing, right? So I need to, yeah. I don’t know. I’m just rambling now, but I love The VBAC Link. I love The VBAC Link. I still will always be a founder of The VBAC Link. I still will always have so much love for Meagan, The VBAC Link, and all of you on your journeys. I’ll still listen to your stories and keep up with everything that’s going on. I’ll pop in probably for a podcast here and there with Meagan. But yeah. There’s been a huge need for a big personal shift in my life and unfortunately, this is the thing. I don’t know what to say.Meagan: This is the thing. It’s just one of the things that need to be eliminated. It sucks. It sucks. Julie: It totally sucks. Meagan: It sucks really bad, but I just want you to know how proud of you I am because I know it wasn’t an easy choice or decision at all. I know that. I know that it was not easy. I’m not going to let you go too far. Julie: Yeah, we’ll see each other. We’ll be around. Meagan: Yes. Julie: At births together, probably. Meagan: I’m excited that you’re still doing photography and still being in the birth world a little bit and finding your place there, but yeah. I’m going to miss you but don’t worry, listeners. You’ll still hear her every once in a while.Julie: Yeah, and shoot me a message. You can follow me on, I don’t know. Can I do a shameless plug for my business? You can check me out on Facebook or Instagram. Just search for Julie Francom Birth and you can find my Instagram and Facebook.Meagan: Yeah, go find her. Julie: You can reach out to me. I would love to hear from you still because as of now, I am not involved anymore in the day-to-day operations and the messaging, the emails, and all of the intricate things that we do. Meagan: I know, all the things, yeah. Julie: It will be sad, but yeah. Come say “hi”. I would love to hear from you. Meagan: Yes. Let her know that you are still with her. Julie: Yeah. All right, let’s get past the sappy stuff. I don’t do well with it. Meagan: I know. I’m like, “Can we just not talk about this right now?” I’m not accepting this right now. Q&A’sMeagan: We do. We have questions that some of our followers have asked and it’s interesting. One of the questions that we saw come up is truly one of the most common questions that we get, I think. I think it’s one of the most common things. It’s about due dates. I shouldn’t say it’s one of the most common, but we had a question asking about a provider who is wanting her to have her baby immediately because they want to avoid a big baby. They want to know how far or if it’s even okay to go past your due date. Gosh, Julie. I struggle with this one a little bit because don’t you feel like it’s ever since the ARRIVE study? Julie: Yeah. Gosh. You know, I feel like it is. I feel like it’s more so. There’s more pressure on due dates. There always has been, but I feel like everyone wants to induce. Everyone wants to put a lot of pressure on you. Not everybody, but there are a lot of places and a lot of places I wouldn’t have expected to do that. Meagan: Yeah. Yeah. I don’t know. It just seems like this due date is such a thing. You know, with due dates, it’s one of those things that you have to do what’s best for you and follow your heart but these providers are wanting to induce. And so I’m actually going to steer away– because there were two kinds of questions in regards to due dates. One was “How far past my due date am I okay to go?” But there was another one saying that they want to. I’m trying to look for it right here. Julie: I have something about what ACOG says in our files somewhere. I’m going to find it about due dates. Meagan: Oh, it was stripping the membranes. It was stripping the membranes because the doctor– and this is at 38 weeks. The doctor was wanting her to go into labor immediately, like ASAP, and wanted her baby to be smaller. It was a big baby versus a small one. It is a small part of VBAC stats. I just want to talk about membrane sweeping, inducing, and due dates. I’m going to talk about three of those things. Julie: All of it. Meagan: All at the same time because they kind of all go into play with one another, right? So let’s talk about stripping membranes. Sweeping a membrane or stripping a membrane is where your provider will go in and separate the membrane. They go into the cervix, separate the membrane, and sweep around. It releases prostaglandins and hormones to help labor start. However, it doesn’t always happen like that. It doesn’t just start all the time. I wanted to talk about what it looks like. I don’t know if there are actually any stats. Julie, you guys, this is going to be really hard because Julie is such a stat person. I’m going to be writing to her all the time and be like, “Are there any stats that you know about this?” I don’t know about the stats or the actual percentage of if it’s going to work or not, but this is just a good rule of thumb for considering membrane sweeping that a midwife a long time ago gave me. I’ll tell you and you can take it with what you want. So if the cervix is “primed”, and I am doing primed with quotations. If the cervix is looking ready, this is the rule of thumb she gave me. It’s 2-3 centimeters dilated, 70-80+% effaced, and the cervix has come at least midline meaning your cervix is not really posterior. It’s not really hard to reach. It’s lining up more with the birth canal. It’s mid. If those things are happening, a sweep is usually something or could be something that may be more effective and bring on labor with a sweep. However, if we are 1 centimeter dilated, 50% effaced, the cervix is really far back there and really not showing signs of readiness, then the chances of a sweep working are a lot lower. And so at 38 weeks, a provider stripping membranes already at 38 weeks, there is a good chance that the cervix will not be “primed” or in an ideal position for a sweep to bring labor on. Some of the pros of sweeping membranes are that it can completely skip an induction because it can work. It can work and people can go into spontaneous labor with that. It’s great, right? We don’t have to use Pitocin and do those types of things. However, if your cervix isn’t super ready and we do a sweep, it could cause something called prodromal labor. Julie knows what prodromal labor is really well because she had, did you say weeks, Julie?Julie: Yeah, it was three weeks. Meagan: Yeah. Three weeks of prodromal labor which is where your body is contracting and acting as though it is trying to go into labor, but it never really turns the curve or the point actually to begin labor. That can leave for very, very, very exhausted mamas, so when labor does kick in, we are tired and do not want to labor, right? So it can bring on prodromal labor because it stimulates the cervix and the uterus just enough to think that we are going to try but because our body’s not ready, it can just contract, contract, contract with no real end result of a baby for a long period of time. So those are some cons and pros. Also, the more sweeping and the more things we have in there, the more we are introducing potential bacteria and things like that. Back in the day when I was expecting, my midwife actually offered to sweep my membranes and because I have a history of PROM, premature rupture of membranes, with labor not beginning, I was a little nervous because I was worried that it might weaken my sac or introduce bacteria because I had a provider a long time ago, while I was preparing, say something like, “Your membranes may have been weakened and broke,” so I don’t know. There aren’t any stats on that that I know of necessarily, but I just didn’t want anything extra introduced. So you’ve just got to take that into consideration as well that you are putting bacteria in and introducing potential bacteria if you are doing a membrane sweep. But it can be something to help avoid induction and if you’ve got a provider that is saying, “Hey, we are going to schedule a C-section because we are not having a baby,” then maybe that is going to be a good alternative. Julie, I’ve heard your mouse clicking. Did you find the stat that you wanted?Julie: Yes. It’s ACOG’s guidelines for postterm pregnancies and induction. This is Practice Bulletin 146. It’s called “Management of Late-Term and Postterm Pregnancies”. What I think is really interesting is that this opinion hasn’t changed after the ARRIVE trial. They actually reaffirmed their stats on postterm pregnancies after the ARRIVE trial was published. So I really like it. There are two things that I wanted to talk about in relation to the induction of labor. First of all, they say at the very last page, it’s the very last section of the bulletin, they talk about TOLAC, vaginal birth after Cesarean, and management of postterm pregnancies. They say right here that– actually, I’ll just read it. Well, I don’t want to read all of it because it’s really long. Okay. “For women who desire TOLAC and who have not had a prior vaginal delivery, awaiting spontaneous labor as opposed to undergoing labor induction most likely avoids further additional increased risk of uterine rupture. Thus, TOLAC remains an option for women with postterm pregnancies who have not had a prior vaginal delivery, but these women should be counseled regarding these unusual risks** such as failure of TOLAC and uterine rupture.”So it says in their bulletin right there that basically these guidelines that they are talking about apply to women even if they have had a prior Cesarean delivery and desire a TOLAC or a VBAC. The second one, or actually there are two other things I want to say. There is a Cochrane review that they site. A Cochrane review is a meta-analysis of several studies. I love Cochrane reviews. They are my favorite types of studies and data because they are usually very, very reliable. They talk about the different outcomes between expectant management and induction of labor. Now, this is before the ARRIVE trial, and remember, the ARRIVE trial is just one single study. Cochrane reviews look at many, many studies and gather the outcomes of all of the studies. I love this because a lot of times, you’ll hear providers say, “Oh, your risk of rupture increases after 40 weeks. Your risk of stillbirth doubles.” They’re talking about relative risk versus absolute risk. The risks for those are very, very, very small still. We are talking about .002% of stillbirth to .004% of stillbirth. And yes, that technically doubles, but it is still a very small risk. Knowing the numbers and knowing what risk you are assuming is very important when you are making decisions for your birth. I like this because it says, “The number of inductions of labor needed to prevent one perinatal death (or one stillbirth) is 410.” So you would need 410 inductions to eliminate one perinatal death. It says, “There are no incidents in the rates of neonatal intensive care admission in this study”, so your baby is not necessarily more likely to need NICU time for induction. That was a review of 10 trials, so over 6,000 infants. Basically, they summarize at the end. They say, “In summary, based on available evidence, induction of labor between 41 weeks and 0 days and 42 weeks and 0 days can be considered** and an induction of labor after 42 weeks and 0 days is recommended given evidence of increased perinatal morbidity and mortality.” So here, ACOG itself says that looking at all of the evidence, it’s safe to go to 42 weeks of pregnancy before recommending a routine induction of labor due to postterm pregnancies. But we have this sudden influx of people rushing to induce at 39 and 40 and even 41 weeks. A lot of people, even my clients will say, “I’m not comfortable inducing before 41 weeks, but if I get to 41 weeks, I’ll probably induce.“All of the evidence out there says you may be safe to go on a little bit longer. But of course, we always advocate for you using your intuition, taking all of the evidence, and making a plan that feels best for you and your baby. But yeah, that’s what ACOG says. Evidence applies. And I love how after, they say, “Sure, yeah. Going between 42 weeks and 0 days and 42 weeks and 6 days, that’s when we are going to recommend it.” And then afterward, they go on and affirm and say, “Yeah. This is even for VBAC too. It’s for people who want a trial of labor after a Cesarean. Meagan: Yeah. What’s interesting is that for this follower, the doctor is wanting to start inducing-type processes at 38 weeks. And I’m like, “Why at 38 weeks? Why are we starting so early?” But it’s because we are seeing this shift. It seems like the 41-week mark is just going away. It’s like 39 is 40 and 40 weeks is 41. It’s like 41 is nonexistent. It’s too far. I don’t know. That’s just how it feels to me. Julie: Yeah. I see that too. Meagan: Yeah. Yeah. Okay, so another question is “First child was breech, so the C-section delivery took place. Currently pregnant with number two and my doctor moved my due date up one week versus last missed period calculation. Due to baby’s size on ultrasound, from what you know, how much past my due date, whichever one is still safe?” Look, I’m reading the same question. So yeah, we just talked about that. Okay, let’s see. “I have had an emergency C-section as my baby had their cord wrapped around their neck three times and their heart rate was dropping. I was not able to go into labor at all, so what is the likelihood of that happening again? I really want a VBAC but am worried as I never went into labor.”Julie: Hey, I never went into labor. Meagan: Exactly. I never was able to have a chance to go into labor either. Just because you didn’t go into labor once does not necessarily mean you are never going to go into labor again. I am a true believer that people’s bodies don’t just hold on to babies for life. I do believe that we will all go into labor eventually. I’m sure there are those random cases somewhere out there that maybe babies were carried longer or something, but yeah. The likelihood of your body not going into labor is low. The likelihood or the chance of your body going into labor before a provider may want you to go into labor– does that make sense what I am saying?Julie: Yeah your provider might want you to go into labor before your body is going to be ready. Meagan: Before your body is ready, yes. And there is a chance that your body will not go into labor by the time your provider is wanting you to go into labor, but that doesn’t mean you are not going to go into labor. You are likely going to go into labor and it’s just a matter of trusting and waiting for your body to get there. So yeah, that would be my answer to that. Julie, anything that you would add?Julie: Sorry, I forgot the actual question. I was just following along with you. Meagan: The chances of her not going into labor. Julie: Oh my gosh, yeah. Meagan: She had a C-section baby. Heart rate was dropping. It looks like the cord was wrapped around their neck. She is wondering what the chances are of her not going into labor.Julie: Yeah, no. Honestly, I don’t know if there is a statistic for that. I remember one case a really, really old long time ago where there was a woman that had, oh my gosh. I don’t even remember. I can’t even speak educated about this. Meagan: Pregnant for a long time. Julie: She was pregnant and the baby had passed around the 20th or 30th week and she didn’t know. The baby was in there for decades. Meagan: Oh. Oh, I think I remember that I have heard a story about that. Julie: Do you remember that? There was one. There was one time that that happened. There might be more, but we are talking about one-offs here. The odds that your body is just not ever going to go into labor are highly unlikely. This is also speculation, but I have a couple of my IVF moms who have had to get pregnant through IVF and needed a lot of help getting pregnant say that their fertility providers, and I am not an expert in fertility anything, but I’ve had a couple of my clients that have gone through IVF say that if their body has problems producing the hormones to get you pregnant, it might have problems with the hormones needed to go into labor. Meagan: Yeah, I’ve heard IVF and things like that might need–Julie: They might need Pitocin. They might need a little nudge or higher doses of Pitocin.Meagan: Yeah, they are suggested to be induced due to other things. Julie: Yeah. Meagan: yeah. Julie: But even that is a little bit like maybe, like maybe, but I don’t know. I don’t think there is anything inclusive to say one way or the other in that regard. If there is, definitely let us know or let Meagan know. Message me too, I guess. Let The VBAC Link know.Meagan: Let The VBAC Link know and I will make sure that Julie knows. Julie: Yes. I want to be educated still. Meagan: Yes. Okay, so another question is “What role does diastasis recti play when it comes to a successful VBAC?”So if you don’t know what diastasis recti–Julie: Diastasis?Meagan: Diastasis. I always say diastasis. Julie: I don’t even know how to say it right. You may be right. I don’t know.Meagan: I bet it’s diastasis. That sounds more medical. Julie: You know what we’re talking about, right people? Meagan: Yes. That is the separation of the abdominal wall.  Julie: The abdominal muscles, yeah. Meagan: Yeah. I don’t know if it necessarily plays any role specifically as far as having a VBAC. Have you ever heard of anything like that? I mean, I had a diastasis recti and I had a VBAC after two C-sections. You might have more pelvic pain because mine caused pelvic pain. This is actually a really good question for Gina or our pelvic floor specialists. I’m actually going to write that down. We are going to have a pelvic floor specialist on. I’m going to write that down and ask that question, so come back to that. Julie: Yeah. Meagan: Yeah because I don’t actually know if it does. I don’t think it does. Julie: I don’t think it does either. I haven’t heard of anything like that. Meagan: Yeah. Julie: To me, the abdominal muscles and the uterine muscles are completely separate from each other, but it might impact your pelvic alignment. You might need to take extra care to go to a chiropractor and see a pelvic floor specialist to make sure all of your connective tissues are nice and loose to go into labor. That’s just where my mind goes. Meagan: Yeah, yeah. It might cause more discomfort but not necessarily make your chances go down of having a VBAC is what’s in my head. I will try and get that confirmed. Okay, let’s see. What other questions? I don’t know if you’re on it. Oh, “what happens to Cesarean scar tissue after you’ve had a VBAC? Do the intense stretching and shrinking help remove adhesions or does it re-adhere?”Personally, I have dense adhesions and they just continue to come. If I don’t actively work out my adhesions and my scar, I just continue to get adhesions and I can feel them. It’s weird but I can feel them. So once you’ve had a VBAC, I mean, I’ve had a VBAC and mine are still coming. I would say that you still probably need to seek pelvic floor specialists or learn how to properly massage your scar. It says, “Do the intense stretching and shrinking help remove adhesions?” I mean, it could maybe stretch it out, but I don’t think it removes.Julie: Yeah. Yeah. Meagan: Yeah, but again, I’m going to throw that one into our pelvic floor specialist episode that’s going to be coming up because I don’t know the exact answer on that. I just don’t know. But from my experience of being seen, the answer is no, it doesn’t necessarily shrink or remove adhesions. Julie: Mhmm, yeah. There’s a way to make them more flexible. Everything you say, yes. I’m just going to echo everything. Meagan: You can work them out. Julie: Yeah and make them more flexible and pliable, but there’s no real way to get rid of them unless you go in and surgically remove them, but then surgically removing them causes more of them so it’s kind of a double-edged sword there. Meagan: Yeah, that’s a hard thing. Once you’ve got that scar there, you’ve got it. And adhesions come with any type of scar. It doesn’t just mean C-section either. It’s really any type of scar. Okay, so it says, “My first pregnancy was last June and that baby was a C-section. I’m now expecting in November. The reason I needed an emergency was because my son wouldn’t come down due to my pelvis being too small. When I spoke to my new OB about a VBAC, she told me that I wouldn’t be–” Can you hear my thoughts as I am reading this?“When I spoke to my new OB about VBAC, she told me I wouldn’t be a good candidate due to my pelvis being small,** that the size will never change, and I will have the same issue as I did with my second child. I just wanted to know if this is true.”Meagan: Um, no. Julie: No. Not true. Meagan: Not true. Not true. Not true, not true, not true. I was also told that my pelvis was too small and I would never get a baby out of it. Julie: So was I. A 4lb, 10 oz C-section baby. My VBAC baby was 8lb, 9 oz with a 99th percentile head. How is my pelvis too small for a baby that size?Meagan: Yes. Let’s talk about heads. There was a question talking about head size. Oh my gosh, I want to see if I can find it. Let me see if I can find it. I’m scrolling through. Julie: We need to get wrapping up, actually. Meagan: I know we do. Oh my gosh. Julie: Unfortunately. Meagan: So no, no, no. You still have a chance. I’m so sorry. I’m going to be blunt, but your provider’s just not being supportive. It’s really, really, really hard to diagnose a small pelvis and it’s really rare, so I would say it was more likely due to position or maybe just not enough time or something like that versus the fact that your pelvis was actually too small. And oh my gosh, there was a head question and I can’t find it, but I want you to also know because I swear it was something about babies with big heads not fitting out. My baby and Julie just mentioned it, but my babies all have ginormous heads. My VBAC baby had a 99th percentile head. I always say that it’s because they are brilliant. He still has a big head and a tiny body. It’s kind of funny. He’s just small but he came out just fine. No tearing, totally fine. It’s a lot of the time positioning. Julie: Yep.Meagan: We have lots of questions that we still didn’t get to, but don’t worry.Julie: I’ll have to come back sometime for another Q&A.Meagan: Yes. I will be doing more of these and Julie is just going to have to come back. Julie: And seriously, come and say “hi”. I would still love to talk to and connect to people. Especially if you are in Utah and local, come see me at the ICAN meetings, the ICAN of Utah County. Follow my Instagram and Facebook pages and Julie Francom Birth. I still am going to be a major VBAC advocate and a big part of helping women just a little more locally here. Meagan: Yes. Julie: I’ll come and say “hi”, I promise. Meagan: Yes, okay. Well, Julie, I don’t know what it’s going to be like without you. I really don’t. Julie: It’s going to be strange. I don’t know what my life is going to be like either. I’m going to have, I don’t know. I’ll spend time with my kids and be able to actually enroll them in sports again. Meagan: Yeah, no. I’m not loving it. Not loving the thought of it, but I am proud of you.Julie: You are sweet. Meagan: And I want you to know how much I love you. I’ve enjoyed this journey with you and I just hope that I can keep this afloat without you. Julie: You will. I’m 110% confident in you and you know I’ll always help you out if you need it. Meagan: Well, thank you. Julie: Goodbye, signing off. I don’t know. Bye! I don’t know what to say.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 Julie and Meagan’s bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands