Episode 210 Julia's CBAC + How To Cope When You Don't Get Your VBAC

After infertility and an initial C-section due to breech presentation, Julia knew that a VBAC was the redemption she needed. During her VBAC prep, she truly did it all.Julia labored hard, completely dilated, and pushed like a warrior. She was calling the shots and was fully supported every step of the way. But as she pushed, the radiating shoulder pain became hard to ignore. Baby’s heart was decelerating. Yellow-tinged amniotic fluid suggested meconium.Julia wanted to keep pushing, but she also knew something wasn’t right. Julia proved her true strength by listening. She put her body and her baby above her own birth dreams. We are SO proud of Julia’s courage and know you will be inspired by her many victories!Additional linksBloom NutritionTVL Blog: Understanding Uterine RuptureTVL Blog: How To Cope When You Don’t Get Your VBACTVL CBAC Facebook CommunityHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Happy Wednesday, everybody. This is Meagan with The VBAC Link and we have our friend, Julia, with us today. Julia’s story is going to be a CBAC. I love CBAC stories. I know that here at The VBAC Link, you think, “Oh, it should be all VBAC,” because that’s what we talk about which yes, it is a main focus of VBAC, but we don’t want to forget about our CBAC mamas. I was a CBAC mama myself and it is so important to talk about that as well because just like every first birth may unexpectedly go into a Cesarean, so are those VBAC births. Sometimes those are unexpected. Sometimes they are desired, and so we really like to talk about everything here and share all of the pros and the cons of everything. I am excited about Julia’s story. I feel like in so many ways, even though I have had a VBAC, I can connect to CBACs so deeply as well because I have had a CBAC. That CBAC wasn’t actually something that I desired necessarily, but that CBAC was something that I found a lot of healing through. So I’m excited to go into this story. Review of the WeekMeagan: But of course, you know we have a Review of the Week. We are always looking for more reviews so if you haven’t yet, feel free to jump over on Apple or wherever you are listening or email us. Google and send us a review. We would love to know how you feel about The VBAC Link podcast and how the stories of all of these incredible people are changing the way you’re viewing and the things that you are learning along your journey. This review is actually on our VBAC course for our Ultimate Parents’ VBAC Course. This is from Dani and it says, “This course gave me the knowledge and confidence I needed to move forward with my plan to have an HBAC.” If you didn’t know, HBAC is home birth after Cesarean. “When you realize that VBAC is just birth and hear the studies and insights that eliminate the mess and evoke a lot of the fear in many C-section mamas, you realize you’ve got this. I was empowered to find a provider that truly supported me and realize how much my gut was telling me my previous provider was not the way to go. I can’t wait to share my HBAC story when the time comes. Thank you so much for all you do.”And thank you, Dani. That is amazing. That is what we want to do here at The VBAC Link. We want to share all of the pros, the cons, and prepare you the way you need to be prepared whether that is for a vaginal birth after a Cesarean or a Cesarean birth after a Cesarean or home birth. Whatever that may be, we want to empower you and put the tools in your pocket for you to use. So if you have any other questions about our online course, we actually have them for birth workers as well. We have certified doulas, which, also, if you are looking for a doula, check out our website. We have so many incredible doulas all over the world. Seriously, all over the world. You can go to thevbaclink.com and click “courses” or “find a doula” to learn more about our online self-paced course. Julia’s StoryMeagan: Okay, Julia. I am so excited to talk with you today. Thank you so much for being here with us, for taking the time out of your day, and for being someone to share a very vulnerable space because I know sometimes CBAC is vulnerable. It is vulnerable, but I’m looking at your picture of you holding your baby after your C-section and it is beautiful. You are glowing. You are absolutely glowing. I mean, your smile is amazing. So I will turn the time over to you to share your experience with a CBAC. Julia: Okay, thank you so much. I’m so honored to be here at The VBAC Link. I had the goal of sharing a VBAC story, but I am proud of myself for coming back and sharing my CBAC story regardless even though it didn’t turn out the way I had planned it to. I hope that my story can help at least one other person as your stories have helped me.  Meagan: Yes. Yeah. It will. It definitely will. I remember having that feeling of that too of wanting so badly to share my VBAC story on The Birth Hour actually if you guys know The Birth Hour podcast. Julia: Yep. Yep, I’m very familiar. Meagan: I was like, “I am going to be a VBAC. I’m going to share on The Birth Hour.” It was not a VBAC and then I was like, “Oh.” And I did. I kind of was like, “Oh. I won’t submit it.” But I regret that. I totally regret that. I actually did submit my VBAC story as well. They get so many submissions as well, but I am so glad that you are here and that you are proud of yourself because you should be. Julia: Mhmm, yeah. Thank you. Thank you. So I’ll start out by tracing back to my first pregnancy because it paves the way for my second pregnancy and birth if that’s okay. Meagan: Right. Right. Yeah, absolutely. Julia: Going back, starting in October 2018, my husband and I had just gotten married and we were ready to start a family. My story has a bit of infertility in it, so I’ll touch on that if that’s okay. Yeah. I started trying to get pregnant in October 2018 and wasn’t getting my period. I decided to take matters into my own hands very quickly and go see an OB. They started me on medicated cycles with them, and I did three of those. Those were unsuccessful. In September 2019, I went to a reproductive endocrinologist, and in November, so two months later, we did our first IUI and it was successful. That’s how my first daughter was conceived. Just wanted to touch on infertility. It’s over now, but it was quite a big part of my story too because just another– I thought my body could do something that is always talked about happening very easily and it didn’t, so that was crushing at the time. It still is part of who I am and also dictated my feelings with my C-sections. I’ll fast forward to finding out that I would need a C-section with my daughter, Charlotte. My pregnancy with her was uncomplicated aside from happening during COVID and just not having a lot of support during that time. I just did an online birth class through my hospital that was just very cookie-cutter. I didn’t really get the opportunity to explore. I did interview some doulas in April 2020 and then it never really came to fruition. When I was 37 weeks, I found out that Charlotte was breech. There had been no indications of it up until that point. My OB does a check at 36 weeks to see if baby is head down and I was a little late for that. That appointment was a little further down. Meagan: Delayed. Julia: Yeah. Delayed. I didn’t get seen until 37 weeks and then at that point, it’s kind of a lot to find out that your baby is breech then because efforts to try and turn them are not as easy. It happens, I’m sure, but not for me. I had the opportunity to try an ECV, an external cephalic version, but I opted not to. I just didn’t have a good feeling about it. They scheduled my C-section for August 6th. I will say that this was hard for me to cope with. I did have a period of grieving. During my whole pregnancy, people would ask me what my birth plan was and I said, “Anything but a C-section.” When that happened to me, I felt that I had jinxed myself, but I know that’s not necessarily true. Her birth was on August 6th of 2020. I went in at noon. They gave me a COVID test. They hooked me up to the machines. There was a little delay because my OB was dealing with a vaginal birth. I remember at the time, even then, I was like, “That hurts,” that the person having a vaginal birth is getting precedence over me. It just was one last dig that I wasn’t getting the vaginal birth that I had hoped for because I had been hoping for a vaginal birth.But anyways, they took me back at 3:00 and my daughter was born shortly after. I had no problems with breastfeeding. She latched quickly. I was only in the hospital for 36 hours just, especially during COVID, they were encouraging people to leave as quickly as possible as long as things were okay. That was my story, so I do think I went home a little too early post-C-section. I remember taking that first trip up my stairs because I live in a two-story home and it was brutal. Meagan: Yeah. I had stairs with my second C-section. We had a breezeway that you had to pull down and then you had to climb upstairs to get to the first level and then climb up the stairs to get to the second level. There were 16-17 stairs in each set. I was just crawling, crawling up them. I was like, “I’m not coming downstairs. Everyone can bring me food. I’m not coming back down.” Julia: Yeah. Yeah, yeah. I had dinner in bed that night or the next few nights. Yeah. Same story. I was like, “I’m not going back down for a while. So I dealt with that. Overall, my feelings around it were I was disappointed that I didn’t get my vaginal birth, but as the weeks went by, my experience as I looked back, was okay. It was straightforward. No complications and my recovery went well. It was hard though as we just talked about it. It’s easy to glaze over that. I had started to read already about pregnancy number two and how it’s extra hard to care for your first child while recovering from a C-section so that was a big motivator for me for my next birth. But yeah. Pretty soon after, I remember sitting in the rocking chair with my daughter while I was nap-trapped and getting on forums researching about C-sections and having weird, sad feelings about having a C-section after a birth. I think that was new to me. I felt a lot of feelings of inadequacy or just disappointment around it. I didn’t quite know that that was normal and then I think researching that led me to find out that a VBAC was an option. It’s interesting to think back to a time when I didn’t know what a VBAC was really. Meagan: Right? Julia: I could talk about it for hours now. But yeah, that term VBAC kept coming up, so I knew that in my next pregnancy that that was what I wanted to aim for in my next birth. After my daughter turned one in August 2021, I pretty quickly wanted to start trying for number two. One, I was genuinely excited to try and start working towards a VBAC, and given my history of infertility, I wanted to get started sooner rather than later. We had to get help with getting pregnant again. We did an IUI and we were lucky enough that it was successful on the first try again. That was in September 2021. I pretty quickly started forming my birth team just having already done so much research on VBAC and knowing that was essential to success. I did go to my first OB appointment at my old OB’s office and just wanted to pick their brains about what their policy was on VBAC. They told me that they don’t induce VBACs or don’t induce with a previous Cesarean delivery. They would give me up until 40 weeks up until my due date to go into labor naturally but if I didn’t, they would schedule a C-section. I heard that and I was like, “Yeah, I’m out of here.” I, in the meantime, joined some local mom groups and my local ICAN chapter Facebook group. I stumbled upon this group of midwives in the Michigan area that was close to me that was very VBAC friendly. I read a lot of success stories with that group of midwives. There was one in particular whose name kept coming up. I reached out to them and got set up with their group. I had to switch complete hospital systems. It was a little complicated but it was worth it. I switched providers and I also hired a doula very early on or signed on with her very early on, maybe at 9-10 weeks into my pregnancy. She also offered Hypnobirthing classes so my husband and I did those virtually. That was really cool. Like I said, with my first pregnancy, I really didn’t get much support to help me towards a vaginal birth although I ended up with my daughter being breech and if I had prepared, that wouldn’t have necessarily changed things much. But I felt really well supported during this pregnancy through those Hypnobirthing classes and exploring the more holistic way of prepping for birth. I got really into– I mean, I will say it was towards the end when I really started practicing my Hypnobirthing breathing and practicing the meditations. I did that and I also started seeing a chiropractor at 20 weeks. I went pretty much every week especially given my history of having a breech baby, I wanted to optimize my pelvic alignment for that. So that was another way that I felt supported just constantly getting really good, positive feedback from my providers like, “Oh yeah. You are such a good candidate for VBAC. You’re doing all of the right things.”I also did the Spinning Babies Daily Essentials. I was constantly thinking about my posture and my sitting position when I was sitting at night on my couch. I would sit forward again to promote good alignment with the baby’s head. I did all of the usual. At 34 weeks, I started red raspberry leaf tea. At 36 weeks, I started eating dates 3 times a day. I was walking. I was sitting on my birthing ball a lot more towards the end just to ideally promote labor to start naturally because as I got closer to the end of my pregnancy, the pressure to go into labor naturally started to build in my head just because I read that the best chance of success with a VBAC is going into labor naturally. That was heavy on my mind as it got closer and closer. I live in Michigan, but I’m originally from Massachusetts so my mom flew out the day before my due date which was June 17th of 2022. When she came out, I felt even more pressure. She was not pressuring me at all, but I just felt the pressure building like, “Okay. The spotlight’s on me to go into labor.” I just remember those few days until I did ultimately “go into labor” were very hard emotionally but they were also nice. I spent it walking with my mom and just doing activities with my daughter to pass the time. It was a time I was very much present just because I was very much aware as the days went by that I would inevitably be having this baby sooner than later. I went in at 39 weeks for my checkup and I knew I wanted to get checked then. I hadn’t been checked until then. I was tempted to but I didn’t just to avoid the mental gymnastics of dilation and all that. At 39 weeks, my midwife checked me and I was a fingertip dilated, but she said I was very soft. My cervix was very soft and my cervix was 80% effaced. She was very hopeful about that. I went home and Googled that. They said that was a good place to be for labor to start eventually. I wasn’t totally closed and high or anything like that. I had the next checkup at 40 weeks and 4 days. I was still the same, a fingertip. Soft cervix, 80% effaced so I was a little discouraged by that. In the meantime, I had started upping my attempts to induce labor naturally. I started pumping at night. I did a lot of curb walking and my doula encouraged me to buy some clary sage essential oil. I guess if you put some on your feet and I had my husband massage my feet with the clary sage oil and put it on some pressure points that it could help kickstart labor. Meagan: Spleen 6 can help. A lot of people go and get pedicures and then they go into labor and they’re like, “Oh what?” That’s what they’re doing. They’re massaging down there really well and it can totally help. Yeah. Julia: Yeah. Yeah, so I did that clary sage and the foot massage the night before I did actually technically go into labor. I don’t know if that helped or if that kickstarted things. At 40 weeks and 5 days, it was about 9:00 in the morning and I was sitting down for breakfast with my daughter. My mom was there and my husband was there, but he was working from home. I went to go stand up and I felt a warm gush of fluid. I was like, “Oh, that’s interesting.” I stopped and said, “Oh my god. I think I just peed myself.”Yeah. Of all the ways I thought my labor would start, I never thought it would be with my water breaking. I don’t know why. You always hear that women are like, “I’m just peeing myself. That’s not my water breaking.” It didn’t come out in a big gush, but it was small gushes throughout the morning. I put on a pad and I did notice even from the beginning that my pad was a little yellow-ish tinged. I didn’t think too much of it. Immediately, my mind went to meconium, but I thought that would be a little more green or brown, I think I was reading, so I wasn’t too concerned about that. I just went about my morning because I was still skeptical that I wasn’t peeing myself and that it was my water. Around noon, I texted my doula to let her know. She was excited that things were happening. I did tell her that the pad had a little bit of a yellowish tinge. She texted back that it was likely meconium but to not be too concerned. Once she confirmed that I got anxious just from what I had heard from birth stories. That’s not the best way to start labor is one, your water breaking first without really any cramping or contractions afterward. That was the other side of it. I didn’t really have a lot of cramping afterward that was indicating that labor was picking up. Once she told me that was meconium, I pretty much was like, “Okay. We need to go to the hospital.” I think in an ideal world given that I was trying to avoid intervention as long as I could that I would maybe hang out at home for a little while longer to see if labor progressed, but once I heard it could have been meconium, I was like, “Okay. We need to go.” So we did. I arrived around 1:00 p.m. that day. I went to triage and got checked. They confirmed that my water had broken and that there was some meconium staining as they called it. I got checked in. We went over my birth plan. The vibe was very positive and I had submitted a birth plan to my midwife. She submitted it to the hospital so it was very nice to know that they were on board with my birth plan. They had looked it over. The midwife that came in to check me said, “I know what your birth plan is and what you want.” That was really nice to hear already and to feel supported. They checked me in. I got into a room and they encouraged me to walk the halls to kickstart contractions and also tried nipple stimulation with pumping. They recommended pumping for 10 minutes on, 20 minutes off, and also going in the shower. All of the rooms at the hospital where I delivered had a tub and a shower. They encouraged me to go in there and use the showerhead for nipple stimulation as well to help kickstart contractions. I did that from 1:00 until about 8:00 p.m. Labor really didn’t start up. Around 8:30, the midwife came in and we decided to start Pitocin. I wasn’t too keen on it just because I knew that starting any intervention like that could decrease my chances of VBAC, but I was also at the same time excited to get contractions going and get things started just because I knew that I was on somewhat of a clock. My midwife group did not push the time between when my water broke and when I would have to deliver. They didn’t put that pressure on me which was very nice, but in my head, I knew that I personally didn’t want it if there was something going on, I didn’t want my baby to be in danger given that my water had been broken for 12 hours already. It broke at 9:00 a.m. and this was around 9:00 p.m. when we started Pitocin and there was some meconium staining in it. I was nervous for myself. I put faith in my midwives, but I knew that I was also concerned. Initially, she started at 2 units of Pitocin and then upped it every hour I believe. She upped it, I want to say, by 2 units every hour. Around 11:00, things picked up. I took a selfie of myself in the hospital bed at 10:45. I was looking back at my pictures. I was smiling and that was the last picture I took for the remainder of the birth up until my daughter was born. That’s how I know that at 11:00 things started to pick up because that’s when I went into labor land and full-on contractions. My husband and I started timing contractions. I was really excited to feel a contraction. I wanted to deliver vaginally of course, but one thing that I missed out on with my first birth was the labor experience because it was planned. I didn’t feel a single contraction with my first birth so I was excited to feel that and at least have that experience I did get that experience so that’s something that has helped me come to terms with it all. When the contractions started, I was happy although I was in pain. We were just trying different positions. I went into the tub and since I was a VBAC, I was on continuous monitoring so being in the tub was hard, but my nurse was great about making sure that the monitors stayed on my belly even when I was writhing around in pain in the tub. They had the band around my belly and then they put a pantyhose sleeve over it to secure the monitor, but it did keep moving around and all that. They never made me get out of the tub or anything to keep it more secure. That didn’t happen. They just worked hard to do their best. Around 5:00 a.m. on the next day, I was up to about 12 units of Pitocin. I was reading back through my notes and my midwife said I wasn’t tolerating those contractions very well, so she turned it down to 10 units. I will backtrack a little bit and say that around 3:00, my doula showed up just because I was in a lot of pain but I wasn’t ready for pain relief yet and just wanted her to come and help me along. My doula showed up around 3:00 a.m.She was very supportive and was helping me through contractions. She did encourage me to get in the tub another time even though I had gotten out. It just was not working for me. It was not giving me pain relief. The tub wasn’t very big. It was kind of like your classic tub, so it was hard to really get in a comfortable position. It even felt like the contractions were worse in the tub. I didn’t experience that relief that I thought the water might give me. Around 6:00 or so, we started talking about pain relief medication. They gave me the option for fentanyl which, they said, would be a short burst of relief, or the epidural. I was pretty well educated on both options, but I did take a little while to make the decision to ultimately go with the epidural just because I knew that again, it could slow down my labor and could lead to not achieving my goal of a VBAC. I was contracting every 2-4 minutes at that point. The surges, I guess I haven’t been calling them surges as we had been taught in Hypnobirthing. The surges were very intense. Around 7:00, I got the epidural and I felt some relief when they gave it to me. They pretty much encouraged me to take a nap. I was able to close my eyes for 40 minutes but didn’t sleep too long. I didn’t get that 3 or 4-hour nap that you sometimes get post-epidural. And then around 10:00, I said that I was feeling some pubic bone pressure. It was just very intense and I could not ignore it. It didn’t seem like the epidural was touching it much. I will say that I wasn’t using the epidural button too much to give me more medication. I don’t know why. I think that maybe I was just in labor land and didn’t think to use it. I did press it a couple of times and it didn’t really seem to touch the pubic bone pressure. I had the midwife come in. She checked me at that point around 10:00 a.m. I was 5 centimeters dilated which was exciting. Meagan: Yeah. That’s way awesome. That’s really awesome. Julia: Yeah. Yeah. Yeah. I know. The whole time, I was just in disbelief that I was living the story that I had heard so many times of actually having interventions and dilating and all that. But when she checked me, I was 5 centimeters, but she also said that the baby was malpositioned. Her chin wasn’t tucked as it should be. It was up, so that was likely causing the pubic bone pressure and also keeping me from dilating more. They hadn’t checked me much. I think that was the first time they had checked me since I went to triage the previous day just because my water had broken and they try to avoid that as much as they can to reduce the risk of infection. So from 10:00 until 3:00, we worked on getting the baby to move into a better position so that I could dilate more. I think a midwife checked me at another point between 10 and 3 and I hadn’t progressed at all. I think there was a little bit of pressure or just a little bit of tension with not dilating during that time, and given the “clock” that I was on with my water broken. We talked about options for what would happen if I didn’t progress more, but by 3:00, she did check me again and I was 7 centimeters dilated. I remember being like, “Oh my gosh. I’m going to have my VBAC. It’s happening.” I remember crying because I was really concerned that I wasn’t going to progress. Especially, I think I was blaming it on the epidural which made me nervous. So that was exciting. Right after that, from 3:00-5:00, I took a nap. It was a really nice time. While I was sleeping, my doula was reading me birth affirmations and up until that point, she had also been helping with different positions as we had tried to move the baby’s head down. I had my head up on the top of the bed facing down on the bed, my head on the top of the bed and she was just reading me birth affirmations and helping me through contractions. In hindsight, it was such a nice time. While I was in a lot of pain, I was enjoying it. I will say a lot of my pain was in my butt and back area. I think I was having back labor. My husband, I haven’t given him any credit yet, but he was amazing during birth and was really putting counterpressure on my back to help counteract the pain that I was feeling down there. It was just really, really, really good with how he worked with me and how he helped me to get through each contraction. That was most of the day. I woke up around 5:30 and I felt pubic pain again and then all of a sudden, it radiated up to the top of my abdomen under the top of my rib cage and it also radiated up into my clavicle. Immediately, I got on all fours and I was like, “I do not feel good.” It was interesting because earlier in the day when I felt that pubic pressure, I was questioning, “Oh, is this uterine rupture?” My doula said, “No. Usually, if you have a uterine rupture, one symptom is that you have pain up in your shoulders.” I was like, “Oh. I don’t have that” at the time when I first felt that pain, but they had attributed it to the malpositioning of the baby. Fast forward to when I said I was in a lot of pain and said, “I really don’t feel good,” I did have that pain in my shoulder. Immediately, I was like, “Oh my god. This is happening. This is rupture.” None of the midwives or nurses were saying that it was. I guess I learned during all of this that there aren’t a lot of easy ways to know if you have had a rupture. It was kind of up to me to communicate how I was feeling. Meagan: right. Julia: You know, because I could have gone along and ignored that pain or thought it was maybe related to contractions or the baby moving down, but it was a distinct pain. At that time, I also started throwing up, but it was at the time that could be transition. I think the nurses thought that was what it was. Meagan: Baby was doing okay at this point?Julia: Yeah. Baby was great up until this point. Yeah. In all my notes, it said, “Fetal heart tones great, in the 140s,” but after I had that episode or series of episodes of vomiting, the fetal heart rate dropped. That’s when things started to get a little dicey or they were dicey. It had been very chill and just letting me do my thing up until that point, but then they started saying, “Okay. We need to start making some decisions because we are having some decels.” That was happening at the same time that iI was dealing with the pain. I forgot some of what happened next, but I had pretty good notes from my doctors that helped refresh my memory and one of the OBs came in. I guess baby had flipped OP, so one of the OBs came in and actually turned her to be in the right position, so that was great. At that point, I was complete. They gave me permission to start pushing. Meanwhile, I was still dealing with this pain. I had become, I think I just stopped talking about the pain as much thinking, “Oh maybe if I don’t talk about it, it’ll go away” or that I could still carry on with pushing and get this all over with and get my vaginal birth. They gave me a chance to push. I pushed for about an hour. I always hear how it feels like it was five minutes, but it was a full hour of pushing and it felt like it went by really quickly. I think during this time, they had inserted an IUPC, the intrauterine pressure catheter just as a way to also monitor how baby was doing and also to backup the pain I was feeling to see if anything was off, maybe they would pick it up with that because that’s the only true way to measure the strength of uterine contractions I guess. I started pushing. It was a really exciting time. I had all my team around me. I had my doula put washcloths on my forehead. I had my husband on one side. My mom was actually there. She was just coming to visit because the rule was that I could have two people at my bedside during birth, two extra support people. My mom was able to come and go to the hospital as she wanted to, but she couldn’t be at my bedside. She walked in at the exact same time that my pain started. It was probably traumatic for her to walk into that. I was screaming and vomiting. Everyone was caught up in that, so I think people forgot about the rule and just ignored it. She was able to be at my bedside while I was pushing too which was really cool because having given birth back in August 2020, I just had my husband which I’m grateful for, but I didn’t have my mom there and I’m very close with her, so it was just like a dream come true to have my mom there while I was pushing, my husband there, my doula, all of the midwives there encouraging me and cheering me on. They brought over a mirror and I got to see the baby’s head. They even brought the pull-up bar or whatever and wrapped a sheet around it and had me pull on that to help me. Meagan: They call that tug-of-war. That’s what it’s called. Tug-of-war.Julia: Tug-of-war. Yeah. Yeah, so that was really great aside from the intense pain I was feeling. I really didn’t feel like I could push effectively. I was pushing, but I just couldn’t push how I thought I should because of this pain. I felt like if I pushed too hard, something was going to happen. Something was going to burst because I did have that in the back of my head that it was probably my uterus rupturing. Like I said, they trusted me to tell them to make the call if things weren’t feeling right. You know, of course, I had done all of this work, and yeah. I had done all of this work to prepare for a VBAC and I really, really wanted this to happen, so I had quieted down about the pain. They let me keep pushing, but then at some point, I was like, “What I’m doing is either putting my life and/or my daughter’s life at risk.” I felt kind of selfish continuing to push despite having this pain and despite pushing through what my body was telling me to do. I just knew something wasn’t right. They had, of course, brought up the concept of the C-section around this time, but they were giving me the chance to see if baby could progress further down. I was pushing and like I said, I didn’t feel effective enough and it was reflected because baby was not moving down that the rate that they would have hoped, and given that the baby was having heart decels, that was really concerning to them. I ultimately made the call for the C-section because I just couldn’t keep doing it. Like I said, I knew something wasn’t right and if I continued to push, I was probably putting myself or my daughter at risk. So that was around 6:30 and then once I made that call, everything was a flurry. I had a C-section before, so I know how things in the OR how busy it gets, and how quickly it gets busy, but I hadn’t had an emergency C-section yet, so that was just a new experience. It was a lot to go from pushing and everyone cheering me on to getting prepped for surgery, getting pulled this way and that way. I had said that my epidural wasn’t working very well. The OB that had since taken over now that it had taken a turn and it might be heading towards the surgery route, the midwives had to step back a little bit. The OBs were in the room and my OB had mentioned something about, “You might have to be put out.” I said, “I would go for the C-section, but I knew that if I had to go under general anesthesia, I was not going to be good mentally.” I did not want that. I did not want to be asleep when my daughter was born.So I did say that. I did advocate for that. I said, “Can’t the epidural be converted to a spinal?” The anesthesiologist was already in there. She was optimistic about that. I forget why it might not have happened and why it’s hard to convert one to the other, but I knew that was a thing that could be done, so I pushed for that. I said multiple times, “I do not want to be put to sleep,” so I’m happy about that at least. And then, yeah. I forget if I walked or was wheeled to the OR, but I was in so much pain at that point. I couldn’t wait for the spinal because I knew the relief that it gives. You feel nothing from the neck down, so I couldn’t wait for the spinal. At that point, my doula said that she was going to leave. I was just about to step into the OR and she said she was going to leave. I don’t know what the rules were, but I believe that just my husband or one support person could go into the OR with me. My mom was still there at that time, so she could be waiting in recovery for me, so my doula said that she was going to leave but that she would check in with me the next day. Yeah. So I remember going into the OR and I had just done this less than two years ago so I remember the whole story of how it goes. You know, getting the spinal, then laying me down quickly, and doing the time out, then the surgery started. I wasn’t sad at that time. My focus had shifted to, “Is the baby going to be okay?” During surgery, at one point, they said, “Yeah. You had a rupture,” so I knew. Meagan: So you did? Did they confirm a full rupture? Julia: My doctor said it depends on who you ask. What ended up happening was not a complete or catastrophic rupture. Meagan: A dehiscence?  Julia: Exactly, yeah. Meagan: Okay. Julia: A dehiscence. It was a 3-centimeter dehiscence that was not coming from my scar at all. It was in my uterine wall elsewhere down below, lower in my abdomen but not near my scar. There was amniotic fluid and meconium leaking out of it into my abdomen. Yeah. So all the while, I was still feeling this pain and this clavicle pain is what became my primary pain during all of it. During the surgery, I kept trying to move because I was in so much pain. The anesthesiologist kept saying, “You have to sit still. You have to sit still.” So that was very hard. So once I was in surgery, my focus shifted to my daughter. I had requested, as I was going into the OR, for a clear sheet. I was trying to fumble for ways that I could make it a gentle C-section as best as I could. I didn’t really prepare for that. I didn’t really put in my birth plan what to do in the chance of a C-section. So I asked for the clear drape, but I don’t think that my daughter was doing well enough when she came out to drop the drape. They never did and I’m assuming that’s why.I’ve also gone through and read her notes and her APGAR score at one minute was a 4. She wasn’t doing so great. She had to be resuscitated somewhat, then by five minutes, her APGAR was a 9. They did say that her cord gasses were concerning, so they did end up having to take her to the special care nursery. But as you saw in the picture, I was able to be with my daughter for some time. I got a picture with her. She was there for a while. Again, it felt like I was in there for five minutes, but I was in there for probably an hour and a half. I had my husband go with her to the special care nursery once they said they had to take her. I was just there and yeah. As they were sewing me back up, they pressed on my uterus. I forget what they were doing but they pushed on my uterus. Meagan: Probably Credé. Julia: Yeah, is that right? Yeah. Meagan: Yeah, they are checking for bleeding and clogs and those types of things. And probably fundal height. Julia: Yeah, they did something, but it made me scream from the pain that it caused. That was a little traumatic, but eventually, I was wheeled out to recovery and my mom was there. Luckily, my daughter only had to be in the special care nursery for two hours I believe. I was reunited with her in recovery and she latched right away and all that good stuff. I was very grateful for that. Shortly after, my OB who did the surgery came in and started talking to me about the rupture. She did call it dehiscence but she said in her book, any sort of tearing in the uterus is a rupture. She told me that I could get pregnant again, but I’d have to wait. I think at the time she said 18 months to conceive again and then she went on to say that a future pregnancy would be very closely monitored and that I would have to deliver between 36 and 37 weeks.That was pretty heavy for me. Meagan: Yeah. Julia: And still something that I am still working through. I guess I feel most sad about the repercussions of trying for the VBAC on future pregnancies just because I tell myself that if I had gone for a repeat C-section, none of this would have happened and I could have gone forward and tried for a VBA2C. Yeah, but as I’ve thought about it, if I hadn’t tried, I would have been very disappointed. I had to try at that point, so I’m glad I got the labor experience that I had hoped for. Like I said, I got to that point where I was pushing. Everyone was cheering around me. I had my doula. I was doing the position changes and getting in the tub, birth affirmations, and all of that but I didn’t end up getting to deliver vaginally which was a big part of my goal and still something that I am working through. But after the fact, I did realize that my daughter could have been– things could have turned out worse for sure. I’m very grateful for her health and my health. I did have some complications after the birth. I had to go to the ER twice in the week after her birth because I had this debilitating pain in my ribs and still on my clavicles. They ended up telling me that it was just trapped air which sounds silly because of how much pain I was in. Meagan: No. It’s not silly. I had that with my second C-section. Julia: Really? Meagan: It’s no joke. Julia: Yeah. Meagan: I’m like, “I just want to poke a hole right here in my shoulder.” It was so bad. Julia: Yeah. Yeah. Whenever I moved, it was debilitating pain. It was crazy. It was trapped air and then also as I had mentioned, the meconium and amniotic fluid had gone up into my abdomen, so that was causing a lot of irritation. Yeah, so the first week of my daughter’s life, I was in and out of the ER. I had to have a CAT scan at one point and drink the contrast. They recommend not breastfeeding and pumping and dumping for 1-2 days after that so I did have to give her formula for a day. At the time, I was like, “Whatever. Everything’s gone not how I had planned, so whatever. I guess I’ll give her formula for a day.” But it was just a day. It is what it is. Meagan: Yeah, but it impacted you too so try not to just cut it back. It’s like whenever everyone’s like, “Well, yeah but your baby’s okay and you’re okay.” You’re like, “Yeah and I’m happy about that, but it doesn’t mean I’m not upset about the other things.” Julia: Right. Meagan: that’s one of the biggest things. It’s okay to be grateful for a safe mom and a safe baby and that everyone was okay, but it’s totally okay to grieve and to feel upset or even mad or sad. You have those emotions. If you don’t allow yourself to have those emotions, we can’t start healing, right? Julia: Right, right. Yeah. Meagan: So I want to talk about a couple of things. One is dehiscence. It’s not a word that a lot of people hear. Like you said, it depends on the provider. It depends on who you’re talking to because most providers correct you. It’s like, “If you had dehiscence, it was a rupture.” There are three layers to the uterus. If the uterine scar opens up partially, but yours didn’t, stretching the scar out can cause that bottom layer to tear open. Yours was in a different place, but it means it’s not through all of the layers. That’s what they categorize as a dehiscence where it was starting. I’m very proud of you for following your heart and following your mind because you were like, “Something’s off.” It’s so hard because you were in that so close moment of, “I can do this. The baby’s right there. I can see my baby’s head.” Julia: Yeah. Meagan: I can’t imagine the banter that went through your mind of, “I’m so close to the birth I want, but something’s not feeling right,” so be proud of yourself for really following that intuition. We talk about that a lot here, this intuition and the intuition is strong. It doesn’t usually bring fear. It brings facts. It’s like, “Yep. This sucks. This isn’t what I wanted, but I have to make this decision.” So yeah.There’s a uterine window, uterine dehiscence, and then uterine rupture, a full rupture. Sometimes, even a window will be documented as a rupture on op reports. It’s really important to give it a look, but still, I mean, it happened and it sucks. It really sucks. It doesn’t happen often and we don’t know even why it happens, but it happens. I’m so glad that you guys are okay and I’m so glad that you were able to have your baby on your chest and be with your baby a little bit more. I also want to talk about how to cope when you don’t get your VBAC. It’s hard. It’s really hard. I can’t say that it’s easy. I can’t say that I didn’t cry my eyes out. Ugly cry. Sobbing. Even though my second C-section was a healing experience that I’m grateful for, I didn’t want that birth. That’s not the way that I wanted to give birth. I had to process it. Not getting your VBAC and processing it. What tips would you give? I’m sure you’re still healing and processing, but what tips would you give to our listeners who may not have ended in a VBAC or may not end in a VBAC for processing and working through that? Julia: Yeah. My biggest tip would go out to people who are trying for a VBAC right now would be just to definitely explore being okay with things not going to plan because I think that dictates how you can cope with things afterward. I think if I had gotten ahead of it a little bit and listened to more CBAC stories and written on my birth plan what I would want in the event of a C-section. It’s such a hard balance of wanting to stay positive and keeping those negative thoughts out of your mind but also not negating the fact that there is a chance because I definitely did not think I would have a uterine rupture. I just had a planned C-section for a breech baby, so I had no indication that I would have a rupture. I think just exploring that and not pushing away those feelings that come up when you see CBAC stories on the Facebook groups. I would even ignore those and just focus only on VBAC success stories. I think if I had surrounded myself with more of that and more of the alternative, I would have come out a little bit stronger. It still would have been hard and it is hard, but if I could go back in time, that’s what I would have done. For women who have had a CBAC and had their story about how things didn’t go according to plan, I would say to get help and not be afraid to get help. I’m lucky that the hospital I delivered at has a program to follow up with women who have had traumatic births and have a history of anxiety or other mental illness. I do have a history of anxiety so I was glad for a consult from a midwife who is also a therapist and works with therapists who will give you help to process your birth. It’s not just any old therapist. They are birth trauma specialists. That was really amazing.In hindsight, it still doesn’t fix anything, but having someone there to support you is important. You can talk to your family about it, talk to your spouse about it, but they are not in your head and they don’t know really how truly, truly invested you were in it. You do get a lot of, “You should be happy.” One tip with working with mom therapists is every time you go to a negative thought about, “Oh, this is all my fault or I did this wrong and that’s why I ended up not having a VBAC,” to replace it with a positive thought. If you are blaming your body for not doing such and such, replace it with something that your body did do. For me, that was, “My body gave me a very strong message that things were not right.” That likely saved my daughter and my life, so when I go to think of those negative thoughts about what I could have done differently, I tried to replace them with that thought or something similar to how my body did work with me during that process. That’s been really helpful. I think that could be helpful for other women listening too. Meagan: Absolutely. Absolutely. Yeah. You know, we say it all too often. We hear it all too often. Failed VBAC. Failed. The word “failed”. I’m sorry, but we did not bleepity bleepity bleepity bleep fail. There is no failure in birth. It sucks that we have even incorporated that word and we use it as “failure to progress”. We use it in medical terms. “Failure to progress”, that’s what the medical providers use it as and we do. We reference that. But holy cow. There is no failing. It’s important to know that. Yes. For me, my body didn’t make it past 3 centimeters the first time, 1 centimeter the second time. My doctor even told me, “Yeah. You won’t be able to.” But that’s not true. I love that you said, “Fill my mind with something positive.” Look what it did do. Look what it did achieve. Look at what I achieved. Look at how hard of a thing I did. Julia: Yep, absolutely. Meagan: I love that. I love that so much. We are going to have a uterine rupture blog and how to cope if you don’t get your VBAC in the show notes but something else I really want to include in the show notes is your website. I love what you do and we will make sure to of course tag you and everything in the post but I love what you are doing. You are a registered dietician. A lot of people write us and they say, “I already had my baby. I’m 6 months postpartum. I want to start really working on this prep early for my future VBAC.” They’re like, “What can I do?” One of the number one things– there are so many things. Education, finding a supportive provider, and all of those things, but truly, it’s working on our whole self. That means mentally, too. We’ve got to work through previous traumas and fears and work through that, but also nutrition. Nutrition and exercise are so important. You help with pregnancy and postpartum. You talk about intuitive eating. You even help with fertility. So before we go, I would love for you to share because you do online stuff, right? Julia: Yep, yep. I see clients virtually all over the country. I’m based in Michigan right now, so a lot of my clients are from Michigan, but I see clients in other states as well. I work from an intuitive eating mindset trying not to focus on dieting and numbers and all of that, but trying to just as we’ve talked about in this episode, learn to trust our bodies when it comes to our hunger cues, eating, and how we like to move our bodies, finding movement that we genuinely enjoy, not exercise that we dread. Meagan: Yeah, yeah. Julia: That’s especially important during pregnancy when you really have to listen to your body, truly, and what it’s telling you. So yeah, that’s what I do. Meagan: Awesome. You even help with snack and meal plans. I mean, just as a busy mom in general, it’s really hard and when you are prepping and you’re like, “I’m raising 1, 2, 3, 4, or however many kids. I’m doing all of the other things around the house. I’m trying to educate myself for this VBAC.” You do all of these things. We sometimes forget to serve ourselves with our food, so I love that. If I could just have that plan, it would be so nice to know that this is what I’m going to eat today instead of, “Oh, I’ll just grab a quick snack that’s maybe not so healthy for me because I’m so hungry.” I love that you do that. We will make sure. It’s Bloom Nutrition. Bloom Nutrition, is that correct?Julia: Yes, yes. Yep.Meagan: We will make sure to put that in the show notes and make sure to tag you. So if you are listening, go hang out. Check out the show notes or go hang out on her page. Check her out on Instagram and Facebook. We’ll have all of that listed because truly, it is important. It is really, really important. Thank you so much for being with us today. Thank you for sharing your story and for being vulnerable. Julia: Thank you so much. Meagan: I know that that had to have been hard in the moment, but I’m so proud of you and I really am so proud of you. I hope you know that you are a Woman of Strength. You are so strong and you are capable of so many things. Even though the birth didn’t happen the way you desired, I know that your daughter way down the road and any kids that you have in the future are going to love you and say, “Thank you for bringing me here today.” Julia: Yep, absolutely. Thank you so much. It’s been great to be here. An honor, truly. Thank you. Meagan: Thank you. 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