Episode 214 Megan's VBAC + Positive Home Birth Transfer

Megan joins us today all the way from England! Megan planned for a home birth after a Cesarean with a wonderful team of midwives. She was well-prepared for any potential outcomes and made sure to secure continuity of care in the case of a hospital transfer. 27 hours after her waters broke with intense contractions and no sleep, Megan was devastated to learn that she wasn’t even dilated at all. She was thankful for the supportive midwife team she had in place at the hospital. As her birth experience presented the unexpected, Megan embraced flexibility. Interventions she didn’t initially plan for brought pain relief, rest, progression, and her VBAC! Our guest cohost and certified VBAC Link doula, Madison, shares her love and wisdom throughout this episode as well. Additional LinksMadison's Doula WebsiteBebo Mia’s WebinarHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsFull TranscriptMeagan: Turn your love of babies and bellies into cash. If you love babies and bellies and want to provide care and support to families, then Bebo Mia’s webinar is the right place for you. Get answers to those burning questions like how to be the voice you wish you had at your birth and how babies and families can be supported by doulas. Learn all about the different kinds of doulas. You can work in fertility, pregnancy, birth, postpartum, or just enjoy working with those squishy babies. Supporting families by becoming a birth worker, aka doula, is perhaps an option that hasn’t even crossed your mind. That’s why we want you to join this webinar. You can have great earning potential while doing something you love. Bebo Mia is the one-stop shop for education, community, and mentorship. Reserve your spot today at bebomia.com/freewebinar.Hello, hello. I cannot believe 2022 is almost over. We only have one episode left of the year, but this episode is going to be amazing. We are so happy that you are still with us for 2022 and we can’t wait until 2023 because we’re going to have really fun things coming. I want to share with you, you’ve probably heard it a little bit in the past, that I’ve been having some co-hosts on the show and it’s so fun to have different voices and people from all over the world sharing reviews and being involved in these stories. These are all of our certified birth doulas who are really fun birth workers. Today, our special guest is Madison and it is so fun to have you, Madison. Thank you so much for being with us. Madison: I’m so excited to be here, Meagan. I am a Cesarean mom myself and I haven’t had my VBAC yet, but taking your class and being able to support VBAC moms better through your class was just amazing, so thank you. Review of the WeekMeagan: Yes. Thank you, thank you. Well, I would love to turn the time over to you to read a review. Madison: Yes, so this review, the title is “Confidence Boost” and it is from a user named musicfeedsthesoul. I love that. The review says, “Meagan and Julie, thank you, thank you, thank you for what you have built here. Story after story, my confidence in myself and my plans for a successful VBAC were lifted. I learned so much from you” and then she put in parentheses “(cervix nerd over here) and your experience with them watching Women of Strength birth the way they desire. I hired a doula for my VBAC baby boy’s birth born on 8/20/22” so not that long ago.Meagan: Oh my goodness, not long at all. Congratulations. Madison: Yes, congratulations. That’s so exciting. She says, “And I felt so in control. So confident in my body and my ability to advocate for myself in the hospital room all thanks to you. Got my VBAC!!!” Love it. “Feeling him come out of my and having him onto my chest was the greatest single moment of relief and joy I’ve ever felt. Thank you for being there along this journey. Big hugs to both of you. Meagan: Oh, that seriously just gave me chills. It gives me chills to hear that. Madison: Same. Meagan: That makes me so happy for her and thank you so much for leaving a review. We really do love these reviews. We like to share them on the podcast. We love hearing them. Some of them even make us cry. They give us chills and they keep us going. They keep me going. I love them. When I see a review come in, I’m like, “Okay. Yes. There is a reason why I’m here” and the reason why I’m here is that I’m doing this and it is helping. I make a difference and I love it. I know that kind of sounds silly because I’m like, “I make a difference,” but that’s what I want to do. I want to try and make a difference in people’s lives and let them figure out how they want to have birth and educate them and empower them no matter if that’s a Cesarean or a VBAC. So I love it. Please leave your reviews. Google, email, Facebook, you can Instagram us. Apple Podcasts. I think even Google Play or whatever the one is for Android. I think you can leave a review there as well. They really are so appreciated. Megan’s StoryMeagan: Okay. We are going to get into Megan’s story. I just want to share a little bit about her. Her VBAC baby actually is- how old is she, Megan?- did you say 12 weeks old? Megan: Yeah. She’ll be 12 weeks this Sunday. Meagan: Yeah, 12 weeks! Just little. Just little. She’s here recording with us which is so awesome. She is living in England and some of the highlights of her birth are a long labor, following intuition, and then you know that term that we are all labeled “failure to progress”, she also had that label which I don’t love. I’ve also had that label personally. And then she actually is a mental therapist by trade. So Megan, I feel like I’d love to know more about that at the end too. But let’s turn the time over to you to get this amazing story out here with the world. Megan: Yeah. Yeah. Thank you for having me. Thank you for that introduction. I’m really happy to be able to share my story because I’ve listened to so many birth stories during my pregnancy and it was really, really helpful for me to feel confident and prepared as much as I could be to have a VBAC. So I have two baby girls. Like Meagan said, one that just turned 12 weeks and that’s is my VBAC, or is about to turn 12 weeks, and is my VBAC and then my first baby girl is now a toddler. She’s two and a quarter, so the babies are just over two years. Two years and one month apart. That baby was born by Cesarean because she was breech. She was born in June 2020 a couple of months right after the start of the pandemic. She was breech throughout the entire pregnancy. Actually, my husband was born breech so I just kind of had a hunch throughout the pregnancy towards the end especially when it started to be more of a concern to the OB that I was seeing that she was going to stay breech. I did, like so many women, try everything to get her to flip but she didn’t. Meagan: Did your provider offer to– I’m always curious. Did your provider offer any help on their end?Megan: Yeah, they offered the ECV, so the external cephalic version I think is what it stands for, but they said that the success rate, I think, is only 1 in 3 for first-time moms. So, fortunately, it wasn’t, I had heard a lot of stories about that being really horrendous. It wasn’t a bad experience for me and it just didn’t work. I think my provider was pretty gentle about it which was why it didn’t actually hurt that bad for me. But he gave a couple of pushes to try to turn her around and just could really tell that because of her position, I think, her little bum was right underneath my hip. He was like, “Nope. She’s not budging at all.” I tried everything on my own and we did try the ECV too. And I actually was okay with having the scheduled Cesarean. I might have tried to find another provider, but from my research– I was living in Colorado at the time. Madison: That’s where I’m from. That’s where I’m living right now. Megan: Oh cool, cool. Yeah. We are a military family so we were in Colorado Springs. Madison: Gotcha. Megan: But from my research, there wasn’t a provider in Colorado. Dr. Stu in California which is my home state, I would have, but it was the start of the pandemic and I was like, “I’m not going to travel states. I don’t even know about getting on a plane right now.” It just wasn’t going to happen and I was okay. I was okay. I am a planner. I liked the idea of having it planned. We could get kennels arranged for our dogs and I just kind of found the silver lining in it and was okay with it. But the morning of my firstborn’s birth, I asked my OB, “How long do I have to wait to get pregnant” because we knew we wanted at least another baby “in order to get a VBAC?” So I had on my mind before even the Cesarean that I would want to have a VBAC. His answer, interestingly, was only six months so I was surprised to hear that. My babies are much further apart than that, but I know that a big question that a lot of women do ask is, “How long do I have to wait in order to have a VBAC?” And he said, “Just six months.”Meagan: There are different studies out there, so that’s the crazy thing is some of them say, “After six months, there’s no difference” and some people say, “If it’s before 18 months, it’s a really high risk.” It’s interesting how provider to provider, you’ll find that different number. Megan: Yeah, yeah. I thought that it was interesting. He seemed like he was a pretty conservative– he wouldn’t have even entertained the idea of a vaginal breech birth. He seemed pretty traditional. He was kind of an older provider. So yeah. Six months and he seemed like he was conservative too. But the Cesarean was a good experience for me. It really wasn’t bad. There was nothing about it. Even the recovery went well. It is kind of a strange thing to one minute– it’s so fast. And now, here’s your baby. They just kind of produce this baby from you. So that part was a little bit strange and I didn’t feel super connected with the birthing experience. I thought that maybe had something to do with it, but it wasn’t bad. There was nothing about it that was bad. Like I said, even the healing was fine. It took me maybe about three weeks to kind of start to feel more myself and like I could move without pain. I did have hypertension during that pregnancy, gestational hypertension and it came back postpartum so that was a little complication, but that wasn’t related, I don’t think, to the Cesarean at all. So yeah. Moving on to the VBAC, the birth that I’m most interested in talking about today. I got pregnant when my firstborn was about 15 months and the pregnancy was super, super smooth sailing. I didn’t even have hypertension and knew that I wanted a VBAC like I said, before I even got pregnant. That was always the plan. The way the care works here is that you are seen by midwives in England. So we moved as a family to England in August of 2020 when my toddler was only 9 weeks old because like I said, we are a military family. We got assigned here. The care does look quite different here in the UK, but it’s midwifery-led. You’re seen by a doctor if you have any risk factors and having a previous Cesarean is considered one of the ones where I would need to be seen by a consultant is what they call them. I don’t think they are considered obstetricians but by a doctor. I was talking about my birth plan at 12 weeks during that first ultrasound that they offered and they said that they would be supportive of a VBAC, so that felt really good then around the middle of the pregnancy, my husband and I started to talk a little bit more about the birth plan. I started to have some anxiety about who was going to watch our toddler while we had the baby since we are here and don’t have any family here in England. My husband suggested and kind of started to almost push the idea of a home birth which really surprised me from him. I didn’t even think it would be something that he’d be comfortable with, so for it to be his idea came as a surprise. Meagan: I love that. Megan: Yeah, yeah. My husband surprises me all the time in really cool ways. So yeah. I started to look more into that as an option and to talk to the midwife that I was working with. She explained to me that it was considered against medical advice since I had the Cesarean, but I think in the UK they are actually required, I might be wrong by that, to offer a home birth so I could continue to explore it even though it wasn’t necessarily encouraged. Around, I would say, 28 weeks, maybe 30 weeks, I told them that I was interested in planning that. I met with a consultant who was that same doctor who I think was basically trying to talk me out of the idea at 34 weeks. My husband came to that appointment and we both felt like, “No, let’s continue to move forward with the plan.” So one of the things that I think is really beautiful about the way that they do birth here in the UK is that while there’s no continuity of care necessarily in terms of seeing the same doctor and the same midwife every time I had an appointment, there is continuity of care in terms of if I had planned home birth and at any point, even if I decided– so if I woke up the morning that I went into labor and said, “No, I want to go to the hospital,” I could easily just go to the hospital. So I liked the idea of planning a home birth because it gave me the option of having a home birth and I could change my mind at any point versus if I hadn’t planned a home birth, I couldn’t wake up and decide, “I just want to have this baby at home today,” and have the support of the midwives if that makes sense. I wasn’t necessarily dead-set. Like I said, it was more my husband’s idea of having a home birth, but some of the things that did appeal to me about it was one, I knew that I would have some more flexibility of staying home longer with my toddler and if I felt like her being around me when I was in labor wasn’t scary for her or a distraction for me, then she could even stay. I heard a lot of beautiful stories of women having their babies in the middle of the night and then their toddler wakes up to a baby and never has to even go anywhere. So that appeals to me. And then also, I really wanted a VBAC. I was really set on the idea of a VBAC even though a Cesarean wasn’t a bad experience for me. It was just an experience that I wanted. From the research I had done, you were much more likely to be able to have a successful VBAC if you stayed at home. If you originally planned a home birth, even if you didn’t end up giving birth at home. I knew that it would help me to avoid that cascade of interventions earlier on so that was another reason why I wanted to plan the home birth. So yeah. I moved forward with the home birth even though it was against medical advice even though it felt– there were a lot of decisions that I made throughout this pregnancy that felt pretty gutsy for me because I’m pretty compliant, a rule follower, I don’t like to ruffle feathers. I kind of go with the flow so it felt courageous for me to be taking a stand against these different recommendations. Meagan: It feels off, right? Megan: It can especially toward the very end when providers– so I’ll just share two. It was against medical advice for the home birth because of the Cesarean and then also towards the end of the pregnancy, I started to have some growth scans actually because I was measuring big. My fundal height was measuring big so they sent me for a growth scan and then the baby was actually small. So the baby was measuring small for gestational age and I wasn’t actually concerned about the risk of uterine rupture for me. I just wasn’t. That just wasn’t a concern for me. I had this feeling, you never know for sure, but I just didn’t feel like that would happen. But once they started to tell me that my baby was small and I had a provider tell me that sometimes small babies are more fragile and have a hard time tolerating that was when I really started to question my decision because I can feel, I just turned 35. I had 34 years on this planet to build confidence in my body’s capabilities, but my baby is just brand new. Anyways, even at that, I had this feeling that my baby was fine and continued to move forward with the planned home birth because she was continuing to grow but also, it’s just this balance where you don’t want to be reckless and you don’t want to be overly confident. I at least wanted to be cautious and wise. I didn’t want to just be stubborn and like I said, reckless, but I also knew deep down that everything was fine and didn’t want to be scared into making a decision that didn’t fit for me. So yeah. It kind of went against my character a little bit and I’m glad that I planned things the way that I did. But yeah, it definitely did take digging deep in terms of that courage piece. Okay. So kind of starting with, I think I covered everything about the pregnancy that I wanted to share. It was really the baby being small for gestational age and then the Cesarean that were the two complicating things in the pregnancy. Madison: Quick question really quick. Megan: Sure, yeah, please. Madison: What was the percentage of growth restriction? Did they say?Megan: Yes, yes. So I had the first scan at 34 weeks and because of the position of the baby– so the sonographer did the measurements and I went back into the waiting room and came back and grabbed me and wanted to remeasure her head. She said because of her position, because she was head down, which was wonderful to hear, she couldn’t get a great measurement of the head. The head was measuring several weeks behind, so at that point, she was at the 3rd percentile which is when they start to consider it a growth restriction. They had me come back every two weeks and then from 36 weeks onward, she was hovering and maintaining right around the 10th percentile. It was the 8th percentile, 9th percentile, and then the last one was right at the 10th percentile so she was just barely considered small for gestational age. There is a difference between being growth restricted and being small for gestational age. She was continuing to grow, so when I talked to– because I did talk to the home birth midwife team about these different concerns and they said, “One, we are not concerned about your Cesarean scar at all. That doesn’t worry us.” And then two, they said that they don’t necessarily worry about baby’s size because ultrasounds can be pretty inaccurate unless the baby is not growing or there is because they also did a placenta doppler. I don’t know if they do this in the US because I didn’t have that experience when I was pregnant with my first. If there are any kind of concerns with blood flow to or from the placenta, then it wouldn’t make sense to have a home birth, but if the placenta looks fine and if the baby is growing on their own curve, they don’t worry so much about its size. Madison: Yes, totally. Megan: I actually did feel like having a smaller baby, in the end, set me up, I think, for more success with having a VBAC because she was smaller and she came out very cone headed which I was grateful for, so I think she did her part to make sure that she would be able to be born vaginally. But yeah. One provider did tell me that sometimes smaller babies can have a more difficult time tolerating labor and that was probably the one thing that I heard that made me feel most nervous about planning the home birth, but I knew if I at any point didn’t feel comfortable with it, I could go straight into the hospital. I was not dead set at all on staying home. Madison: Can I just say that I see that a lot, the difference between how midwives explain risk and how OBs explain risk? I feel like OBs sometimes try to pull on your heartstrings a little bit to get you to sway one way or another where it sounds like your midwives were like, “This is the reality and you get to make your own decision.” Megan: Yes. Yes, and I appreciated that. I felt very supported by the midwives, very supported. And if there is a risk, I want to know about it, but yeah. Exactly like you said, I felt like the midwives gave me the information and let me make a decision about it on my own whereas at least one of the doctors that I spoke to was pretty shaming and told me– so in the end, I did agree. I had this hunch throughout this whole pregnancy. I wanted a Fourth of July baby. My baby was born on July 3rd, but the baby was going to come on that specific weekend. So I initially did agree to an induction. They recommended induction at 39 weeks for small gestational age, so I kind of felt pressured honestly to schedule this induction at my last appointment and I knew that I would just reschedule it if I needed to. I did schedule an induction, I think it was for Friday, and then called to push it back just by a few days because I had this hunch that the baby was going to come that weekend. It was scheduled for Friday and I talked to a doctor about pushing, just a random doctor that I hadn’t met before because anyways that’s who had called me for the appointment, on Monday and he was very shaming. He told me I was putting my baby at serious risk and told me that the placenta was going to stop working. I got off the phone with him. I rescheduled the induction still for Monday, but got off the phone and cried and cried and cried, so I was definitely impacted by some of the things that were said to me, but I also trusted the decision that I was making and didn’t think that I was doing anything really risky by pushing the induction back by just a few days. Something that does bother me is that there’s a lot of conversation about the risks of not acting, but there’s not a lot of discussion about the risks of acting. And so in my mind, if small babies do have a hard time tolerating labor, then what’s it going to be like for her if I get induced? To me, that seems a lot more aggressive if I’m deciding when she’s going to come and maybe she’s not ready yet. Maybe she wants a little more time to grow and then also, just the different methods of induction can be more aggressive and more difficult for a baby. There was a lot of, like I said, information thrown at me on how it’s risky and not smart to not act, but no information about the risk of induction really was given to me, at least verbally. I was given some pamphlets that I could look through, but I think that’s a big piece that’s missing. I get that that’s from a place probably of providers protecting themselves from a liability perspective, but I just wish that I hadn’t been shamed because I spent a lot of during my pregnancy educating myself and I just really do feel for women who maybe haven’t done that and I did feel as confident as I could about the decisions that I was making. For someone else in a different position where maybe they hadn’t educated themselves or didn’t feel as confident in their decision or their knowledge, I think it would have been an even more vulnerable position and I just think it breaks my heart that doctors do talk to women in such a vulnerable time in their lives the way that I was spoken to. Meagan: Absolutely. Megan: So anyways, that was my biggest complaint towards the end of the pregnancy. Otherwise, I felt like I was empowered even from– so the consultant that I was working with throughout the pregnancy was the same provider, it just happened to be a random doctor that called me on this one day. And even he, I didn’t really like his style, but even he, I felt like, was like, “Okay. You’re going to do what you’re going to do and at the end of the day, we’re here to support you.” So I did appreciate that doctor for that fact. The recommendation is for induction at 39 weeks for babies that are small for gestation age, but by the time I had gone to the doctor for that final growth scan, I think I was one day shy of 39 weeks, so that doctor and I decided to schedule an induction for when I was 40+1 because I was already at 39 weeks and I was like, “My baby is growing fine. You want me to come in for an induction tomorrow? That doesn’t make any sense.” He agreed. “Let’s schedule it for 40+1. Let’s do a lot of” they call them stretch and sweeps here. I think maybe they are called membrane sweeps in the US. I don’t know if there’s a different term, but stretch and sweep. “Let’s do as many as possible between now and then and then have you come in at 40+1.” So I went in for my first stretch and sweep when I was 39+1 and the midwife told me, “You’re not dilated at all. We can’t even do a stretch and sweep.” She tried and it was actually really uncomfortable because my body wasn’t ready for it at all. I started bleeding right after that and I continued to bleed actually until my baby was born, so I just continued to kind of spot. Madison: Did hearing that you were not dilated at all, did that mess with your mental state at all, or did you know that this doesn’t necessarily mean anything?Megan: Both. It definitely messed with me and the cervical checks– my whole labor turned into this mental game for me and the cervical checks did not help at all. But I also did know that cervical checks aren’t a crystal ball and that it didn’t necessarily mean anything about how things would look in the future, but it still was discouraging. But yeah. I started spotting. I started cramping. I started having menstrual cramping throughout the weeks. That’s why going back and having the induction one week from them felt too rushed because I was like, “Look, my body isn’t even ready for a stretch and sweep.” He wanted me to have 2-3. “How am I going to fit these in?” It was really uncomfortable for me and the fact that I bled didn’t feel good for me either. So I was like, “I’m not going to schedule one for Monday. I don’t feel ready.” So I scheduled another one for the following week and that’s one of the reasons why I pushed the induction back to Monday to what I was 40+4 I think is what it was. Anyways, so yeah. I went back on Friday. Thursday night, when I was on my due date, I started to have contractions. I was cramping all week, but I started to have contractions that felt rhythmic. From 1:00 AM to 6:00 AM on Thursday, so I guess it was Friday morning, I was up having contractions every ten minutes that were lasting about a minute. They weren’t painful. They got my attention and they kept me up. I was awake through that whole time, but I just put a heating pad on my pack. It was kind of intense menstrual cramps, really. But they were rhythmic. I woke my husband up that morning and was like, “Look, we’re having our baby today. Are you ready to have a baby?” I was really excited and then they fizzled out. Basically, as soon I announced that the baby was coming that day they stopped completely. So I went back in, that was the day I had scheduled that second stretch and sweep. I went back in in the early afternoon for that and this is when it was even more discouraging. The midwife said, “In this last week that you’ve been having all this cramping and you’ve been having these consistent contractions last night, you’re still a 0. I still can’t even do a stretch and sweep for you.”The method of induction that I had talked to my consultant a bit about that I was the most comfortable with was the Foley bulb. I asked the midwife at the time because Friday was my original date of having the induction scheduled, I said, “Could you even place a Foley bulb right now with me not being dilated at all?” She said, “No. If you were to have come today, no. We wouldn’t have even been able to place a Foley bulb.”So that was kind of validating. It was discouraging to hear that but also validating of my decision not to have the induction scheduled for that day because I think I would have just had everything packed and then just turned around and gone back home because I don’t think I would have agreed to another method of induction at that point. Okay. So that was Friday. Still not dilated at all and I was confused because I had had all of these what I thought were these contractions. The midwife asked me, “Were you feeling the contractions mostly in your back?” I said, “Yes.” She said, “Because it looks like your baby is sunny-side up, so OP I think is what it is.” Posterior, anyways, faced the wrong way. That was really discouraging to hear because my first baby was breech and now it was just like, “What’s with me and these babies that aren’t in the right positions?” So it kind of sounded like I was having back labor and it wasn’t productive at all because my baby wasn’t in the right position. I went home and had a normal evening except for the fact that I was exhausted because I had been up for five hours the night before and hadn’t really slept since 1:00 AM.I told my husband and I knew that I was going to be having a baby in the next week, so I told my husband, “I need to go to sleep at 7:00 PM.” He put my toddler down for bed and I did. I went to sleep at 7:00 and woke up at midnight with, very similar to the night before, these contractions that weren’t super intense but were rhythmic and coming in a pattern. I had talked to– oh, I hired a doula. I hadn’t mentioned that, but I talked to her about the fact that the baby was in a bad position and she suggested some things to get her into the right position. One of the things that she suggested was curb walking. So this is going to make me sound like a crazy person, but when I had insomnia during the pregnancy, I live in a very safe neighborhood. I would sometimes get up in the middle of the night and go on walks. I had the urge to do that this night too, so at midnight, I got up and went and walked around my little village and did curb walking while listening to The VBAC Link. Actually, in hindsight, because my labor was so long, maybe wasn’t the wisest choice to be exercising essentially before this marathon that I was about to do, but I also don’t regret it because it was actually a really nice memory of just me alone. I was talking to God, talking to my baby, and telling my baby, “I’m ready for you to come.” I was listening to The VBAC Link like I said. My mom even called me because there is this time difference. I talked on the phone with her for a little bit and it was kind of sweet. I did a bunch of curb walking and got home at 2:00 AM and tried to go back to sleep. I laid back down and was still having the contractions rhythmically but similar to the night before where it was one every 10 minutes. And then, I heard a little pop sound which I would not have heard if it was during the day, but since it was at night and I happened to be awake, I heard a little pop sound. This was at 3:30 and then went to the bathroom. I couldn’t tell if I was peeing or if I was leaking fluid, but then went again and it was becoming more obvious that I was leaking fluid, but it was just a trickle. I was getting excited so I went downstairs. I’m not sure what I did for a half hour, but I did call the hospital and let them know, “I think my water broke.” And at this point, as soon as my water broke, I think I had this surge of adrenaline because my contractions were really intensified and I just kind of got into this state. But I did want to wait because the morning before, I had woken my husband up really early and told him, “We’re having a baby today.” I wanted to wait. I decided that 5:00 AM was a reasonable time to wake him up. I don’t know why, but that was morning because I had been up all night. Meagan: That was long enough. You waited long enough. Megan: I did. I waited an hour and a half. I called the midwife and they were going to come by to see if it was in fact my fluid. So yeah. I woke him up at 5:00 and then the midwife I think arrived at 5:30 and came to my home which I was so, so grateful that I had planned this home birth because I had midwives come to my home three different times. I would have at least for the first two times, at least the first time, at 5:30 in the morning, I would have had to go by myself. I don’t know what I would have done with just my toddler and my husband and how we would have worked that out, but having someone come to my home was really, really nice. I declined a cervical check at that time. She had offered one, but because my waters had broken and I know the risk of infection goes up ever so slightly once it has, so I didn’t know if there had been any progress, but at that time, she told me, “You’re clearly not in labor to where we would stay” so she left and said that she was ending her shift at 5:00 PM. She said, “Maybe I’ll see you before I end my work day.” I was like, “Maybe? Won’t you definitely? Aren’t I going to have this baby in the next few hours?” I was confused that she wasn’t sure if it would be her that would come back even though it was 12 hours from now. I did. I did feel like my contractions went from feeling noticeable to feeling uncomfortable and I was trying to do some things to keep them going because I knew that at this point, once your waters had broken, there is a little bit of this time clock that they want you to be on. And so I was trying to do things. I took a bath. I was trying to do things that were relaxing. I was doing things with my toddler that I thought would give me an oxytocin boost, trying to do things to keep things moving and I did. My contractions did continue. I asked my doula to come. I think she came around 12:30 in the afternoon. As soon as she arrived, I don’t think it had anything to do with her because she was wonderful and I felt supported by her, I think it was just something about maybe having someone new come into my home or something, I started to talk with her and my contractions slowed down. I was still having them but they weren’t as consistent, so things kind of did start to stall there and my daughter’s daycare provider, fortunately, ended up being available. So I had her come pick her up at 3:00 and my thought was, “As soon as my daughter is in good hands and I know she is being taken care of, then maybe my contractions will pick up and I’ll be able to settle into them.”But they didn’t really. They didn’t really start to intensify again until early evening and then I think it was at 7:00 PM. So now, we’re over 12 hours since my water had broken, maybe 17 hours. Somewhere around there. I had a midwife come back to check me and she checked me again. Actually, yeah. Anyways, I don’t know if I necessarily would have wanted to be checked, but what she said was– they had told me I had a birth pool that I needed to wait until a midwife was there to get into the pool, so I asked about getting into the pool because I was wanting other options for coping with the contractions. They said, “Well, we usually recommended checking you first because we don’t want it to stall you. We want to make sure you’re far enough along.” I don’t know. I think they just wanted to check on me to see if they needed to stay and that was kind of a reason for it. They checked me and I still was not dilated at all. I was so discouraged! I was like, “What is my body doing if this isn’t moving forward?” I was tired at this point and starting to feel more of that pressure of this 3:30 AM deadline that was starting to feel close to needing to go into the hospital. So she suggested that I rest and that I take Tylenol and try to rest. I did take Tylenol and I did try to rest, but the only position that I was comfortable in during the contractions was on my hands and knees, so this whole time, I would be talking with my doula, talking with my husband, and they would know that my contraction was coming because I would collapse on my hands and knees. This whole time, that’s what I was doing to cope with the contractions. Meagan: That’s making me think about the position.Megan: Yeah. Meagan: Asynclitic or something. Megan: Yeah. Yeah. I think that my body knew that that’s what I needed to do in order to get her into the right position, but it was the only way that I could cope with contractions. So I couldn’t sleep because every few minutes, the contractions were coming frequently at this point too. My doula, we decided to call the midwife back out because they wanted you to have three in 10 minutes that lasted a minute long each and I was having those, so I felt like it was a good time to have them come back. And then to hear that even though I was meeting that threshold of calling them back out, I still wasn’t dilated at all was really, really discouraging. But that midwife said, “Feel free. Try to get some rest. Feel free to go into your pool and call us back if things change. Otherwise, go into the hospital at 3:30 AM.” So I tried to rest, wasn’t able to rest. But I did get into the pool. I think I tried to rest from 9:00 PM to 11:00. I think I ended up getting into the pool at 11 and was in the pool for 3 hours. This is the part of my birth story that feels kind of dark. I was really loud. As soon as my water broke, I started vocalizing through all of the contractions. That’s just what my body wanted to do. By the time I got into the pool, I was thrashing around in the pool making crazy animal noises and I felt like a killer whale in this pool. I was alone because the doula and my husband were there, but I was in the pool by myself and I was in a lot of discomforts. I was just really discouraged. I think before I even got into the pool when I was with my husband and I went into the bed to try to rest, I told my husband, “Look. I think I just need to go to the hospital and tell them that I want another Cesarean not because I want another Cesarean and not because I am in so much discomfort that I can’t tolerate this anymore, but because my body’s not making any progress right now. I don’t know what it’s doing. I don’t think that it’s going to make any progress. I have never had this experience before of it working, so maybe my body just doesn’t work. I don’t want to continue this and exhaust myself even further just to have surgery, just to need to take care of a newborn. I don’t think I can do all of that. So why don’t we just go in for a Cesarean–” Madison: That’s a lot to be processing while you’re in labor. How long had it been at this point? How many hours from when you first noticed a contraction? Megan: It was about the 24-hour mark. Madison: Okay. Megan: And I think that if there is something about me, I think labors are just long and that can be normal and I was really grateful for my doula. That’s the biggest way that she supported me is telling me that this is normal because it did not feel normal to me at all. But I think yes. This is what I was going to say. I think that if there is something about me that isn’t so well-lined up with the birthing process, it’s that I kind of do overthink and I think I had a really hard time getting out of my thinking brain and just letting my body do what it needed to do. I was. These were all of the thoughts that were racing. Especially, I think it all started with that 24-hour deadline because they had even scheduled the induction at the 24-hour mark. I felt this time pressure from the very beginning and I think being in my head in that way was not helpful for my progression. So if there is something about me that made the process more difficult, I think it’s that. But yeah. I was definitely really discouraged before getting in the pool and then being in the pool, while it did feel good to be weightless, it did just feel like a darker– and it was the middle of the night– time when my birth felt the darkest. Getting closer to 3:30 AM, they had scheduled me for an induction. My doula, I think this was at 3:00 AM, suggested that I call the midwives because she could tell that things had intensified for me while I was in the pool. But I called the midwives yet again another time and asked them to come out to my home again and check me again to see if I had made any progress maybe they could stay and I could avoid having to go into the hospital because she knew that my preference was to be able to stay at home. The midwives came back out and the same midwife that had checked me at 7:00 PM or whatever time it was checked me again and said that I still was not dilated at all and that I looked the same as I had looked before. I was so, so, so discouraged. At that point, I kind of wanted, honestly, to go to the hospital because I wanted some support. I wanted some extra support with pain and I knew that I needed to rest. Yeah. I was at my limit. So we did. We got some things ready and headed to the hospital. I think we got there at 5:30 AM. Everybody talks about the car ride being horrible. The car ride was horrible. It really was because I was only comfortable on my hands and knees and I couldn’t be on my hands and knees. I did have a TENS machine that I used throughout those first 27 hours before I went to the hospital and that was actually really helpful. I recommend a TENS machine to anyone. That really helped me cope for those first 27 hours. So we got to the hospital and actually getting to the hospital felt like a big relief because we just had extra support. At that point, I had been up since midnight, my husband had been up since 5:00 AM. The doula, I think, had got up pretty early as well but came over to my home at 12:30-1:00 PM, so we had all been up and at it for a while. But getting to the hospital and having some fresh, energized people supported us. It turns out that we actually were the only people there which is really unusual because usually, the hospitals are pretty overloaded, but it happened to be a night when I was the only patient there. All the midwives brought a special energy to them which I think is because they weren’t taking care of anyone else and they were truly energized and fresh. So that felt good. They had the room set up for me with some pretty lighting. The town I live in in England is known for having a pretty cathedral and it had a view of the cathedral. I felt really welcomed and supported upon arrival at the hospital. I was never against the idea of going to the hospital, but it felt like a turning point in the labor arriving there and having such a sweet welcome. So I got there and they talked to me about some different options for some pain relief. They offered me an injection of diamorphine which they said could cause some problems for the baby. It could make them a little sleepy so they don’t recommend it if you’re about to give birth, but it can be great for these earlier stages of labor when you’re not dilated. And then the doctor that was there came in who was wonderful. She suggested that I get on IV antibiotics. I wasn’t hugely concerned. In fact, The VBAC Link episode that I was listening to right before my water broke actually was an interview with Dr. Stu and he had mentioned that the risk of infection only goes from .5% to 1% once your water is broken, so I didn’t think there was a huge risk of infection, but at this point at the 24-hour mark, I was happy to go into the hospital because I didn’t feel like I was coping well with labor and I just needed more support with pain management and to rest. But also, I was like, “Okay. I’m already against medical advice because of the Cesarean. I’m already against medical advice for home birth for this home birth.” I really didn’t want there to be this third risk factor that I was fighting up against. I was happy to go into the hospital at this point even though I wasn’t really concerned about the increased risk of infection at the 24-hour mark. I felt like it was this artificial timeline, but again, didn’t want to be pushing back against a third reason to not have a home birth. So she suggested IV antibiotics which I agreed to and then suggested that I be started on Pitocin so the Foley bulb, I guess, wasn’t an option anymore because my water had broken is what she said. She also suggested another cervical check which I didn’t really want, but she said it could be helpful for her to take a look at my waters and make sure that they are fully broken because I guess sometimes if they are not fully broken, then there can be a cushion of the water bag that maybe prevents there being that full pressure against the cervix which can prevent dilation. She did. She said there was a little bit of fluid in between my baby’s head and my cervix. She broke that. They started me on IV antibiotics. I did get this diamorphine injection and was able to rest. I was started on Pitocin. I was able to rest. The diamorphine that they gave me did really allow me to rest in between contractions. I could still feel them and then they started the Pitocin at 8:30 AM. I think around a few hours into that, the medication started to wear off. The injection that I got was only supposed to last about 4 hours and the Pitocin really started to intensify my contractions. They were just on top of each other, so before I had been getting a break in between them, but these were back to back which was kind of the point– and I did ask them to do the Pitocin slow and to tell me before they increased the dose. Those were my requests because I know that they can sometimes up the Pitocin maybe without telling you once you have the IV placed and then also they can maybe increase the dose pretty quickly. They did give me a smaller amount and increased it slowly, but I could feel the contractions intensify where I eventually asked, I think around 11:00 AM, to turn it back down because I wasn’t coping well with the pain from the Pitocin especially with having such a long labor already. At that point, the midwife was like, “Look, this is going to work or this isn’t going to work. We really need to give the Pitocin an opportunity to work,” so she wanted me to keep the higher dose of Pitocin. I said, “Okay, but I need more pain relief,” so I did get the epidural which was kind of hard for me because I didn’t originally want that and also really because in my mind, any intervention that I did decrease my ability to have a VBAC. But also, in my mind, I still wasn’t dilated at all and so I’m like, “Look, I’m needing an epidural when I still haven’t dilated at all.” I just felt a little bit pathetic about that. But I did. I got the epidural and that worked really well. I didn’t have any pain hardly at all. I could hardly even feel those contractions and then at the 6-hour mark from when they had started the Pitocin. They started it at 8:30. They checked me again at 2:30 and I should say, an hour before this, I started to feel a lot of pressure on my behind. I just started to feel a lot, a lot of pressure. I told the midwife that and she said that it was a good sign. When she checked me at 2:30 PM, she said, “The baby’s head is right there.” That was just the sweetest moment for me. I felt so much relief. Meagan: After all of it too, it’s like, “Yes.”Megan: I was in disbelief in all of the right ways. I was just so, so, so happy and so relieved. It was not what I was expecting to hear. Honestly, I was kind of expecting to hear the same thing I had heard so far like, “Oh, still not dilated at all.” I knew at that point that the recommendation would be for a Cesarean, so I was really, really happy. I was overjoyed. What they suggested was that we wait an hour from then. They give you an hour to relax and rest and then you start pushing. That hour was the sweetest time in my whole labor experience because my husband and I talked about what position I wanted to push in. My husband and I finally decided. We had the hardest time naming this baby and decided on a name for our baby. I was just overjoyed. So yeah. Then an hour came and it was time to push. I decided that I wanted to push in a squatting position because the hands and knees position, even though that was the position I wanted to be in the whole time, felt a little bit vulnerable for me. With all of these people behind me, I wanted to see what was going on so I wanted to be facing forward and I wanted to be squatting. The pushing phase didn’t– so I did have the epidural although I had a really low dose. You can do clicks of it and I had done the first two clicks but hadn’t done it in a while, so I was able to feel the pushing, but it didn’t feel painful for me. It could have been because of the anesthesia. It could be because I am someone who actually felt relief because I know that’s the case for some women, but they started to– this was the frustrating part. One of the frustrating things about being in the hospital was that they had these CTG monitors here. It’s like the non-stress test bands on your tummy that they wanted me to have the whole time. But because I was on my hands and knees throughout the birth, they kept shifting around, and then they’d be concerned about losing the tracing on the baby. Anyways, so when I was pushing in the squatting position, I was leaning forward and the monitor shifted. So while I was pushing, they started to have some concerns about the baby’s heartbeat even though I think it was just that it shifted and it started to pick up my heartbeat instead because after the baby was born, that’s what they told me may have happened. But there was this drama around the pushing phase of, “We need to get this baby out right now.” They were suggesting episiotomy. They were suggesting forceps and it just felt like this huge sense of urgency. They called the doctor in and all of these people were rushing in. I wasn’t super concerned about my baby’s well-being at that moment, but I also was like, “I know that I need to get this baby out.” So I did. I pushed her out in 20 minutes I think it was. She came pretty quickly and that was exhausting after everything I had been doing. I was so grateful that I had the rest that I had both from the pain relief that was injected and also from the epidural because even though there are parts of you that don’t like the fact that I needed the pain relief, I think in the end, I needed that rest in order to be able to effectively push her out as quickly as I was able to because it was such hard physical work to push her out. I felt like I needed to do it really quickly. But yeah. She came. She was born at 4:14 PM. She came out. She was 6.5 pounds. A little, super skinny thing and she’s the sweetest baby. She’s the very, very sweetest baby. I felt so grateful to be able to have a VBAC and so much relief that she was okay after everything. The doctor who came into the room when they called him in I think also knew that the monitoring was just kind of funky because he told me at the moment, even before he got fully involved, that my baby was fine and winked at me and gave my husband a thumbs up. I was just grateful for him even within some of the panic of the pushing phase and of really the whole pregnancy and the whole birthing experience, I was grateful for the calm and the peace that I did experience throughout it all. And yeah. She was perfectly healthy. They, I guess, test the blood of the placenta to make sure that she wasn’t oxygen deprived more than they would expect a baby to be and she wasn’t, so they didn’t have any concerns with her after she was born. They didn’t have any concerns about infection. The cord was wrapped around her neck multiple times and her whole body. I had the longest cord the midwife had ever seen and she said she had been practicing for a while, but I wouldn’t have even known had they not told me. She was absolutely fine.The midwife gave me a tour of the placenta. I told them that I was interested in seeing the placenta and she was like, “Oh, that’s my favorite,” and gave me a whole tour of it. She showed me everything and was really enthusiastic about it. They brought me toast and tea for me and my doula and my husband afterward which is a cultural thing here to have and that was also a really sweet moment. I tried to get the baby to latch right away. She just was with me the whole time. We didn’t have to be separated at all. And yeah. It was a good experience in the end. There are some things looking back that maybe I would have liked to do differently or I might do differently next time, but in the end, I was processing some of this with my husband last week in preparation for knowing that I had this interview and my husband was like, “But look, we got what we wanted,” and that’s true. Even if maybe, I needed more pain relief that I wanted or there are different things that were a little bit more chaotic or dramatic in the end, we got what we wanted and there are more things about my birth experience that I’m happy with than maybe parts of it that I wish maybe were a little bit different. So in the end, it was good. Meagan: I love it. Sometimes those ends when it’s like, “I’ve got to do this right now,” it can be really intense. Really intense, but I think it’s pretty incredible how we are just capable of dialing in 150,000% and just getting the job done. Megan: I felt like my eyes were going to come out of their sockets, I was pushing so hard. Meagan: You were pushing so hard. Megan: I really didn’t want an episiotomy or the forceps so that was also a motivator for me. Because I wasn’t actually that concerned about my baby. There was this peace that kind of transcended the whole experience, a peace that was incongruent with what was going on in the room that almost felt like, “Okay, I’ll get this baby out as quickly as possible to keep you all happy, but my baby’s fine and I’m fine.” And then to have the doctor come into the room and kind of reflect back to me what I was already experiencing that my baby’s fine, I’m fine and everything is going to be fine. But providers see things. They see bad outcomes probably more often than they would like to, so they are geared up, especially in a hospital setting for being prepared for something going south. So I don’t necessarily fault them for that. Meagan: Yeah. For sure. Awesome. Awesome. Well, huge congrats. Love on that little one. Thank you for sharing and taking the time today to be with us. Madison, is there anything that you wanted to share today as well? I want to make sure we hear your voice before we end. Madison: Yeah. I just wanted to say, Megan, the difference in your birth stories and how you really emphasized that you made sure that you got educated the second time around, I’m a birth educator at a birth center here in the area and that’s my whole thing. Education is the way that you can, first off, minimize birth trauma and second, have your best chance at not only a vaginal birth but a positive birth experience. Education is so, so important so I’m just really happy that you did that for yourself. An amazing birth story. I’m so proud of you as a doula. Megan: Thank you, yeah. The education piece is so important. I don’t think you can educate yourself enough. I really don’t because I had educated myself and there were still a lot of things that came up. I wasn’t expecting my waters to break before. There were still things that come up that you might not know a ton about. I think it’s also okay to ask for education at the moment which I didn’t do enough of but to ask for the information if you’re in a state to do so at the moment because you can’t educate yourself enough and there are going to be things that will come up that maybe you don’t know everything about. Information is power. Madison: Yes. Hiring a well-educated doula is a great way to be able to get that information at the moment too if you are not comfortable asking questions to your provider at the moment. Megan: Yes. I agree. I’m very grateful for my doula.Meagan: Awesome. Well, thank you ladies for being with us today. It was such a pleasure. Megan: Thank you. Madison: Thank you, Meagan. 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