Episode 253 Sarah's VBAC with a Family Doctor

Today on the podcast, Sarah joins us from Minnesota. Sarah got COVID-19 very early on in her first pregnancy during the height of the pandemic. The protocol at her practice was to recommend a precautionary 39-week induction. Sarah trusted her doctor and consented to the induction along with other interventions that were suggested. Her birth ended in a Cesarean under general anesthesia. During recovery, Sarah’s knees would buckle to the point where she needed assistance walking and fell until the problem slowly resolved. When she achieved her VBAC, Sarah was able to immediately walk unassisted. She wasn’t groggy from just having had anesthesia. Her throat didn’t hurt. She got the immediate skin-to-skin she missed the first time.Sarah is such an amazing example of how powerful a VBAC birth can be, especially with the right prep and the right team. We just love how hands-off and supportive her doctor was. Sarah went into her birth mentally and physically strong. She labored hard, stayed calm, and pushed her baby boy out in 20 minutes!Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsMeagan: Welcome to The VBAC Link. We have a story for you today coming from Minnesota. We have our friend, Sarah. And Sarah, tell me. Did you have your babies both in Minnesota or have you moved since then? Sarah: Yes, both in Minnesota. Meagan: Both in Minnesota. All right, so Minnesota parents, listen up. This is a wonderful episode in your area. Review of the WeekAs always, we have a Review of the week but first I want to talk a little bit about COVID-19. Sarah and I were just talking about how we have seen so many COVID-19 stories coming through. They had their C-section through COVID-19 or even had their VBAC during COVID-19 and then now they have gone on to VBAC. There is definitely a trend of situations that we are seeing so I’m just so curious today. Go comment on today’s episode and let us know if you have any relation, but a lot of providers are wanting to induce if you have the virus, COVID-19. Sarah, that was kind of the case with you, right? They wanted to induce because you had COVID-19. Sarah: Yes. That was kind of the standard of care at that point. Meagan: Yes, which is kind of interesting to think about the new standard of care. I really am curious to see one day what the Cesarean rates did during COVID-19. You know, there is some evidence here and there on it, but I’m really curious to see what the Cesarean rate did because we do have a lot of people saying that they were induced because they had COVID and then they ended in a Cesarean. So we’re going to talk a little bit. She’s going to share her birth and her induction story that then led to her VBAC. But of course, we have that review. It is by Raving Abbeh and the title is “Confidence.” It says, “I found this podcast at 34 weeks pregnant and it helped me gain the confidence to fight for my chance and get a VBAC. I hope to submit a success story in a few weeks.” And guess what? This was also during 2020, so Raving Abbeh, if you haven’t submitted your story, we would love you to and as always, you guys, we’re always accepting stories. We definitely record in chunks, so know that if it takes time, that doesn’t mean you haven’t been chosen or you will never be chosen, but if you want to submit your story, go to thevbaclink.com/share. Sarah’s StoriesMeagan: Okay, Sarah. Welcome to the show. Sarah: I’m so excited. Meagan: I’m so excited. I’m so, so excited. Well, tell us more about this 39-week induction and why they were saying it was the new norm. It was the protocol, right? Sarah: Yes. So at this time, I was working full-time in the hospital where I gave birth as a radiographer– an X-ray tech. I was kind of in the world a little bit. It was definitely not a fun time to work in the hospital. I actually tested positive when I was 8 weeks pregnant, so very newly pregnant. I was seeing family med for my provider and what they were doing at that time, they said, “Okay. This is what’s going to be different. You’re going to meet with a high-risk OB who specialized in COVID.” I would have growth ultrasounds every 4 weeks and then also, they were recommending this induction at 39 weeks. When I asked about that, what she said was that they had seen issues with the placenta. That was the reason that they had. I actually looked back on it now and I think in the study, they really only had 16 pregnant people so that was what they were basing this all off on. Meagan: Which is really nothing to start making a protocol so wide-ranged. Sarah: Right. Right. And actually, right now, my sister-in-law had COVID and she’s pregnant. She had COVID at the same time I did at 8 weeks, but now it’s 2023 and her doctor is not doing the growth ultrasounds. They’re not recommending induction. There actually is nothing different with her current, right-now pregnancy which I find interesting. Meagan: Interesting, right? Right? Sarah: But again, it can range. Meagan: In 2020, it’s interesting because they were like, “Oh, we’re going to have you with this provider who specializes in COVID pregnancies,” but how does someone specialize that fast? Sarah: Right. The person that was the specialized person was the highest-up person in the department of OB. Meagan: Okay, so definitely a specialized OB. Okay. Sarah: Right. I actually only ended up meeting up with her one time because if there was anything abnormal, that’s when I would go to her but my pregnancy was completely normal. I had no issues related to COVID or related to anything else which was obviously a blessing, but kind of also a bummer because now, I’m going to have this completely unnecessary induction at 39 weeks.Meagan: Yeah. Sarah: She did mention at the time that if I wanted to go past 39 weeks, I could definitely make that choice but she would do NSTs. Now after learning so much and being where I am now, I would have been like, “Okay. Let’s go longer and do NSTs,” but at the time as a first-time parent, I was like, “That sounds kind of weird. Let’s just do what you think.” Meagan: It sounds intense with all of these extra visits. It’s a lot. It sounds like a lot. Sarah: Yeah. Otherwise, about that pregnancy, being a first-time parent and having this medical background, it’s no surprise probably that my attitudes towards the doctors were that I completely trusted their knowledge with the COVID stuff because it was so new. Meagan: Oh yeah, and scary. Sarah: Yeah, definitely, but I was completely unaware that there was such a wide range of ways to treat pregnancies and so many different attitudes on how to birth babies. I was just clueless to the whole thing about the cascade of interventions and why do inductions have an increased risk of C-section? I was completely clueless to it. I am just used to with a doctor, you have a certain condition and there are ways to treat it. It was very narrow. But with birth, there are midwives. There are doulas. There are so many different ways to treat someone’s birth and pregnancy that was just over my head. When people would ask me, “Oh, why are you having an induction?” and tell me that maybe I shouldn’t do that, I was like, “Oh, well why wouldn’t I when they say that is the best thing to do for this COVID situation?” For me, it was like, “Well, they know better than me.” Meagan: Right, yeah. Sarah: I think you say all the time that you don’t know what you don’t know. Meagan: You don’t know what you don’t know and you can’t judge yourself for not knowing what you don’t know. Sarah: Yes. I definitely had to work through forgiving myself for sure. Meagan: Yeah. You have to take the information. I think I talked about this too. My husband had said this. We took the information we were given and made the best choice that we felt we had with the information provided. Sarah:  Yes. Meagan: Right? And that’s what you did. Sarah: Right. Honestly, it’s funny now. Even just preparing for birth in general, take away the COVID part, it’s kind of funny how I did basically nothing to prepare for birth. I just focused on my registry and other things like that after the baby got there. It was kind of because I had this, “Oh if I go with the flow, I’ll have the best outcome. I don’t want to put too many expectations on myself. I don’t want to pressure myself. I’m just going to go with the flow. I don’t know how my body is going to handle it,” which does have a place. There is a goodness to that, but I think I was a little too extreme where I was like, “My mom had C-sections. I know if that happens, it happens.” It was just very, “Whatever happens, happens.” Now, I look back and I’m like, “Well, now all I did was have no tools in my toolbox to deal with pain, labor, or resources to help make those hard decisions that I was going to have to make.” I had nothing in the background to help me with that. Meagan: No tools in your toolbox. Sarah: Exactly. That’s why it was very different for my second birth but at that time, I was like, “Okay, whatever happens, happens. I don’t know what’s going to happen to me or how my body is going to take it, so we’ll just see what happens.” I was scheduled at 39 weeks on a Monday and actually, that Friday before, they called me and said, “Hey, do you want to come in early? We have a lot of people scheduled on Monday.” I was like, “Oh, I’m excited to meet my baby. I’ll go in even earlier,” which is like, oh. Okay. That weekend, we were actually moving into our new house an hour away. Meagan: Oh my gosh. Sarah: We actually spent one night at our new house and the next day we drove back to Rochester to have our baby but we were so excited. Meagan: Yeah. Absolutely. Sarah: I wasn’t even thinking about anything else. We were scheduled for a 7:00 PM Saturday appointment then. When I got there, I was completely 0% dilated. Closed. 0, 0, 0, -3 station. Furthest from ready. Meagan: Not ready to have a baby, yeah. Sarah: No. So they started me with Cytotec overnight and in the morning, they placed the Cook catheter then they started Pitocin right after. I faintly remember watching Beauty and the Beast bouncing on a ball, but that was the extent of any movement in my labor. Like I said, I didn’t prepare for anything. I just was like, “Oh, bounce on a ball. Everyone says that’s good.” I didn’t do much. But what did start happening was the baby was having decels, not liking the Pitocin, so I had to get moved from side to side. I was lying on the bed– not the best position to have the baby not be so high up. Meagan: Right. Sarah: But then by 10:00 AM, they took out the Cook catheter. I was 4 centimeters dilated. Things were moving along. But then at 11:00, they had to turn down the Pitocin because again, the baby was still not tolerating it very well. Then I felt a big pop in my belly and I was like, “Oh, is this what it feels like when your water breaks?” I was excited. I’m like, “Oh, that sounded like a balloon popping.” So they came in and they were like, “No, we don’t see anything. Your water didn’t break.” I was like, “Oh, okay sure.” Meagan: I felt something. Sarah: So then a half hour later, they came back in because they had to actually turn off the Pitocin because the baby still wasn’t happy. They checked me and they’re like, “Oh, there’s all your water,” and it gushed out on them. So I was like, “Okay, well at least I know that I can trust my intuition even though you didn’t quite believe me.” Meagan: Yes. Sarah: But I’m not crazy. It did break. The contractions were getting really intense at this point. I tried laughing gas. It didn’t really work. At that point, I decided, “Okay. I’m ready for an epidural. I feel like I’ve gotten as far as I can with what I prepared,” which was nothing. I actually found out this after the fact, but at this point, they actually gave me medicine to stop my contractions. Meagan: Like terbutaline or something?Sarah: Yes, exactly. They gave me that at this point. I actually have no recollection of this, but I was able to look at my records after the fact and I was like, “Oh, I never knew they even gave me that.” Apparently, they gave me that to stop things or slow them down or whatever. I was about 5 centimeters dilated at this point and they placed the epidural. Everything went smoothly with that and then an hour later, they were like, “Oh, we’re going to start the Pitocin again.” I was like, “Okay.” I was 5 centimeters at that point and then 40 minutes later, they checked me and I was 9 centimeters. Meagan: Whoa, so your body went into total relaxation mode and dilated. Sarah: Yes. Yes. I was like, “Cool. That was fast.” They had just sent away the doctor. They had to call her back. Shortly after that, I was at 10 centimeters, ready to go. This is when they had me start pushing. One important part that I know now is that I don’t remember ever feeling pressure or the urge to push or anything like that. They were just like, “Okay. It’s time to push.” I’m like, “Okay.”I did end up pushing for about 3 hours. They did let me try a few different positions. They tried to turn down my epidural to help too, but she never really progressed past that zero station. So nothing was happening. I was mostly on my back for all of it.I remember them saying that they would let me push for the most at 4 hours, but at the 3-hour mark, I was exhausted. I felt like we had made no progress. I was just like, “Nothing’s going to change in another hour at this point for me. I don’t know what I’m doing. You try to tell me how to push. I still don’t know.” Meagan: Yeah. You’re just like, “I’m tired.” Sarah: Exactly. The contractions were beginning to be really painful. Again, I didn’t really have a way to cope with them. The pushing wasn’t working so I consented to the C-section. I just remember feeling so defeated and just crying, being wheeled into the OR. My doctor stayed right by my head and talked to me until my husband was supposed to come in because I kept saying, “Hey, I feel these contractions. They are strong.” They were trying to give me all of the medicine to numb me enough. They were doing the prick test to make sure that I couldn’t feel it and I just remember it was really hard because my nose was plugged up from crying. I felt like I couldn’t breathe anyway. I wasn’t sure about the pokes. I was like, “They are sharp to me. I feel them. They don’t feel like pressure. They feel sharp.” They were like, “Okay. Well, we’re going to have to put you under.” They put the mask on me. I breathed in and went to sleep. Meagan: And you were gone. Sarah: Yep. Then I was gone. Meagan: Your husband probably never came in then? Sarah: So he did get to go into the OR. She was born. They let him go in so he was all gowned up. He was in the OR. He kind of tells it like, “Yeah, it was so weird. I looked over and there you were on the table.” He wasn’t so close to me. Meagan: Sleeping. Sarah: But yeah. I was sleeping. He did get to do skin-to-skin. They let him do that in the OR which was really nice. They got a bunch of pictures of her getting weighed and him cutting the cord in there so it was nice to have some of those pictures that I can look back on. Meagan: Right. Sarah: That’s something. Meagan: Right, yeah. It helps you relate, too, when you’re not awake. Sarah: Exactly. It was definitely a weird experience. But when I did come to, apparently, I had been awake longer but you know how that works. When you’re waking up from anesthesia, it’s kind of weird. But apparently, when I woke up, they told me that I was just like, “Where’s the baby? Where’s the baby? Where’s the baby?” They rushed me back. I don’t remember any of that, but what I do remember is when I woke up, my throat was so sore and hurt so bad. But she was on me and she latched immediately and started feeding so that was really special. Meagan: Yes. Sarah: Just how she was able to eat right away and I didn’t have any problems with that which was really nice. I know that can happen sometimes. That’s basically that birth. Meagan: An unexpected ending and a less-ideal situation, but then to come out and have things work out really nicely was probably really healing and comforting. Sarah: Yes. Right away, I was definitely happy. She was healthy. I was okay. She was eating. But I remember just recovering from a C-section, you’re in a fog. I remember my legs being in those machines to keep the blood flowing, having a catheter, having my sore throat, and whispering to talk. That kind of thing was definitely not a fun recovery in that aspect right immediately after. Meagan: Yeah. Sarah: I actually had a really weird thing. I had problems with my knees. Meagan: Oh. Sarah: I have never heard anyone else talk about this. Meagan: Interesting, like wobbly and strong? Sarah: So what happened was once they took out the catheter and then they give you the, “Okay, it’s time to try to go to the bathroom for the first time.” When I tried to stand up, my knees would just buckle. The first day, I had to have two people assist me to the bathroom. The second day, it was also a two-assist. Slowly, they started to not always buckle. I was in the hospital, I think, for four days. Four or five days. Eventually, they wouldn’t buckle but when I got home, they would buckle when I went upstairs. I did fall twice but slowly, they did get better. It was fine. It was just if I unexpectedly took a step. My cat scared me and I stepped and then I would fall because my knee wasn’t expecting it. Meagan: I just looked it up because I am legitimately curious. It says, “Acute lower limb compartment syndrome after a Cesarean.” Sarah: Oh. Hmm. Meagan: Interesting. So it can happen. Sarah: Interesting. I was just kind of assuming it was a mix of me being numbed from the waist down for hours and then my legs being up in the air for hours and then being in the C-section, and then also laying down. Do you know what I mean? Something with that, but no doctor or anything ever said anything to me about it. They were just like, “Oh, okay. That’s weird.” Meagan: Yeah. Really, really interesting. It says that it’s rare. Sarah: Oh. Meagan: It’s pretty rare, so you get to be in one of those rare groups. Thank you for sharing. Sarah: Yeah, so otherwise, I hadn’t really fully processed the birth but every time I would tell my birth story, I would choke up or cry and that’s when I realized, “Oh, maybe I didn’t really like that very much” because at first, you’re just happy the baby is okay and you’re okay. I actually remember right afterward, I was like, “Oh, okay for any other baby, I’ll just schedule a C-section. This time it will be planned and I’m going to be awake for it.” I honestly wasn’t even thinking about VBAC right away. I was just like, “Oh, the future will be easier. It will be fine.” But when my daughter was around 6 months old, I started to listen to The Birth Hour and I found myself searching C-section stories, looking for things like mine which led me to hearing VBAC stories, searching those out, and then finally finding The VBAC Link. That was the big game changer. I am so appreciative of you guys having this podcast and keeping it going on and all that. Meagan: Absolutely. Sarah: Such an inspiration. I learned so much even from both podcasts about interventions, doulas, birth teams, and most importantly, trusting in a woman’s body. It kind of leads me to this big thing. It’s like, why do we have to go through some sort of trauma to become an advocate for women and educate ourselves? Meagan: Right? Sarah: I feel like that’s such a theme. Meagan: It’s so true though. It’s so true. Why do we have to go through a really crappy experience? It doesn’t always have to be crappy. I’m not saying C-sections are crappy, but a big experience to have passion and to feel that motivation behind that.Sarah: Exactly. Yep. Sometimes, it’s so hard because it’s like when you talk to someone who hasn’t been affected by this kind of situation where it doesn’t go their way in the hospital, it sounds like a conspiracy theory. “You can’t trust the doctors.” That’s not what we’re saying. It’s so much more than that. Meagan: It is. It really is. It’s not even just in birth. Truly, right? My husband does not do what he does, I think, mainly just because he didn’t want to do it one day. It was like, “Hey, this really unfortunate situation happened to someone I love and I want to be available in a different manner to help them or help anybody else.” So he took on his profession. It’s like IBCLCs– I’m sure a lot of them have had unfortunate or poor nursing experiences and are like, “We want to help other people have better experiences.”Sarah: Yes, because it’s the information that, “Oh, wow.” It makes complete sense that, “Oh, things might go a little bit better if you let your body naturally do it.” Oh, well yeah. That makes sense. It makes sense that, “Oh, if I have someone who’s trained in positioning, maybe if I move my body in this way, then I can get my baby in a better position to come out better. Oh, that makes sense. Why didn’t I know that? Why didn’t my doctor say, ‘Hey, there are some positions that can help.’” It’s confusing to me. It’s like, well that makes sense. Meagan: Yeah. Sarah: Yeah. So obviously, I just dove right into all of the VBAC stuff and learning all about that and listening to different stories. I was super excited for my next pregnancy because I had made the decision, “Yes. I’m going to go for a VBAC and I’m super excited about it.” I was ready to do all of the things to make it more successful. We got pregnant when my daughter was around 15 months old. We wanted a two-year age gap and they’re both two years apart in April so that worked out for us. Meagan: Perfectly, yeah. Sarah: So the things I did to make it more successful– they are all things that people on this podcast talk about. For physical things, it was workouts that focused on birth prep. I didn’t do anything crazy like walking for miles and miles every day. I just did the minimal which was doing some exercises every day for hips opening, cat/cow, and all of that stuff. I did the Miles Circuit later on in pregnancy every day. I ate my dates every day. I drank my tea.Then I think the biggest thing, too, is mentally preparing. For mentally preparing, I got my doula. I really love that the doula does the meetings before the birth. I didn’t even know that when I had heard people talk about doulas but meeting before and talking about what birth plan I wanted, what things– Meagan: Your desires. Sarah: Exactly and what things could happen. I’m like, “This would be so helpful for a first-time parent to know all of this stuff.” I wish I had gotten her with my first. Also, just talking about coping mechanisms, what are some positions that we are going to do, talk about scenarios. It was great. Then I also, for mentally preparing, I looked up a bunch of different coping mechanisms. I actually did Hypnobabies. I wasn’t consistent with the meditation, but it was very helpful to practice the breathing and visualization. Meagan: I did too. I did it as well. Sarah: I was really bad at the meditations so that didn’t stick with me, but it was really, really great to practice the breathing and all of that. And honestly, just listening to birth stories is mentally preparing because I would really only focus on positive stories toward the end of my pregnancy. I was like, “Okay, now we are in the home stretch. We are just going to stick to all of the positive ones.” The big thing, too, was finding my provider. I joined The VBAC Cesarean Support Group on Facebook way earlier and everyone had all of the recommendations of who to go to. My provider is actually family med, but he is more like a midwife. Actually, my doula said that he’s actually more crunchy than a midwife as a family med. For all of the births that she attended, she said, “He is more hands-off than a midwife.” I’m like, “Wow.” Meagan: Wow, that’s cool. Sarah: And what’s great is that he attends all of his births so there is no rotating call schedule. Meagan: Which is huge. Sarah: There’s no, “Who’s going to be there?” He’s very trusting of women’s bodies. I did my due diligence and I asked him, “How often have you personally seen a uterine rupture? How often do you use the vacuum? How often have you done episiotomies?” You know, so just asking him all of the things. He had really great responses and I felt really solid with him. Meagan: Which is really important, right? To have those conversations also. We know that when they come in and they say, “Hey, do you have any questions?” It’s really okay to ask questions. Sarah: Yes. That’s the big thing. So because he’s not an OB, I had to go do a consult with the OB that he works with in the hospital. The OB who works in the hospital definitely wasn’t making me fearful, but there’s a certain form you have to fill out that says, “Hey, obviously if you’re successful with your TOLAC, that’s going to be the safest option for you. But if you’re not successful, that’s the least safe.” It’s easy to plant doubt, but after I saw him again, I asked my provider, “How often do you see it?” It was such a small amount and since he’s one of the VBAC go-tos, I felt very confident with him. It was really nice to have that fear taken away in that way. Meagan: Yeah. Yeah. Sarah: And then this is kind of interesting. Just for fun, I did message my old provider at my previous hospital just to see what she would say about my chances for VBAC. I actually messaged her before I was pregnant. I said, “Hey, I am kind of processing and struggling from my C-section. What do you think about my chance for VBAC?” It was just on a message. What she said was, “You did everything you could at that time to have her vaginally, but she just didn’t fit your pelvis for whatever reason. We think of fitting as a lock and key situation. Both pieces have to work together to open, so there’s no way to know if a future baby would ever fit your pelvis better than she did.” Then she kind of went on. I thought, “Nope.” I’m like, “Nope. I’m not taking that in.” Meagan: Yes. Sarah: It was interesting. Meagan: Thank you so much, but no thanks. Sarah: Exactly.Sarah: Exactly. I’m like, “I don’t think she didn’t fit my pelvis. That’s not a thing.” Meagan: But you know, it’s an easy thing for people to say or diagnose. It’s like, “Oh, well your baby was perfect. You were perfect, but the two together didn’t really match that time.” Sarah: Right. Meagan: That doesn’t necessarily mean that’s true. We just don’t know. Sarah: Again, we can’t go back in time and have me try something different. Meagan: Yes, yes. Sarah: But I think it’s interesting that she said that. Meagan: It is. Sarah: Again, I talked to my doctor. He’s like, “Oh yeah. Great. Let’s do it.” Meagan: Yeah. Sarah: He said, “You’ve got this.” So you know. Otherwise, I’m preparing. This is the funny thing too, again. At first, I didn’t have any intention of trying to go unmedicated. At first. I was like, “I definitely want to VBAC,” but I wasn’t trying to do that. I was just focused on the VBAC part. But once you hear enough birth stories, you know that if I do all of this preparation and I go as long as I can without this intervention, I’m going to have the best possible chance of a healthy vaginal birth. If it still ends in a C-section, it’s because that was what had to happen not because I didn’t know any better. Meagan: Right. Sarah: So that’s when I was like, “Yes, okay. It makes sense for me to try. I should just try to go unmedicated. I should just do it. Whatever happens, happens.” I still am keeping my go-with-the-flow but with a lot of preparation. It was kind of funny because when I would tell people that, “I’m trying to go unmedicated,” people will say the craziest things to you. Meagan: Right? “I could never.” Sarah: Yes, or “I know someone who did and it was the worst thing they ever chose to do. They said, ‘Never do that.’” It’s like, I know and I’ve heard many, many stories of people doing it and are very happy with the outcome. So definitely right before, I was 37 weeks. I was like, “I’m going to read Ina May’s Guide to Childbirth.” Everybody talks about it, but I just wanted to hone in and focus on those unmedicated birth stories and just say, “How did you guys do this? How was it successful?” That was really helpful. I really liked that book. That was really good. Meagan: Yeah. I really like it too. Sarah: Yeah. Otherwise in this pregnancy though, I physically felt really good. I got Braxton Hicks contractions which I didn’t have in my first pregnancy. That was definitely new. Meagan: Yes. Probably exciting. Sarah: It was exciting. I was like, “Okay, yeah. Every birth is different.” That was one of the Hypnobabies thing that stuck with me. Each baby is different. Your birth is going to be different. Don’t let that fear creep in on you. But at 33 weeks, I found out the baby was breech so that was scary. Meagan: Yeah. It throws you for a loop, right? Sarah: Yes. When I found out that he was breech, I immediately messaged my doula. She gave me Spinning Babies exercises to do every day. I was making sure I was sitting forward and all of that stuff. Then I went to see a chiropractor first and then she also gave me this massage therapist who was trained in breech balancing massage. I went to both of those and the baby was flipped at my next appointment at 35 weeks. Meagan: Yay. Sarah: So I was very happy. The coolest thing with the massage therapist—in our state, I’m pretty sure she is maybe the only one who does this breech balancing massage. She told me because I actually went to do a follow-up appointment. Even though he was already head down, I was like, “Let’s just go again to make sure.” She said that she was treating six other breech moms at that time and they had all flipped when I came back from my second appointment. Meagan: Oh my gosh. Sarah: Yeah. I’m always in the groups. I’m like, “If anyone is breech, try this specific breech balancing massage. Yeah.” It’s really interesting just listening to her talk about it because she is so knowledgeable about, “Hey, your baby is breech for a reason. You have these muscles that get tightened. Your pelvis is this bowl and if things are in the wrong position, the baby wants to be head down. If I can release all of these muscles and make more space in there, even if the massage might not on its own make your baby flip, but giving your baby that space, then your ECV is more successful if you do that. Meagan: Right. Sarah: I was very happy because I had done all of this work and hyped myself up. I wouldn’t want to have to schedule a C-section for this reason after all of that but if it happened, it happened. Meagan: Yeah. Sarah: So everything was going good then until my 39-week appointment. I had a high blood pressure reading so I was like, “Oh great.” But my doctor was not worried. He had me do an NST, labs, and monitor at home. I came back in a few days and everything was good. That was nice. Actually, the day that I went back for my follow-up for my high blood pressure was the day that I got my birth records. They had my birth records there for me. I had gone this whole time. I was almost 40 weeks and I was like, “I still really want to see.” Meagan: You had requested them? Sarah: Yeah, and it just took a really long time to get them. When I had that appointment, I was able to get my birth records earlier than I thought. I didn’t think I was even going to get them by the time I had the baby. I was able to read through them and kind of work through it. My doula was like, “Oh, do you want to call and talk about it?” I was like, “Yes.” It was kind of like a fear release for me because that night I went into labor. Meagan: Yeah. Did you find anything in there that you didn’t know before? Sarah: I mean, that one thing was that terbutaline. I didn’t know that. And then I was just curious about some of the dilation. Also, I saw on my records too that the surgeon who did my C-section put, “This patient is a candidate for a TOLAC.” Meagan: Oh yeah. Sarah: It was nice just to have that and to see that the surgeon who did my C-section would put that on my note like, “Yeah. They are a candidate.”Meagan: Yeah, it’s helpful. Sarah: Just working through it too was nice to see it in a timeline. So that night was the night I went into labor. At 2:00 AM, I woke up with my contractions. Right away, they were 3-7 minutes apart. I had the same situation three weeks before where I woke up and had contractions that were 3-7 minutes apart, but they fizzled out and didn’t come back. I only had that situation one time earlier. So I was like, “Oh, this could be another practice. This could be the real thing.” But they were stronger than the last time. That’s the biggest thing too. Even though they were so close together, I was handling them so well that I was like, “I think I’ll just wait this out,” which is interesting because if you’re a first-time mom, you’re like, “Hey, this is 4-1-1. I’m having them.” Meagan: You have to go! Sarah: And they’re long. A lot of them were long like at least a minute, but they just weren’t strong so I was like, “Okay, well I’ll wait.” Then my husband woke up at 4:00 AM. I was like, “Hey, I’m having these contractions.” His response was, “I’d better hurry up and go work. I’ve got some work to get done.” He’s like, “Oh no. I gotta go.” So then he went away to go work on stuff. Then by 6:00 AM, I was like, “Okay.” I had a couple really strong ones so I was like, “Oh.” Then I was also getting back labor so I was like, “All right. Time to text the doula.” I was like, “Hey, this is what’s going on.” She was like, “Well, your back pain might be because of the baby’s position, so try to do the Miles Circuit. Eat a good breakfast. Hydrate. I’m preparing you for possibly a long day.” I said, “Okay, sounds good.” I had my bagel with cream cheese. I got my Body Armor drinks out, but when I tried to do the Miles Circuit, it was so intense. I could not. The minute I laid down and I had a contraction in the Miles Circuit position, the laying down one, it was like, “Whoa, no.” Meagan: Not gonna happen. Sarah: I’m like, “I think this is time for me to start going into some prep mode here.” So I dimmed the lights in my room. I had my ball but I actually didn’t like bouncing on it so I never bounced on it. Meagan: Was it uncomfortable? Sarah: Yeah. For me, that seated position was uncomfortable. For me, I was in a forward-leaning position. I’d lean against the wall and sway or I’d have my husband come. I’d hug him and sway. I’m like, “This is working out okay.” The back labor was a different aspect that was like, “There’s got to be something I can do for this back labor.” I messaged her and she’s like, “Okay, well obviously have him try to do hip squeezes,” but he wasn’t really getting the job done with the hip squeezes. She recommended the shower to also help us see if it’s going to calm down or if it will keep going. I got in the shower and it was magic. The heat on the back was perfect. My favorite thing ever, but the hot water ran out after 15 minutes and I was so sad. Meagan: Oh shoot. Sarah: So the hot water ran out and I was like, “Oh man.” I got out of the shower and I was like, “Now we might just have to go to the hospital right now because I need hot water. I want to get in that tub.” That was my dream was getting in the tub. Meagan: Right. Sarah: So my doula checked in with me at this point and asked about the shower. I was like, “Yeah.” I think I was kind of in denial because I was like, “Oh, it’s medium intense,” but they were still happening. She was like, “Okay, well maybe you should start heading in as long as they are staying 3-4 minutes consistently for an hour. Go ahead and start heading in.” At this point, she also tells me that she is actually in another birth. Then she joined me with the backup doula so she was at another birth. I was like, “Oh bummer.” But my backup doula ended up being amazing as well. But you know, when you’re preparing with someone— Meagan: Can I just say right there that is a real thing? It’s usually if you have to have a backup doula, it usually works out so well. Right? Sarah: Yeah, it was so good. Meagan: But like you were saying as I was cutting you off, as you were preparing with someone else, it’s hard. Sarah: Yeah, it’s kind of a bummer because you know this person so well and you had worked with them, but it worked out perfectly fine too. I really like my backup doula. She’s great as well. She told me, again because I was like, “Hey, what can I do for now? We’re going to head in probably soon but what else can I do for this back pain?” She was like, “Do you have a heating pack?” I’m like, “Ooh, yes.” I was putting a hot pack on my back which again, wasn’t hot enough for me. Meagan: You needed a hot tub. Sarah: It did something. At this point, my daughter had actually woken up because we were still at home. It was about 8:00 and she was so sweet. Every time I’d have a contraction, I’d go into my room. I’d have my calming music on and my swaying but then I would leave and I’d come back out with her. She was just so sad. She wasn’t crying, but she had these big tears welling up in her eyes. I would hold her and she would pat my back. She was like, “It’s okay.” It’s like she knew that something was going on. I was like, “I’m okay. It’s okay.” She was just kind of like, “What is going on?” I wasn’t making loud, loud noises but I would be doing horse lips through them or moaning. Meagan: Coping. Sarah: Yeah, nothing too crazy, but for her, she could tell that something was going on. Luckily, my mother-in-law and sister-in-law came over shortly after that around 8:30ish. My sister-in-law took my daughter and was like, “Let’s go play,” so she was good. She was good. My mother-in-law saved me because she said, “Oh, I will boil hot water.” So she got a big pot and boiled hot water. She put cloths in them and put those on my back. That was amazing. Meagan: I bet that felt really good. Sarah: Right. So at this point, my husband probably should have been getting the cars ready for us to go to the hospital, but instead, he was cleaning the house frantically. Meagan: That was probably his way of coping. “Oh my gosh, this is happening. I’m going to go work and then I’m going to go clean the house.” Sarah: Yes. Yes, so we’re like, “Okay, it’s time. We’ve got to get going.” I’m like, “Yeah. I’ve got to get going.” So finally, we get in the car. My back is soaking wet from these hot towels but they are saving me. Luckily, the drive was only 10 minutes. I had my hot towel in there. It wasn’t the most comfortable, but we got there. They checked us in and they moved us to triage. At this point, again, the sitting position was not my position for labor. It was, “Nope, not happening.” I was always kneeling, facing the back of the bed. The back of the bed was up. I held onto it. Then when I was in triage, though, I didn’t have my coping mechanisms. I didn’t have my hot towels. My next plan that I had was the comb technique. I had packed a couple of combs. I was telling my husband, “All right. Your hip squeezes—” he was trying to find the combs and of course, he couldn’t find the combs that I brought. But he did remember that he brought his own comb. Meagan: Hey! Sarah: So I was able to take his comb which I can say RIP to his comb. I used it. There were little comb tings, whatever they are called, the teeth of the comb were everywhere at the end of my birth but it definitely worked. So then every time I would have a contraction, I was pushing on the comb and breathing as they were checking me into triage. But they were able to kind of get the band on me. They gave me an ultrasound to make sure the baby was head down while I was in triage. Then they checked me. The nurse checked me and when she was down there, she was like, “Oh, it’s really hard to tell how dilated you are because you have a bulging bag of waters and I really can’t tell what you’re doing.” She was like, “I think you’re almost complete.” I’m like, “Okay.” Meagan: Whoa. Sarah: I’m like, “Okay.” This whole time, she’d been trying to call someone on her radio, but they were really busy. At that point, she was like, “Okay, let’s get this room.” She was like, “I’ll just wheel you on this bed unless you want to walk.” I’m like, “Actually, I want to walk.” I was actually thinking, “You know what? I think I want the bed that is in the room. The triage beds aren’t probably as comfortable.” That’s where my mind was so I was like, “Let me just walk.” Meagan: No. Sarah: So they get me in the room and again, my doula is on her way but she’s not there yet. It’s about, I think, 10:00. My doctor comes in. They put the little IV on my arm in case I need any medicine. All I’m doing right now- Meagan: Hep lock. Sarah: Yes, exactly. All I’m saying is that I just wanted to get in the tub. This is me the whole time in triage. Meagan: I just want the water. Sarah: I want to get in the tub. I want to get in the tub. The comb is helping, but I want to get in the tub. So he comes in. I’m like, “Hey, can I get in the tub?” He’s like, “Well, you can but I should probably check you first if you want me to. If you’re really close like the nurse thinks, then you’ll have to push soon possibly.” I’m like, “Yes. Check me because then, if I’m not, I can get in the tub.” That was in the back of my mind. He checked me. He’s down there for a while and I’m finally like, “Okay, you’ve got to get out.” He’s like, “I understand why they are having a hard time. Yes. You have a big, bulging bag of waters. I can tell why she had a hard time and I think you’re maybe 7 or 8 centimeters but I can’t tell. As soon as the water breaks, you’re going to be fast.” I was like, “Sounds like I can get in the tub.” He was like, “Yes, you can.” Meagan: You’re like, “Perfect.” Sarah: Perfect. This is when my doula came around this time. She helped get the tub in motion because they were like, “Well, it’s going to take a while. We’ve got to get you on these mobile monitors.” She went in and she got the water going and I was able to get in the tub. The only problem is that once I got in the tub, I was like, “Oh, I think I have to poop,” which is the magic— Meagan: Means you’re going to have a baby! Sarah: She was like, “Well if you want, you can sit on the toilet and see if you actually do poop.” I was like, “Sounds like a plan.” I sat on the toilet facing the back of the toilet. I had my hands on my comb. My comb was with me everywhere. That’s when I had the scary, scary transition contraction. I was so happy I had her there because she was saying all of the right things and at this point, I can’t remember any of them except for her saying to me, “This is the hardest part, but it’s also the shortest. You are in transition.” When I heard her, I was like, “Okay, that makes sense.” I was a little shaky. You just feel so out of control. I was like, “Whoa. I don’t know about this. I’m not sure about this.” Meagan: You start questioning. It’s weird. Sarah: It is really, yeah. But she was saying all of the things I needed to hear, so I was good. So then I was like, “Okay, no poop is coming. Let’s get back in the tub.” So I got back in the tub, and then I had probably one contraction and then a lab person came to the door and was like, “I’ve got to take your blood.” We’re like, “Uh, okay. Let’s just wait until she’s in between contractions.” I’m like, “That’s a good idea.” So she comes in. She turns on the light. I’m like, “This is throwing off my vibe.” She sits down next to me and she scans my band and then they were like, “Okay, let’s wait for the next one.” The next contraction came and it was the, “My body is pushing! I’m pushing. Help!” I had that fetal ejection reflex, but my water was still intact so it was more of the water ejection reflex. Meagan: It was pushing that, yeah. Exactly. Sarah: My body did the thing where it pushed on its own. I’ve always heard about this when I’ve listened to the podcasts that this happens. I was always like, “Oh, I want that. That sounds nice. Do it for me,” but I did not like it. Nope. Especially because I was in the tub, maybe that’s why, but I just felt so out of control. I was like, “Whoa. I’m not controlling this pushing,” but I was also very excited because I knew that meant it was time. The lab person promptly left the bathroom and they never got my blood. I don’t know why they needed it, but they never got it. Meagan: I know. It’s so weird, “We need your blood right now.” It’s like, “Really? Why?” Sarah: Yeah. Especially when, “Oh, I’m in transition about to have a baby.” I think you’re okay. Meagan: Seriously. Sarah: I had that. So that happened and then my doula was like, “Well, do you think you want to get in the bed?” I’m like, “Yes. If a baby is coming, I need to be on the bed.” So again, my favorite position—even my tub position was my hands and knees. I was draping my hand on the back of the bed kind of in that—I wasn’t really hands and knees because I started that way and then I ended up hugging a pillow and kind of squatting back. Meagan: Yeah, okay. Sarah: Yeah. I started pushing. Again, my waters hadn’t broken yet which was obviously, this is a big thing with my provider. He is hands-off. Any other provider would have said, “Do you want me to break your water?” Meagan: Absolutely. Sarah: That would have been a thing. It was kind of interesting that “Nope. I’m just doing it all on my own what my body wants to do.” I was pushing for about 10 minutes and then my waters exploded. They all knew it was coming, so no one got drenched, but it was so loud. Meagan: Everyone was probably a little sensitive in that area. They were probably like, “I’ll walk over here.” Sarah: Yes. They expected it. My doctor was like, “I might get drenched, but I’m ready for it.” But he didn’t. Meagan: That’s okay. Sarah: It was so loud. I was shocked. It was like a gunshot. It felt like it was just like BAM when I pushed it out. So that was great. Then about 5 minutes after that, he was born. I pushed the waters out and then pushed him out. His head was right there and they were like, “Oh, you can reach down and feel the head.” I’m like, “I can’t.” I had to reach down. I’m like, “My arms are too short.” So then I pushed him out. It was about two pushes I think.Yes, as soon as that water was done, yeah. He was two pushes after that. It was about 20 minutes of pushing total. Meagan: Whoa. That’s like nothing. Sarah: Yeah, then I got to flip around. They put him on me and they didn’t cut the cord until it was done pulsing. They did delayed cord clamping. They did the golden hour. He was just on my chest the whole time. I birthed my placenta which was fine. I did have a small tear which was just something I was scared about with an unmedicated birth. I’m like, “Oh, that will be not pleasant. I hope I don’t but again, no idea. I probably will. Most people do.” It was a very small, I guess, second-degree tear but he numbed it. It just felt like a bunch of little bee stings. He numbed it and stitched it. It was fine. Baby was on my chest for that whole hour. What was crazy to me—I also consented to having the Pitocin drip afterward to get the— Meagan: The uterus to contract down, mhmm. Sarah: Yes, yes. I had that. Once that was done, I was able to just stand up and go to the bathroom. Meagan: Amazing, right? Sarah: I could just get up to go to the bathroom. I felt good. I felt fine. This was about 10:50 in the morning, so yeah. I was at the hospital for an hour and a half before he was born. Later that night around 5:00, we had family come over to see the baby that night. I felt as great as could be with still normal postpartum stuff. Meagan: Right. You did just push a baby out. But you weren’t knocked out and coming too and all of those other things. Sarah: Yes. So yeah. That’s about it for that.Meagan: Aw, yes. Well, congratulations. I’m sure that was a very different experience. I mean, I’m sure both babies were, right? We all cherish our babies’ births but to be more present in your baby’s birth, I’m sure definitely left an impact. Sarah: Yeah. Even my husband told me that for this time, he actually teared up and felt like it was just such a more of an emotional experience even for him which is completely understandable. It was actually really scary for him with the C-section he told me. They tell you, “Hey, we’re going to go put your wife out. We’re going to come back and get you and then you’re going to come and be part of it.” He’s sitting there waiting, waiting, waiting. They just kind of say, “Hey, you can’t go in anymore. We knocked her out. You have to wait here. It’s going to be a while.” Then he’s just like, “Oh, is she going to be okay?” It was a little scary for him too, that first one. This was a lot, obviously, more emotional and just a really cool experience for both of us. Meagan: Yeah. I’m sure it was very healing for both of you like you said. That couldn’t have been easy for him walking in and seeing you in that manner. I mean, the fact that he even brought it up. “It was weird when I walked in and you were laying there but then I’m over here doing skin-to-skin with this baby.” Sarah: Yep. Meagan: I’m sure it was so healing for both of you. Huge congrats. Sarah: Yeah, thank you. Oh, and one thing to mention with the doctor is that because I gave him all of my birth plan too, at no point in this hospital situation was I ever offered anything. They knew what my preferences were. They never said anything about any interventions at all. They never said, “Do you want us to break this water?” Everyone was on board. It was great. Meagan: Yeah. You really didn’t feel like you had to fight along the way. Sarah: Yeah. It was all supportive which is what I wanted. Meagan: Yeah, and what you deserved. Sarah: Yeah. It was really great to have that. Honestly, the thing I also really liked about pushing in that position where you are facing the back of the bed was that I didn’t see all of the people staring at me. It was nice because—and not that it would have mattered—but I’m kind of socially anxious in that situation so it was nice to just be focused on my husband’s hand holding me. I’ve got my comb. I’m breathing. I’m totally in it. I’m not looking around. With the C-section, that labor was like everyone was staring at you. You’re pushing and trying and nothing is happening. It was so nice to just be here in my world. I never even saw anyone. Meagan: Yeah. Sometimes you see people’s faces and they are not wanting to communicate with their mouths so they communicate with their faces. So when you are just staring at all of these people surrounding you, you find yourself, “What are they saying?” Sarah: Yeah, exactly. Meagan: You start questioning it. It pulls you out of that space. It sounds like you were really able to stay in that space because maybe you didn’t see any of that. Sarah: Yes, exactly. When I was pushing, it was really hard. I’m not saying it was easy. “Oh, unmedicated in 20 minutes.” No. It was hard work. There were times when some doubts would creep in and I was like, “What if he’s in the canal too long? Will he be okay?” It would be easy for those doubts to creep in, but my doctor and my doula were all saying the things that I needed to hear. “You’re doing it. Your body knows what to do. Keep pushing this way. Push like you’re going to poop.” They were saying all of the things to keep me focused. It would be so easy if you’re not ready to give birth to a baby, that feeling would be very scary. You would feel very out of control. I could see how easy it would be for that to be very, very scary. Having the people there that knew what to say to me was very helpful. Meagan: Yeah. Absolutely. The team is really that powerful though. It really, really is. Sarah: Mhmm. Meagan: So get a team. If you’re looking for a doula, we’ve got doulas on our website that are VBAC-trained and certified. Get a good provider who is supportive and loving and willing to just like Dr. Ryan, just yeah. “Let’s do this. Let’s do it.” Super supportive from the get-go. “Yeah, we have to have this consult, but I’m not not supporting you by sending you to this consult.” Sarah: Exactly. Yep. He’s like, “This person knows that I do a lot of VBACs. They’ve been through this before.” Meagan: Yes. Yes. Sarah: Yeah. Meagan: Well, huge, huge congrats.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