Episode 195 Rebecca's Precipitous VBAC + Cervical Laceration

“Every baby, every delivery, and every birth is so different.” Rebecca’s first birth was a smooth, textbook experience. Less than 12 months later, Rebecca arrived at the hospital ready to deliver her second baby girl. However, after four hours of pushing, unmedicated manual rotation, and scary heart rate readings, Rebecca knew she needed to consent to a C-section. In surgery, Rebecca was told her pelvis was too small to ever birth a baby vaginally even though she already had a prior vaginal birth! She also experienced a cervical laceration. Rebecca was left traumatized after such a drastically different birth experience. With her next baby, Rebecca fought for healing and for her TOLAC. Her third delivery was quite unlike either of the two previous deliveries. We can’t wait for you to hear about her wild ride and to learn from her particularly unique experiences!Additional linksIntrapartum Cervical Lacerations PubMed ArticleThe VBAC Link Blog: Special ScarsSpecial Scars, Special Hope Facebook GroupHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Good morning, everybody. You are listening to The VBAC Link. Today is the first episode without Julie and let me tell you, I am already missing her so much. It’s going to be a little different not having this podcast with her. I was just telling our guest today how weird– I don’t even know what episode number we are on right now because Julie was such the backbone. She did all of the technical, little-detail things and I am going to have to get used to that.So bear with me as I am weaning into doing all of the podcast stuff by myself. Today, we have our friend, Rebecca, and she is going to share her story. You guys, she has a special scar, or a cervical extension I should say, that ended up turning into special scar. We don't have a ton of these episodes on the podcast. They are not as common and one of the reasons why I am personally excited for her to share her story is because they are not as common but they are still possible. We really want to get the word out there to do your research and do what’s comfortable for you, but know that it is possible.Something that’s also a little different about her story is that it was from the cervical extension. I can’t wait for her to share a little bit about this. We are going to talk about what a cervical extension even means, what that looks like, and what it could mean for future vaginal births. But of course, we have a Review of the Week. Normally I would turn the time over to Julie, but we don’t have Julie, so I am going to read you a Review of the Week. Review of the WeekMeagan: Today’s review is by Sarah and she said, “One month ago, I had a successful VBAC induction just 18 months after my Cesarean section. I almost called to schedule a repeat on my due date because I was so scared. I found your podcast and listened to it for two days straight. It gave me the courage to go through with induction and I am so glad I did. I’m hoping more people find this as a resource.”Oh, that’s awesome. It looks like she emailed us that. We love reviews. As you know, we have Apple Podcasts. We have Spotify. We have Google play. We have just Google. You can leave us a review on Google. But just like Sarah did, you can email us a review. So if you’ve had a good experience or something that you would like to share with the world, please email us. Feel free and we will slot this into the review and maybe read it on the next podcast. Rebecca’s StoryMeagan: Okay, Ms. Rebecca. We are so excited to have you. Thank you so much for taking the time out of your day to share the stories of your three kiddos, right? Do you have three?Rebecca: Yep, three girls. Meagan: Three girls! You’re a girl mama. That is so awesome. And remind me, they are all pretty close like 4, 3, and 1?Rebecca: Yep. Yep, that’s right. Meagan: Yes. 4, 3, and 1. That is so awesome. So you are really busy in your life.Rebecca: Yeah, just a little bit. Meagan: Yes. Oh my goodness. Are you guys planning on having more? Do you have any idea if you are wanting any more?Rebecca: I’ve always liked even numbers, so I’ll probably have one more but we joke that each one gets spaced out further and further apart. So not anytime soon at least. Meagan: Yes. But hey, you know what? Julie had this too where all of her kids are really, really close. It might be chaotic right now when they are little, but then they are the best of friends and they are all in the same time. My sister and I are three years apart. It’s still not that very far, but I love that when they are really close, you are always going to school together, you are in the same friend zones and in the same types of things. It might be chaotic when they are little but it will be so fun I bet.Rebecca: It will be worth it hopefully.Meagan: It will be so awesome. So awesome. Well, cool. Well, thank you for joining us today and I would love to turn the time over to you to tell us about these beautiful girls’ births. Rebecca: Okay. Well, my first birth was very uncomplicated. Pretty much the only strange thing that happened was that my water broke at 37 weeks in the middle of the night. I was totally unprepared because everyone says that first-time moms go until 42 weeks, and so I just wasn’t even in my mind thinking that was possible. But it was a great birth. It lasted about 10 hours, labor did. It was unmedicated. I didn’t have any tearing and it was just kind of textbook, I guess, in that way. Then, when my daughter was about 4 months old, I started coming down with what I thought was the flu, and then I also started having some food aversions which was weird. And so I asked my doula. I was like, “Is this normal postpartum? Are my hormones regulating or what’s going on?” And she was like, “Rebecca, you need to go take a pregnancy test.”Meagan: You’re like, “Uhhh.”Rebecca: It was positive. I was in denial. She said she knew for a week before I did what was happening. Meagan: Oh my gosh. Rebecca: Yeah. I was just in denial. So that put their due dates within 12 months of one another. So both October and it was just a very difficult pregnancy emotionally and physically. I had to give up nursing because I’m one of those who dry up when I’m pregnant. I just felt a lot of guilt. My husband seemed to be completely unaware of how hard it was going to be where I was like, “Do you understand having two kids 12 months apart? This is going to be very hard.” Anyway, so with her, I was expecting to go into labor early. 37 weeks came, rolled around, and no baby. 38 weeks came. 39 and finally, after my due date, I went into labor which already felt like I was three weeks overdue just because my first daughter came three weeks early. It was just so mental at that point. We got to the hospital and I was already 9 centimeters so we thought this baby was coming. I pushed for four hours and she would not come out. They called in the senior midwife and she was like, “The baby is OP.” And so they were having me do all of the things. What’s it called? The Walchers?Meagan: Oh yeah. That’s intense. Rebecca: Oh, it was terrible. It was really painful, but they could just not get her to turn into a favorable position. They tried manually turning her and I still didn’t have the epidural at that point. Finally, the midwife was wanting to call it and I said, “What are my options?” She was like, “A C-section.” I was like, “Well, how about we do an epidural and see if that relaxes me, and then see if you can try turning the baby?”At that point, I was just willing to try whatever so they agreed. They let me sleep for a few hours and then came back in. It was the middle of the night and they started manually turning. She was responding to it, but then all of a sudden, she just started having heart decels down to the thirties and they freaked out. They were like, “Okay, we are not doing that. We will let you try to push her out sunny-side up essentially.”And so I pushed and she started descending, but then her heart did the same thing down to the thirties.Meagan: Wow, that is scary. That is scary.Rebecca: Yes. It still, I mean, I’ve worked through it in therapy now, but yeah. Just the room, you could just tell the mood changed. They were just staring at the monitor with her heart rate. It was at that point where I was like, “Okay. We’ve done it. We’ve given it our all. This is the right call.” So they prepped me for a C-section. Overall, it wasn’t terrible. They didn’t strap my arms down or anything. She had descended so far down, so they had to come back through and push her back up. During that, my cervix tore.She came out screaming. My husband told me it was a girl because we don’t like to find out beforehand. Then, they were taking out my placenta and I heard the midwife and the OB. They were both like, “That’s weird. I’ve never seen anything like that.” They were just talking back and forth about something going on.Meagan: And you’re listening to them. Rebecca: Yes. I know my baby’s okay because I can hear her and I think I asked, “What’s going on?” The midwife was like, “Oh, I’ll come and show you once you’re in recovery. I’ll show you your placenta.” So they started stitching me back up and I’ll get back to the placenta, but they started stitching me back up and the OB said– he was one of those where he’s a great surgeon but he doesn’t have bedside manner. He made some comment like, “Yeah, you shouldn’t waste your time trying to VBAC. Your pelvis is way too small.” I got so angry. I’m on the operating table and I said, “I’ve already had a vaginal birth.” You could tell he was caught off guard. Obviously, you didn’t read anything about me before you gave me the surgery. Meagan: And this diagnosis of, “You will never have a vaginal birth.” That happens so often! Rebecca: I know. It makes me so angry when I see that because yeah, obviously, my body has pushed out a baby. Meagan: Well, yeah. Even mine hadn’t and he was like, “Your pelvis is too small.” The thing is that I easily could have believed him, right? Rebecca: Yeah.Meagan: When you’re laying there, cut open, vulnerable, and you’re told, “Don’t ever do this. Your pelvis is too small,” you want to naturally just believe these providers. I’m not saying that these providers are ever totally wrong or anything, but they give these diagnoses and we just believe it. Rebecca: Yeah. Meagan: So it’s hard.Rebecca: I mean, yeah. I don’t know what he was using to make that judgment, but it was obviously wrong as we are going to see. My body had already done it, too. Meagan: Yeah. Rebecca: I think that when I said that, he tried to recover it by saying, “Well, how much did your last baby weigh?” I told him and he said, “Well, I guess your magic number is somewhere between your first baby’s weight and your second baby’s weight.” I was just thinking, “I don’t think that’s how it works.” Meagan: Uh-uh. No. Sorry, dude. Rebecca: Yeah, exactly. So yeah. He got reprimanded, I think, for that one by the midwives. It made me so angry. But anyway, in recovery, the midwives brought my placenta to show me. It was wild. She said that she had never seen anything like it. It was a bivalve placenta and there was a velamentous cord insertion in between the connecting tissue. So it was just very exposed and apparently, I had vasa previa too. Their assumption was that when my baby was turning, it was compressing the cord and causing the heart decels essentially.And so they said it could have ruptured during surgery, or sorry, if I had actually pushed her out, it could have been pretty bad. So it was really crazy. She took pictures of it and texted it to all the people. She thought it was two placentas. The OB disagreed so the jury, I guess, is still out on what it was, but I had had a lot of bleeding during the pregnancy and they had assumed a vanishing twin or something along those lines early on. They couldn’t quite figure it out. It just kind of stopped. So they don’t know what exactly was going on with the placenta if it was just, yep. It was crazy. But that was my second birth and it just was very traumatic. After having such a smooth, textbook first birth and feeling so empowered to have this 12 months later was just devastating. Thankfully, my doula recommended therapy. I got into a therapist and really was just able to work through that birth trauma which is one of my big recommendations to people who have unexpected C-sections is to work through your birth story. There is so much healing in that. I am now able to look back at the birth and it’s not necessarily the happiest day to look back on, but I’m able to see it and not cry whenever I talk about it. Meagan: Yeah, yeah. Rebecca: Yeah. So that was my second birth, and then now leading into my third, I was determined to have a VBAC. One, to prove it to that OB who told me my pelvis was too small, but just for myself. I knew how much I loved my first birth and I just really wanted that again. After we got pregnant, in one of my first appointments, I was just chatting with the midwife and I said, “Oh yeah. The OB mentioned something about a cervical tear during the C-section. Does that affect anything?”Her face changed and she goes, “I’m going to get your OP report and read it. I’ll be back in a few minutes.” She came back in and said that I had a low-lying, transverse scar, but I had a midline cervical extension. So essentially, my cervix had torn and it had torn up to where my C-section scar was, so it was in the shape of a T.Meagan: So did that cervical scar tear up into your uterus?Rebecca: Yes. Meagan: Okay.Rebecca: But not into the contracting part. Meagan: Gotcha. Rebecca: So it was still low. But it was, yeah. It was very hard for me to figure out what exactly it was because I was trying to Google all of these words like, “What does this mean?” And then they were finally able to explain it to me. It was shaped like a T essentially. And she said that she seemed very confident that I was going to risk out of having a trial of labor and I was devastated. I was really upset, but she ultimately left it up to one of the OBs in the practice to sign off on. I knew I was going to see him at my next appointment, so I just spent a ton of time researching. I was texting all of my friends that are doctors. Nobody knew what it meant. I was searching for research articles. I joined the Special Scars Facebook group trying to find some more stories. I eventually found a PubMed study that was on cervical lacerations and how they affected subsequent pregnancies. It wasn’t really an apples-to-apples comparison. I was like, “You know what? These women had cervical tears and went on to have vaginal births afterward. I’m going to take this to the OB.” I was armed and ready. And then I went to the appointment and he was like, “Yeah. There’s not really any data or studies on how this impacts your risk of rupture.” I told him about the study and it was weird. He was just like, “Okay, yeah. You can have a trial of labor.” And I was shocked because I was just expecting to have all this pushback. I don’t know if he was more comfortable because it was lower and not in the contracting part of my uterus or if he could tell I was very determined and had done my research and was willing to take that risk, but he essentially gave the green light and then I never heard anything about it the rest of the pregnancy. So that was really exciting and I just continued. During the pregnancy, I went to the chiropractor. I ate dates. I drank red raspberry leaf tea. I was doing Spinning Babies, HypnoBirthing, and meditations. I was just trying to get in the right head space and get my body ready. And then near the end, I started psyching myself out. In one of my last appointments, I was obsessing about the baby’s position because the baby wasn’t– what is the ideal? It’s like, LOT?Meagan: LOA. LOA, but OA. We want the baby looking down towards the mom’s back so as the baby comes down on your pelvis, the neck can flex underneath the pubic bone, then they rotate and make room for the shoulders. But LOA is kind of like a great spot to start because the uterus will naturally rotate the baby away. Rebecca: Yeah. So I think the baby was ROT, where the baby typically turns posterior during labor.Meagan: Yeah. They start on that side because they rotate back, to the left, then to the front. And so if you’ve got a baby that’s on the right but looking sideways, which is ROT, it means the baby’s back is on the right side but sideways in the middle if that makes sense. I’m using my hand, but people can’t see me. And then the baby rotates. But then you know, most labors have a high chance at some point of a baby going in a posterior position. Whether they stay there or not, yeah. ROT for sure. Usually, you are going to have a baby there. Rebecca: Yeah. I was paranoid, I think, from my previous birth. I said something to the midwife when she confirmed that the baby– I think it was ROT. I was just like, “I can’t birth an OP baby.” She just looked at me in the eyes and was just like, “No. You couldn’t vaginally birth the last one, but this is a different baby and this is a different birth. The majority of these babies turn and are going to get in the right position.” So that set me at ease. I started having prodromal labor starting around 38 weeks and then the day after my due date, I started having lower back cramping and aches. It felt like period cramps, super mild. I said to my husband, “You know, lower back pain can be an early sign of labor.” At this point, he just looked at me and was like, “What isn’t an early sign of labor?” And I think if looks could kill, I was so annoyed at that point. Which, in all fairness, I had been telling him every single day for two weeks that I thought I was in early labor and it was all just prodromal labor. Meagan: Hey, you were still having laboring signs and prodromal labor is still labor. It’s just not progressive labor. Rebecca: Right, exactly. So I didn’t appreciate his smart-alec remark. But I did try timing them. There was no peak. They just fizzled out. That evening, I lost my mucus plug again. I told my husband and my mother-in-law, “I think tonight might be the night.” But I didn’t want to jinx it, so I didn’t send my older kids home with her because I had done that the last time and I had to do the walk of shame where she had to bring our kid back to us because I didn’t go into labor. So I was like, “Okay. We are just going to go to bed.”I went to bed at 10:30 that night downstairs in our guest bedroom because the struggle was real with the pillows, getting comfortable, and that whole third-trimester routine. One hour later, after I had gone to sleep, I woke up to a contraction. I stood up and immediately heard a pop and my water broke. I went to the bathroom to check the color and make sure it was clear, and the contractions were coming. This was real. And so I just knew that we needed to leave for the hospital as soon as possible. The problem was that my husband was upstairs asleep and I literally could not walk past our kitchen. In our kitchen, I fell down to my hands and knees. I thought I was screaming his name, but he told me later that I was just actually whisper-screaming and he doesn’t even know how he woke up. He heard a weird noise and apparently I was whispering, but it was weird. He came downstairs and in my mind, I’m on my kitchen floor and I’m like, “I’m totally getting the epidural. I have nothing left to prove. I’m getting that epidural as soon as we get there,” which, hindsight is 20/20. I was obviously in transition at this point, but he called his sister. Thankfully, she only lived two streets away so she was at our house in five minutes. I told him, “You need to call the on-call midwife and let them know we’re coming.” He hadn’t packed a bag yet. He did not have a hospital bag packed. He’s like, “I can’t call.” So he put it on speaker phone, dialed it, and set it down on the floor while I’m on my hands and knees working through contractions and he was running around packing a bag. So the midwife, she’s like, “How far apart are your contractions?” And I’m just like, “They’re back to back. They’re double peaking. I can’t get off the floor.” And she’s like, “Okay. You need to come in soon.” “That’s the plan. We’re heading in soon.” So somehow, they get me to the car and before we get to the car, I told my husband, I’m like, “Hey, grab one of those puppy pads that we never used in the closet,” because we had just gotten a new car two months before and obviously, my water was leaking. So I was in the back seat riding on my knees holding the back of the headrest and we get in the car. We start driving and all of a sudden, my contractions started spacing out again. I was like, “Oh, this is so nice. I’m getting a break finally,” which, once again, hindsight is 20/20. Contractions start typically spacing out right when you’re supposed to start pushing. We’re halfway to the hospital and my body just starts bearing down. We’re in the car and I’m like, “Oh my gosh. I’m pushing and we’re in a car.” My husband was like, “Do I need to pull over?” But at this point, we’re on a bridge. We drove from Louisville over to Indiana to give birth. We’re on the bridge over the Ohio River in between the two states and I was like, “No. You cannot pull over right now.” I said, “You need to call the hospital and tell them to be waiting for us. This is an emergency situation.” Meagan: I might have a baby on the side of the road.Rebecca: Yeah. At that point, I’m like, “There’s no way by the time an ambulance gets there.” Meagan: Oh yeah. No, it was probably best to just keep going. Rebecca: It was just like, “Keep going.”Meagan: Yeah. Rebecca: He calls the hospital and it’s this lady. She’s like, “Sure. Just come in and you can go up to labor and delivery.” He’s like, “No. You don’t understand. My wife is having a baby,” and she’s just giving him the runaround. I was like, “Tell her that I’m a third-time mom and I’m pushing.” He told her that and she was like, “One moment,” and immediately transferred him to the emergency room department. They said they would be waiting for us and we were like, “Okay good. That’s what we like to hear.” We were almost there. My body’s bearing down. I pulled down my pants and stick my hand down to make sure I don’t feel a head because I am pushing hard. Actually, I pooped in the car and it landed on the puppy pad thankfully. Meagan: Hey!Rebecca: I was mortified. Well, I think I was more– it’s so silly. I was like, “It’s a new car and I just pooped in our new car!” But you know. Meagan: But we all know that pooping is a sure sign that a baby is coming, so it’s not like it was a bad thing. Rebecca: No. I just, you know. It would have been nice to–Meagan: What did your husband say about that?Rebecca: Later, he actually left the hospital to go clean out the car a couple of hours after. Meagan: “I’m going to go clean that up.”Rebecca: Yeah. You would not want that sitting in the car. But he said it wasn’t bad because it all was on the puppy pad. Meagan: So you just fold it up and put it in the garbage. Rebecca: Yeah, it wasn’t bad. So that’s my tip for all you listeners. Have a puppy pad in your car just in case. Meagan: Yes. Puppy pad and a bag or something for vomit. No matter how far along you are in labor, something to do that because you never know. Sorry, my dog’s toy is squeaking in the background. You never know when you are going to poop or puke. Rebecca: Yep, very fair. I definitely puked in my first labor. So anyway, we get to the hospital and they’re waiting. I can see the team outside. They come up to the door on the side that I’m on. She checks to make sure that there’s not a head and she’s like, “You defecated, but that is normal.” She’s trying to reassure me. I’m like, “I know it’s normal to poop. It’s okay.”They’re trying to convince me to get on the gurney and I’m like, “I’m not laying down on that. I will crawl onto my hands and knees.” This entire time, I pretty much have not been off of my hands and knees. So they get a sheet and cover me because my pants were off at this point and they wheel me up to labor and delivery on this gurney with me on my hands and knees. They get up. I have my eyes closed the whole time. They get up to labor and delivery and somebody whispers in my ear and says, “Hey Rebecca, this is Sarah. You’re going to be okay.” It was my favorite nurse who was there with my traumatic birth and stayed the entire time. She was actually a student midwife too, so I was just immediately put at ease. They get me up. They know they’re not going to be able to COVID test me so they put me in the COVID positive room because they’re obviously not going to stick a Q-tip up my nose at this point. The ER people just had no idea what to do. They were like, “Do we need to run a line? Should we run an IV?” Sarah, the nurse, was just like, “There’s no time for that. You’re not running an IV on her right now.” They’re trying to convince me to get over into the labor and delivery bed, but I don’t want to move. They’re like, “We promise you that it’s much more comfortable than the gurney. Please.” So they finally scoot them side by side and I crawl over. I stay on my hands and knees and they get the monitors on me. She checks me and she’s like, “Oh yeah. You’re complete.” I was like, “What station is the baby?” She just laughs because, in my head, I was complete with my last pregnancy and still pushed for four hours, but she goes, “The baby’s right there. You’re +3. This baby’s coming.” In the background, I can just hear that they’re on the phone. There are no midwives on the premises and there’s no OB. They’re kind of panicking because the first call midwife is over across the street with a birth center patient and so she can’t leave, so then they had one driving from 20 minutes away, and then the OB that I do not like from my C-section, they called him and he was on his way. He was not the person that I wanted to see either. But everybody’s like 20 minutes away. I said, “I have to push.” And she’s like, “Okay, you’re fine. You can push.” I literally pushed. Baby came out in that first push fully. No head molding or anything and I just lay down. I was so exhausted. Then I turned around. They handed her to me and told me it was a girl, which, I was shocked because I thought it was going to be a boy. It was such a different pregnancy. So yeah. The nurse ended up catching her. I think it was 15 minutes after we got to the hospital. She was born at 12:26 a.m. and I had woken up to that first contraction at 11:30 p.m. Meagan: Oh!Rebecca: So it was pretty much exactly an hour and it was just wild. Meagan: Oh my goodness. Oh my goodness. Rebecca: I could not believe it. So yeah. That’s the story. It was just a whirlwind. Meagan: Yeah, yeah!Rebecca: Yeah. I’m kind of scared to have another kid honestly because I’m like, “What happens if you don’t get to the hospital?”Meagan: I know. Well, I mean, it happens and people usually call EMTs and things like that, but yeah. You might have to plan first sign of anything maybe going. I don’t know. It’s totally what you want more.Rebecca: Yeah.Meagan: Another thing, too, is sometimes with a history of pretty solid prodromal labor, as a doula, if I have a client that has had a week of prodromal labor, in my mind, I kind of anticipate potentially a precipitous birth. It doesn’t always happen. It doesn’t always happen, but especially for a mom that has had a baby before and her cervix has dilated and effaced and everything, prodromal labor can sometimes be a sign that labor could, not always, but could go quickly.Rebecca: Well, I think I remember reading that, or what I at least told myself was that every contraction I had then in the moment was, “This is one less that I’ll have later.”Meagan: Yeah. Rebecca: I don’t know how accurate that is but it seemed true at least in my case that I had very few, yeah. I mean, it was just so fast but it was interesting. My body, looking back, did not get off of my hands and knees. I delivered on my hands and knees. I think the baby was turning. That’s what my body knew because it felt crazy in my body. I don’t know. I felt like she was banging around. I don’t know if that’s right. She was obviously rotating or something but my body knew that this was the position I needed to be in and I did not get out of it for anyone. That was it. Hands and knees, the whole time.Meagan: Intuitive. Your body was intuitively going into that position which I think is amazing. I think it’s amazing that our bodies can communicate to us that way where you get into a position and you’re like, “Nope. This is not working,” and then you get in a position and you’re like, “I’m not leaving. This is where I’m staying.”Yeah. That is so awesome though. I love that your provider– I love that one, you did research and you spoke with your provider and were able to have that conversation of, “Okay, yeah.” And then I also love, this is not in regards to the laceration, but I also love when your baby was in a less ideal– as what the world says is less than ideal– not LOA but ROT, she’s like, “Yeah. You’re baby’s going to rotate. It’s going to be fine.”Rebecca: Yeah. Yeah.Meagan: You kind of needed that. Rebecca: Oh yeah. I think mentally, I had hit a wall even though the whole time I had been listening to affirmations and getting in the right headspace, but then right there at the end, it was suddenly just this mental game of, “Can I do this? I don’t know if I can do this.” I was so thankful because I feel like it really put me over that hump for sure. Meagan: Yeah, for sure. Well, awesome. Well, if you guys do end up having more children, hopefully, you make it to the hospital or wherever you decide to birth. Hopefully, it goes well. Rebecca: Well, yeah. Somebody suggested a home birth and I’m like, “A home birth midwife would not have gotten there in time and my husband would have been catching that baby.”Meagan: Yeah. That happened to a friend of mine who had the same thing. It was very precipitous. The midwife was not even that far, but she also said, “I probably waited too long to tell her to come.” She was in denial. She was like, “I just don’t. I don’t really know. I’m okay. I’m doing okay.” And then it shifted so fast and I’m like, “Yeah. You probably should have called her.” She even said that. She was like, “Yeah, I probably should have called her sooner.” Her husband caught the baby.Rebecca: Oh wow. Meagan: The midwife was there to catch the placenta. Rebecca: See? Yeah. That’s essentially, I think, what happened. The midwife got there in time for me to deliver the placenta at the hospital at least. But yeah. Yep. Nobody was there for the actual baby. Meagan: Nobody was there, yep. And that happens. That happens. Sometimes these babies– and like you said, there was no shaping of the head. Baby dropped, rotated, and came out. Rebecca: Yep.Meagan: Yep. Your body did some awesome work. I love that. So with your cervical laceration, obviously, it didn’t necessarily stop you from dilating. Rebecca: No, not at all. Meagan: There wasn’t any scar tissue or anything like that. Have you, in your research, found that sometimes where there are lacerations to the cervix, it can delay dilation or cause issues with dilating? Rebecca: Well, yeah. There was an article also on cervical scar tissue. I was concerned about that. I remember bringing it up to my midwives and they’re like, “We won’t really know until you’re in labor if you have a lot of scar tissue and if you do, we might try to just break it up or your body will eventually.” They said, “A lot of times, there’s a big jump in dilation.” So you’re showing all of the signs that you’re not very dilated and then all of a sudden, you jump from a 3 to an 8 and that scar tissue breaks up essentially.So I mean, I guess presumably there could have been scar tissue and it was just–Meagan: It just broke on its own.Rebecca: It broke open an hour before the baby was born. I don’t really know but there wasn’t any by the time I got to the hospital that was causing issues.Meagan: Which is great, yeah. Have you had any problems monthly with pain or anything like that?Rebecca: No. I need to probably go back to a physical pelvic floor therapist. I did go with my third pregnancy because halfway through, I started feeling some pressure and whatnot. It was really helpful, so I’m all about that soapbox too about pelvic floor therapy. Meagan: Oh, I know. Rebecca: I have not prioritized it but I was telling a friend the other day, I’m like, “I don’t think things are back to normal after that really fast labor and pushing.” Thankfully, I only had a first-degree superficial tear that they didn’t stitch, but it’s still after three pregnancies. Things are feeling not painful, it’s just that I feel like some therapy could be helpful for me maybe. Meagan: Yeah, for sure. We’re going to be recording another episode with a pelvic floor specialist here in the next couple of weeks. Rebecca: Awesome. Meagan: Yeah, stay tuned everybody for that because it’s going to be really great. She has a lot of really, really, really great info on that. She has, oh my gosh, so many amazing things just on her Instagram. So that will be good. But you know, I think that vaginal or non-vaginal, pelvic floor stuff is really good to do to just tune in, learn how to strengthen and release, and all of that jazz down there. So yeah. I mean, I’ve only had one vaginal birth with two C-sections and I feel like I probably need some more pelvic floor love. I’ve gone, but I probably need more too. Well, that’s awesome. So I was trying to find the PubMed article that you were referencing. Do you know the title of it? Is it the Intrapartum cervical lacerations? Rebecca: Yes. It’s that one. Meagan: Okay. That’s the one I found. Perfect. Yeah. They did quite a significant study. There were just over 81,000 deliveries in this study and it said that 131 or .16% were complicated by cervical lacerations. It doesn’t happen a lot, but it happens. It says that a lot of the time they get cervical cerclages, so I was wondering if anyone ever talked to you about cervical cerclage.Rebecca: Nope, they never mentioned it. Meagan: That’s awesome. Yeah. I have a friend that has a cervical cerclage. When she gets pregnant, she starts dilating really, really, really early. Like, really early. Like, 18 weeks. So they had to do a cerclage. But anyway, it says, “Regression and cervical cerclage precipitous labor.”Rebecca: Really? I totally didn’t even know that. Meagan: Oh, so I saw precipitous labor and I thought, “Oh, that’s really interesting.” But I think that’s probably because it happens so fast and baby just comes out really, really fast, but you had precipitous labor the second time and didn’t have any further complications so that’s really awesome.Rebecca: Yeah, yeah. Meagan: So anyway, I’m going to link this article to the show notes and you can check it out if you guys want to learn more about cervical lacerations and how they could impact future vaginal deliveries. But yeah, I mean, it still looks like many people go on and have uncomplicated vaginal deliveries. Rebecca: Right. The way it was explained to me is that it could happen a lot more than they realize where they knew because of the C-section, but you could tear your cervix during birth and if you’re not hemorrhaging or bleeding a lot, then they might not even catch it. It might just heal on its own. That could lead to scar tissue so I am curious if it is more common and we just have no idea. Meagan: Right. And that’s another thing, even talking about uterine rupture, right? There are different types of uterine rupture. There’s dehiscence and stuff and yeah, obviously, with uterine rupture we usually know, but there are probably many times that people have dehiscences where it’s really thin or windows. We see windows but we see them because you are cut open and you see the uterus. But if you don’t have a C-section, we could still have windows, but we don’t see them so we might have more uterine windows than we know but we are just not seeing them. So yeah. It’s interesting that if things aren’t coming forth in concern or bleeding and things like that, then we may not ever know. Rebecca: Yeah, exactly. Meagan: But yeah. In this conclusion, it says, “Intrapartum cervical lacerations do not appear to affect the outcome of subsequent pregnancies.” So that’s pretty awesome. And obviously, it went up a little bit. We are going to link the Special Scars Group. We’ll do our Special Scars Blog, and then I’m also going to link this PubMed article in the show notes. So if you guys want to go check that out, click on the show notes below and have fun reading. Well, it was wonderful to have you and hear your beautiful stories. I mean, they are all so different in so many ways. It’s really crazy to think about how you’re the same person, but you’ve had three very different deliveries. I think that is birth and that’s how it can always be. I think especially when we are going into a VBAC, it’s important for us to remember that just because one birth was one way doesn’t mean it’s going to be the next birth. That’s not going to be our story for every birth because I know it’s easy to do. We know what we know. We know what we’ve lived through and even you said, yeah. It’s easy to reflect back or maybe be triggered and things, but just know that every delivery is different even though you are the same person. Every baby, every delivery, and every birth is so different. Try to remember that as you are going through things. There may be similarities, but it doesn’t mean it’s the same. Rebecca: Right, absolutely. Meagan: Yes. Awesome. Well, thank you so much for sharing your story with us. I can’t wait for the world to hear you. Rebecca: Well, thanks for having me. I really appreciate it. 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